I was having a conversation last night with a woman whose daughter works in healthcare in Brazos County in Texas. Here is the situation we were discussing. A person tests positive for COVID-19. They then get a repeat test every x number of days until the test is negative. My friend was under the impression that multiple positive tests for the same person were lumped into the same category and reported as a new positive cases as well as a new positive test.

My questions:

1. If a person has a positive test the first time, they are recorded a a positive new case as well as a positive test, Is this correct?

2. When a person has subsequent testing with positive tests, are they counted again as a positive new case as well as a positive test?

I am hoping that there is a way to differentiate, but I have not seen a standard across states/counties/etc. My concern would be inflated numbers if multiple people with multiple positive tests are being reported as new cases.

Any insight is appreciated.

I think he was asking about "new" with regards to reporting statistics and not in a clinical sense.

For example: When the testing facility reports the numbers to the next level up is it detailed enough to say "we tested 5000 people, 200 tested positive, of those 200, 50 were existing infections and 150 were new infections.

Wrong thread

Yes, I was referring to reporting for statistical and informational purposes not clinical definition. Thanks for that clarification.

Can't comment on reporting, but it would make sense to not report these people as new.

Anyone know who does the reporting?

Given the county health department are collecting the information, is it coming from the dr/hospital that ordered the test?

Some counties have labs and could get the info directly from the lab. Other counties don't have a lab and send off to a private lab.

I guess the real question is are the positive tests reported along with patient information (needed for contact tracing anyway). If so, it would be possible to filter out all the repeat tests.

seems that florida was doing this.

https://www.clickorlando.com/news/local/2020/04/28/testing-numbers-from-floridas-covid-19-dashboard-may-not-show-complete-picture/

Quote:

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"If Lab Corp sends in 5,000 test results, Lab Corp does not distinguish between someone who has never had a test or someone who tested positive and then tested negative twice. It's just not the way it's done," DeSantis said.

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Accurate test reporting would be a fantasic leading indicator and would provide valuable information about how exposed certain areas are, how effective mitigation strategies are at reducing/slowing spread ultimately saving more lives and speeding the economic recovery.

But since we arent testing broadly enough and certainly arent reporting the data consistently, the numbers being reported are probably doing more harm than good, because they are being driven by state and local politics instead of the other way around.

Marcus Aurelius said:

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This phenomenon is well described. After the clinical symptoms have waned, the illness is passed, yet the nasal swab RT-PCR is repeatedly positive. It is thought to be inactive viral RNA and not considered a new infection.

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Correct, we're seeing immunocompromised patients still testing positive 7-8 weeks after initial diagnosis sometimes.

They are not still contagious and it is not clinically significant.

So once you are positive, but then are symptom free it does no good to get retested because it will probably still say positive?

Big Al 1992 said:

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So once you are positive, but then are symptom free it does no good to get retested because it will probably still say positive?

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It may stay positive for a while. We aren't relying on negative tests to determine when to take people off of precautions. It's based on symptoms and time since diagnosis/symptom onset.

It's a struggle with nursing and providers outside those fields regularly treating these patients, because they get very nervous around people without documented negative tests. I get called about this issue at least 10 times a day when on service.

Federale01 said:

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Can't we move away from caring about the case numbers and keeping our eyes on other metrics like hospitalizations, etc? With the unreliability of test, lack of testing, reporting lags, etc, the overall number of cases is a bit of a pointless metric at this point as it in no way reflects reality. It can be an indicator it seems, but I question whether it is something to base policy on.

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It really doesn't matter what people on a message board are focusing on. Decision makers and professionals are focusing on hospitalizations and deaths. We know that a lot of people will test positive.

Is the "timing criteria" you all are using still 3 days symptom free and at least 7 days from onset of symptoms?
Are you retesting at all or just using the timing criteria? I would be more interested in the outpatient recommendation compared to those requiring hospitalization. (although that may not matter). Thanks for your advice.