More information would help citizens assess risk of COVID-19

Sometimes it seems like the experts don’t even have all the data they need

As Americans are able to move toward the resumption of normal activities, the pace at which the transition happens will vary widely among individuals.

For some, it will be a gradual and cautious return to public places. For others, it will be full immersion after a longtime delay.

What would help all people make informed decisions about the risks of their behavior would be more information. It is difficult to draw conclusions from the currently available data.

Top medical researchers at the University of Iowa can’t even claim to have the key to predict what’s to come. The epidemiology group’s research published May 4 forecast a median outcome of 747 deaths by Thursday, May 28. In fact, Iowa’s death toll stood at 519 on Friday morning.

Their research was published shortly after the April 29 high point of 787 new cases in Iowa. Was that the peak? Hard to say. On Monday, May 25 — Memorial Day — the state had just 162 new cases. “This is the beginning of the end,” an optimist might have thought. Then on Tuesday, May 26, the state had 554 new cases. “This is the surge following the reopening of business,” another might think.

Whether you’re tracking deaths or positive cases, the numbers alone are not necessarily predictive of trends and telling in terms of risk assessment. When a county increases testing, beginning with long-term-care centers, a spike often follows.

But too often, we have no idea why spikes are occurring.

Last week, there were hundreds of new positive cases in Sioux, Wright and Buena Vista counties in Iowa. Yet there was no information forthcoming about an outbreak in any business or facility.

Even the state, it seems, doesn’t have all the information it wants. Iowa Department of Public Health officials talked last week about an outbreak among workers at the Tyson Foods plant in Storm Lake, where 555 of the plant’s 2,017 employees have tested positive so far. That prompted multiple questions about where other outbreaks might be, in light of some county spikes. But IDPH officials noted that businesses are not required to report outbreaks to the state — even when they involve more than 10% of employees. Some businesses have voluntarily reported outbreaks. But the state can’t necessarily confirm an outbreak on its own, given that workers can be tested through various outlets.

Locally, the Dubuque County Board of Health learned it has no power to compel the use of personal protective equipment or other requirements in long-term-care facilities, even if there is a known outbreak.

In Wisconsin, even less information about long-term-care centers is available, even when they are not privately owned.

Grant County, Wisconsin, has 94 confirmed cases and 12 deaths. This is a county with a population half the size of Dubuque County. A contributing factor is very likely the outbreak at Orchard Manor in Lancaster.

At least 27 cases of COVID-19 have been reported at the Grant County nursing home, but state health officials for weeks have declined to disclose whether additional cases have occurred at the facility as the county’s total cases climb. Nor have state officials confirmed whether any of the county deaths are linked to the Orchard Manor outbreak. The last update came on April 28, when it was reported that eight staff and 19 residents had COVID-19.

County officials also have refused to release updated case figures — and this is a county-owned facility.

Meanwhile, Grant County Health Department Director Jeff Kindrai recently said 70% of people in that county who had been diagnosed in the previous 14 days did not know where they could have contracted the virus, which suggests the county will experience more cases in the future.

Limited and sometimes spotty information leaves area residents to draw different conclusions about their risk of contracting COVID-19. Are a majority of cases in the state related to outbreaks at long-term-care facilities, meatpacking plants or other businesses? Or is community spread growing? Knowing that would help people assess risk.

It wouldn’t violate patient privacy to indicate a basic indication of transmission when it is known. Are these front-line workers? Are they people who have traveled by air? Are they folks who have been cautious about social distancing?

Or, as Kindrai noted, are these folks who have no idea how they might have gotten it?

Telling people to be smart and responsible doesn’t do much good when they can’t easily discern what’s cautious and what’s overcautious.

Elected officials and health experts should work toward providing people with as much information as possible. Without more context, it’s pretty easy for people to use pieces of information to support their preordained position about just how safe it is to move about our communities as we typically would.

-Dubuque Telegraph-Herald


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