Coronavirus Update and Health System Preparations - 6/18

Testing and Confirmed Cases
To protect patient privacy, DCH has established a minimum threshold of five for reporting numbers of inpatients with laboratory-confirmed cases of COVID-19.

DCH internal counts as of 3:20 p.m. on 6/18/20:

• 56 inpatients are being treated for COVID-19.
• 16 inpatients who are positive for COVID-19 are being treated in the ICU.
• Six who are positive for COVID-19 are on ventilators.
• 986 (cumulative) unique positives for COVID-19 tests including results from the ED, triage tent and inpatient. These individuals are not necessarily in the hospital.
• 8,836 (cumulative) unique negatives for COVID-19 at DCH sites.
• 1,239 (cumulative) positive COVID-19 at DCH sites. These individuals are not necessarily in the hospital.
• 10,158 (cumulative) negative tests at DCH sites.
• 244 inpatients (cumulative) who were positive for COVID-19 have been discharged.
• 57 inpatients (cumulative) who were positive for COVID-19 have died at DCH. This is not an indication of the cause of death, only that the individuals were positive for COVID-19 at the time of death.
• 28 Tuscaloosa County residents (cumulative) who were positive for COVID-19 have died (per the Alabama Department of Public Health).

Also included is a chart showing the percent positive among those tested at DCH locations. This chart reflects totals by the end of each day (except today).

Unique Positives and Negatives
DCH is continually looking for ways to track the progression of this virus and provide meaningful resources so that our community can make informed decisions. One such metric is the percentage of positives from testing, but what does that mean?

A few weeks ago during Mayor Walt Maddox’s Town Hall, a few viewers asked about the testing and I (Andy North) responded. The questions were, in summary, do the DCH testing numbers reflect one result per individual or every test result? I indicated one test result per individual, but upon further investigation, I found out that response was inaccurate.

In the included chart labeled “Cases – Positive tests as a percentage of Total,” the green and dark blue lines have been shown for some time now; the light blue line is new. The green line represents the percentage of growth or decline in the COVID-19 test results at DCH. This is calculated by taking the cumulative total number of positive tests conducted at DCH locations and dividing that by the cumulative total of all DCH tests.

However, within those numbers are multiple positives and negatives for some individuals. This happens, for example, when a long-term care facility requires two negative tests before a patient will be accepted back from DCH. In that case, the individual would have the initial positive followed by at least two negatives. All of those results would be included in the total positives and negatives reported to date by DCH.

Today we are providing a new calculation (light blue line) showing only one or a “unique” result per individual. A unique positive is anyone who has tested positive at a DCH location but only the first test is included. Unique negatives would be anyone who tested negative (counted only once). If the person subsequently tests positive, then the positive would be added and the negative removed. The percentage of growth or decline is calculated by dividing the unique positives by the total unique positives and unique negatives combined.

The Alabama Department of Public Health shows cumulative confirmed cases, which they define as a laboratory confirmation of the virus (shown as “total positive” in our Alabama section of the testing results chart). The denominator for the state data appears to be defined as total cumulative tests conducted.

Every method of presenting data has pros and cons. But hopefully everything combined will be useful in making decisions that will keep you and your loved ones safe.