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Tyree Daniels, with the Louisiana National Guard, administers a Covid-19 test on Wednesday, December 2, 2020, at the Lafayette Parish Health Unit on Willow Street.

The legislative auditor says Gov. John Bel Edwards may not be getting complete-enough information on COVID testing to accurately determine the positivity rates used to decide when masks need to be worn, what businesses can open when and visitation to nursing homes.

Numbers of positive tests and deaths are not being overreported on the Louisiana Department of Health online COVID dashboard, Auditor Daryl Purpera said Monday. But a substantial number of labs, whose results were tested in September-October, are not submitting how many tests are being taken and are turning in results late, which impacts the daily “positivity” rate calculations – how many positive tests among how many tests taken – upon which a number of state decisions are made as requested by the White House.

For instance, the governor’s order allows bars to stay open if the parish has a positivity rate of less than 5% for two weeks. But if the parish exceeds 5% for two weeks, they must shut down again.

Louisiana Department of Health Secretary Courtney Phillips agreed some providers didn’t provide complete information but added that many urgent care clinics don’t have the internet connectivity to report their findings immediately. Her staff excludes those results from their positivity calculations.

“LDH strongly believes that the positivity rate calculated is as reliable as possible. LDH would agree with a characterization of the data not being ‘complete,’ but surely not unreliable,” Phillips wrote in response to the audit’s findings. “In fact, LDH adheres to the highest data integrity standards and it is unlikely the small minority of test results not yet reported to LDH as required would substantively affect percent positivity calculations.”

As of October 1, 2020, the state Office of Public Health reported 2.3 million tests, 166,584 positive cases, and 5,329 deaths on its dashboard. Auditors looked at a selection of the tests results and found that 4.1% did not have a date of the test and 50.4% were not submitted, as required, within 24 hours.

“We found that it took laboratories more than five days to submit 19.4% of positive COVID-19 tests to the Office of Public Health once the test result was known,” the audit stated. “We identified COVID-19 tests that were billed to Medicaid but not included in the testing data, COVID-19 tests that were performed on a routine basis for organizations such as the National Football League but not included in the testing data, and laboratories that reported only positive test results or only negative test results.”

“I’m not saying we shouldn’t be doing all this,” Purpera said. “But my job is to ensure accuracy, so they need to get all the reliable and complete data.”

Of the roughly 600 labs conducting the tests, 294 reported only positive results and 64 others reported only negative results. Under the regulations, the labs are supposed to fill out 18 points of information, including race of the person tested, as well as the total number of tests conducted, including those that turn up negative, along with the positive results, Purpera said.

“As a result, the Office of Public Health cannot ensure that the data on the dashboard is complete. The lack of complete test data could affect the reliability of the positivity rate and the state’s ability to make informed decisions during the pandemic," Purpera said.

State health department officials said they do not have the staff to determine whether laboratories are reporting all COVID-19 test results. They also don’t have the legal authority to require the submission of those results. Instead, the health department relies on outreach and education of laboratories about the requirement to report all COVID-19 test results. But compliance is getting better.

The testing and reporting protocols were hastily put together in March at a size that had never been done before, Purpera said. Consequently, the National Association of State Auditors, which he heads, decided to conduct a national survey of how well the protocols were working. Louisiana is the first state to complete its analysis.

“We’re doing the same procedures across the board and hopefully are getting a cross section of the U.S. How well did we do this time? And can we do better next time?” Purpera said.


Email Mark Ballard at mballard@theadvocate.com.