COVID-19 Q&A: What do those outstanding positive lab results mean for the daily totals?

February 15, 2022
Dr. Kathryn Turner, deputy state epidemiologist, Division of Public Health

As of Feb. 14, there are at least 32,100 outstanding positive lab reports that have not been reviewed by the local public health districts. Many of those lab records will result in new cases of COVID-19 being added to the dashboard. However, some reports are additional test results for a person already counted as a case and some might be for people who do not live in Idaho. Daily new case counts will be updated as those outstanding positive lab reports and recently received lab reports are processed.

Why are there so many outstanding positive lab results?

There are outstanding lab results because of the sheer number of people in Idaho who were testing positive for COVID-19. Lab records must be reviewed by the local public health districts before they can tell if the result represents a new Idaho case and in what Idaho county that case should be assigned.    

Which local public health districts are behind in reviewing the lab results from their counties?

During the week of January 16, more than 38,000 positive lab reports were sent to public health districts in Idaho. During that week, there were periods of time when more than 1,000 lab reports were being sent in a single hour. During the peak, public health districts were receiving the same number of lab reports in a single hour that they had been receiving in a whole day before the Omicron variant surge.

Each public health district has its own way of reviewing lab tests and following up on them. The Department of Health and Welfare is providing technical assistance to some of the public health districts at their request to help them catch up. Here’s a chart showing the number of outstanding positive electronic lab results in each public health district, as of 3 p.m., Monday, February 14.

Idaho

PHD1

PHD2

PHD3

PHD4

PHD5

PHD6

PHD7

32,049

2,135

0

4,750

18,697

6,467

0

0

Percent of Total

6.6%

0%

14.8%

58.3%

20.2%

01%

0%

 

Do the outstanding results represent cases?

It’s important to note that one positive lab result may not represent one case. Some results might not be for people who live in Idaho, but were tested here. About 5 percent of lab results are for people with two results within one to three days of each other. A person might have an antigen test in the doctor’s office and then have a follow-up PCR test to confirm the result. Some people might have two PCR test results a couple of days apart. This may be because a person needs a test result quickly for travel or attending events and wants to be sure their result arrives in time. It could also be because they took a second test because they are hoping the result of the first test they took is wrong.

And finally, a positive result doesn’t count as a new case if that person has had a positive result less than 90 days ago because they can still test positive for the virus even after they are no longer sick.

That’s why the review by the public health district is so important.

How are the outstanding results being incorporated into the data on the COVID-19 Data Dashboard?

COVID-19 cases  are counted in the new daily totals when they are reported to the state. That means some new daily cases counts will be higher than they would have been if the case had been counted when the positive lab result was received.

However, daily new case counts are only a “snapshot” of the moment when the data are prepared for the state dashboard update published at 5 p.m. each day. There will always be a time delay between when a lab report is received and when a new case is counted  because lab reports are received 24 hours a day. For instance, if a lab report is received at 4 p.m. on a Thursday, it might not be counted as a case on the dashboard until Monday. This was true even before the Omicron variant surge because most public health districts don’t operate overnight and on weekends.

The positive lab results are counted in the percent positivity rates that are available on the Laboratory Testing tab of the dashboard. And even though some public health districts have a large number of positive lab reports to process from the peak in mid-to late January, they have been keeping up with new lab reports for the last two weeks; current case rates on the Weekly Hotspots and Local Trends tab of the dashboard are accurate.  

Dr. Kathryn Turner is the deputy state epidemiologist in the Division of Public Health in the Department of Health and Welfare. She has worked for the department for 17 years and oversees the Epidemiology, Immunization, Food Protection, Communicable Disease Surveillance, and Refugee Health Screening programs for the division, but has been focused almost entirely on Idaho’s pandemic response since February 2020.

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