Thread by @ohio_data

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🧵Because Ohio's COVID 'case' definition isn't expansive enough..

Along with yesterday's admission that cases were declining, Dr. Vanderhoff also announce a new adjustment to how we will count 'cases' going forward.

First of all, Ohio has one of the most expansive 'case' definitions (if not THE most expansive) of any state. We count all PCR positives, regardless of symptoms or contact like other states. But we also count 'probables' as full 'cases'.

Most other states separate these 'probables' from the confirmed by PCR cases. Not Ohio. They are full and equal 'cases' with symptomatic, low cycle threshold PCR positives.

So let's go over what constitutes a 'probable' again. Most probable cases are antigen positives, with or without symptoms or contact, which is in direct contradiction from the manufacturer's instructions, FDA warnings and CDC guidance.

But in Ohio, a positive test result on an inappropriately used (and admittedly, highly faulty [tinyurl.com/xw5skzzs])tests is enough to call you a 'case'.

Also, as outlined in the attached graphics, just the presence of extremely vague symptoms & mere existence as a student or LTC resident is enough to officially call someone a 'probable' case.

So what does that have to do with the new expanded definitions announced yesterday?

⭐️ The announcement was that in order to capture what might be 'reinfections,' anyone who tests positive or is otherwise identified as a 'case' >90 days after they tested positive/were identified as a 'case' previously will become a brand new case -

- with no indication that these are the same individuals who have tested positive before.

tinyurl.com/y2wdc7p7

And whether or not the person is infected or infectious at all.

Keep in mind that PCR tests, in particular, are exceptionally sensitive. And they cannot detect if there is live virus or not.

If you are someone who is naturally immune from a first infection, & you are exposed to SARS-CoV-2 in the air - you inhale it, it sticks in your mucus. Your immune system recognizes it & takes care of the problem quickly. You never become infected. You are never infectious.

But you can test positive on a PCR test depending on how high they feel like cycling your test.

Meanwhile, antigen tests are not so specific, and will be positive (or negative) for all sorts of reasons. But in the state of Ohio, all positives are created equal.

To understand what the full impact of this change in our accounting may be, I've attached a chart that shows the difference between the number of positive antigen tests reported (from the data at tinyurl.com/4h56bpnb) and the number of new probable cases assigned on that day.

If each positive test represented a new case, then the number plotted should be '0'. If there are more cases than positive tests, then the number will be negative, and if there are more positive tests than new 'cases', then the number will be positive.

It is not going to perfectly align due to variations on symptom onset, reported date vs assigned date, etc, but we can see that there has been a massive increase in positive antigen tests that have not translated into new 'cases'.

It could also be that more 'cases' are being appropriately confirmed with PCR tests than earlier in the pandemic (though I have heard no such indications, but maybe someone in the system can confirm if this is happening)

It could also be testing the same person who is positive over and over and over again in the near term. Or it can represent individuals who had previously been marked as a 'case' testing positive again, but who could not be counted separately in their system.

⭐️Now they can be counted again and again and again, every 3 months, with no one able to tease that information apart.

#Ohio
#COVID19
#InThisTogetherOhio