At Least 22 States Count ‘Probable’ COVID Cases or Deaths in Totals

Nasal swab test kits and medical gloves are seen at a mobile COVID-19 testing station in a public school parking area in Compton, Calif., on April 28, 2020. (Robyn Beck/AFP via Getty Images)

At least 22 states count in their COVID-19 statistics cases or deaths that haven’t been confirmed with a diagnostic test. These “probable” cases are determined based on symptoms and other general characteristics.

While useful to track for epidemiologists, such cases add noise to the national data as some states report them and some don’t. Also, different states began reporting such cases at different times, making data comparisons with earlier periods difficult.

COVID-19 is caused by a novel coronavirus that emerged in China in 2019 and has since spread around the world. The United States has seen more than 3.8 million cases and more than 140,000 related deaths, according to the Centers for Disease Control and Prevention (CDC).

The problem is that different states report statistics on the epidemic differently.

Some states, such as Arizona, Ohio, Michigan, and Virginia, include probable cases and deaths in their totals.

The nonprofit Council of State and Territorial Epidemiologists (CSTE) instructed health officials in April (pdf) to define probable cases in people with at least some symptoms (such as a headache and a sore throat) who belong to “a risk cohort,” or have had contact with people who’ve tested positive, such as by residing “in an area with sustained, ongoing community transmission.”

Probable deaths are usually defined as someone dying at least partly due to an illness that looked like COVID-19, but wasn’t confirmed by a laboratory test (which can be conducted postmortem).

Some states, such as Arkansas, New Jersey, and Washington, only include probable deaths, but not probable infections.

Some states, it appears, only include probable infections, but not deaths. Maine and Kansas may be in this category, their COVID websites indicate. The Epoch Times contacted all 50 states and the District of Columbia, but only 33 responded to the inquiries. Maine and Kansas were among those that didn’t immediately respond.

Then there are at least 12 states, including Alabama, Illinois, Massachusetts, Minnesota, and South Carolina, that report probable cases or deaths or both, but list them separately. In these cases, the CDC still includes the probable cases and deaths in the totals for those states.

At least eight states, including Alaska, Georgia, Missouri, North Carolina, Nevada, and Oklahoma, report neither probable cases nor deaths.

There are also special cases. Florida, for example, says in its COVID reports that it counts people who tested positive for COVID antibodies among its case total. That introduces another problem, because people normally retain coronavirus antibodies for months, so the tests may reveal weeks- or months-old infections that have little to do with the current state of the epidemic. Antibody tests are also usually less reliable.

At least some states count fatalities of persons who’ve tested positive toward COVID deaths, even though the people may have died of other causes.

Washington state has counted all deaths of people who tested positive for COVID. Since June, it has vowed “to work on changes to provide more context to death reporting and report death counts that reflect deaths where COVID-19 caused or contributed to the death,” states its COVID web page. As such, it has removed 65 deaths. Of those, 56 were “natural deaths unrelated to COVID-19” and the rest were suicides, homicides, and accidents, according to the Washington State Department of Health’s July 14 report (pdf).

The Colorado health department reports on its website both “Deaths Among Cases” as well as “Deaths Due to COVID-19.” But the CDC only uses the higher “Deaths Among Cases” figure.

Connecticut and North Dakota count COVID deaths in a similar fashion.

None of the four most populous states (California, Texas, Florida, and New York) immediately responded to The Epoch Times’ inquiries.