In Reopened States, Numbers Are Everywhere. Clarity Is Absent

(Bloomberg) -- It’s been at least two weeks since many states started lifting stay-at-home orders. Movie theaters in Texas, gyms in Tennessee and restaurants in South Carolina all have been open for business.

Many feared that states would pay a steep price for dismissing the coronavirus pandemic, but governors, encouraged by President Donald Trump, said they couldn’t wait any longer.

The data haven’t taken a side -- yet.

It’s still too early to tell whether early-moving states are seeing a spike in Covid-19 cases, said Jennifer Nuzzo, a professor of epidemiology at Johns Hopkins University.

“Two weeks is the full incubation period, so someone who is exposed today may not become sick for two weeks,” she said, adding that identifying a hot spot using death counts can take even longer. “Deaths take three or four weeks to show up.”

Revving Up

The early signs appear mixed. South Carolina, for example, reported an average of about 154 new confirmed Covid-19 cases per day in the two weeks leading up to easing restrictions. In the two weeks since, the daily average is up only slightly, to 168.

In Georgia, where Governor Brian Kemp directed the country’s most aggressive reopening plans by starting April 24, many businesses -- especially restaurants in the metro Atlanta area -- began opening for dine-in service only this past week, making it too soon to measure the effects.

In Tennessee, which began easing restrictions three weeks ago on April 27, the average number of daily cases has increased by 25% over the two weeks prior to reopening. But the state’s positivity rate, the percentage of administered tests that come back positive, is down to 3.8% from about 5% three weeks earlier, according to the Johns Hopkins Testing Hub.

South Carolina, Georgia, and Texas -- all early to ease restrictions -- have also seen decreased positivity, a key metric in identifying a hot spot.

Challenges remain, thanks to varying state testing practices and the reliability of their numbers. Data since May 1 on Tennessee’s department of public health website includes a footnote: “Illness that began during this time may not yet be reported.”

Data Gaffes

Georgia has been criticized for putting out confusing data suggesting new Covid-19 cases fell faster than they actually did. The same week Georgia reopened, its health department changed the way it counted cases, attributing newly confirmed ones to the date symptoms appeared, instead of on the date they were discovered. The effect was to show a flatter curve.

The state fixed and apologized for a second overly rosy graphic on the health department website last week. That one scrambled dates and other information in a way that implied new cases had fallen every day for the previous two weeks in the five most infected Georgia counties. Governor Brian Kemp’s office said the intent was to show peak dates more clearly.

“Our mission failed,” spokeswoman Candice Broce wrote in a tweet. “We apologize. It is fixed.”

Not all states are testing consistently, or expansively, said Nuzzo of Johns Hopkins. Nor does the number of tests always equate to the number of people tested because some people get multiple tests.

“A state may be testing, but they may not be testing in all places,” she said. “We know some of the states, their testing has been clustered in certain parts of the state and they’ve left other parts of the state with a bit of wanting for access.”

Nuzzo is paying particularly close attention to Texas, the nation’s second-most-populous state, which completed just over 27,000 tests per day in the past week. California, the nation’s biggest, is completing 40,000 tests per day, Governor Gavin Newsom said on Monday, adding that the state administered 57,000 tests in a 24-hour period over the weekend.

“The threat has not changed,” Nuzzo said. “The numbers have come down a bit in some places and we’re just going back to mixing, which will absolutely increase the case numbers unless we do something else.”

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