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DC Health finally published COVID-19 outbreak data. Councilmembers and reporters had been asking to see this information for some time. One reporter even submitted a Freedom of Information Act request. Last week, DC Health Director Dr. LaQuandra Nesbitt suggested her agency wouldn’t share the data because it could be misconstrued by the public. Now that the outbreak data is published, what does it tell us?
An outbreak is defined as two or more cases reported at a specific location, such as a school or church, within a 14-day period. DC Health, however, hedges that an outbreak doesn’t mean investigators determined a definite link. The location is not necessarily the source of transmission.
The data published on Monday, which tracks outbreaks between Aug. 1 and Nov. 26, identifies colleges and universities, K-12 school buildings, childcare centers, restaurants and bars, and food retail buildings as the top locations where outbreaks occurred:
Jennifer Bianca Browning, an analyst in the Office of the DC Auditor, is pleased that DC Health published the outbreak data, alongside exposure data. (Exposure data lists the top activities people participated in two weeks before testing positive.) Her office recommended that DC Health publish this data. “I think when it is not reported, it can lead to distrust or suspicion, so I think it’s a really good first step to have this out,” says Browning. “And now that lets people ask more questions.”
Looking at the available data in D.C., it is hard to know the scale of each outbreak. Louisiana, for example, publishes how many cases are associated with each outbreak. For example, in that state, 10 outbreaks at casinos are tied to 238 cases, and 34 outbreaks at child day care centers account for 122 cases. Louisiana also reports outbreaks by school. The DC Auditor recommends reporting new cases, not just outbreaks, at the school and childcare center level.
It is also unclear what percentage of the District’s total cases are outbreak-related. “When many cases are originating from unknown sources, the risk in the community is much higher than when known outbreaks are the primary source of new cases,” explains Resolve to Save Lives, an initiative run by former Centers for Disease Control and Prevention Director Tom Frieden, in a recent report. This is why the DC Auditor recommended that DC Health stratify new cases and the daily case rate by outbreak and community spread.
“Granular data is more actionable,” D.C. Auditor Kathleen Patterson told City Paper, echoing her favorite quote from the Resolve to Save Lives report.
The locations identified in the outbreak data, as well as the activities identified in the exposure data, do not always appear to be a factor in the new coronavirus restrictions announced in recent weeks. On Monday, Mayor Muriel Bowser announced her administration was prohibiting high-contact sports, but the activity is rarely reported in exposure data. Gyms also do not appear to be listed in outbreak data, but Bowser just restricted all indoor group exercise classes, too.
Browning says it makes sense that D.C. is not just using the data to inform restrictions. Food retail buildings and childcare centers are among the top locations listed in outbreak data, but people have to go grocery shopping, and essential employees going to work have to drop their kids off somewhere, she says. (Nesbitt has said that DC Health is considering a number of things when making recommendations.)
It appears some are using the data to justify or critique the city’s coronavirus restrictions. “It is past time for DC to move back to Phase 1,” tweeted Ward 4 Councilmember-elect Janeese Lewis George. “It’s also clear with the new data that we need to wait to open schools only when it’s safe.”
Some wish DC Health would have provided more context when releasing the data. “Our primary fear is that it misleads the public and it will create fear among parents and the general public,” says Kimberly Perry, executive director at DC Action for Children. (She has advocated for childcare centers hit hard by the pandemic.) “We believe it can be misleading because it is not reporting the source. It’s reporting where the case was reported.”
“What we would like to see is a fuller explanation of the data,” Perry adds.
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