As Maryland touts declining coronavirus numbers as justification for its reopening pace, a Sun analysis performed this month by reporter Scott Dance and analytics director Kalani Gordon showed that the state has been significantly underreporting COVID-19 cases and deaths in nursing homes and elder care facilities — the front lines for the most serious disease complications.
Data released June 10 undercounted deaths by nearly 400 people and underreported infections by nearly 2,000 cases. Why? Because the supposedly cumulative and “total” numbers actually aren’t. Turns out the state wipes the slate clean for facilities once they haven’t reported any new cases or deaths for 14 days. Apparently, all those who came before no longer matter. We wonder what those folks might have to say about that — or their loved ones, for those who didn’t survive the illness.
An accurate and thorough picture of where the state stands today, and stood in the past, is critical in determining where we’ll go in the future — how far and how fast. Discrepancies in elder care reporting, involving the people most vulnerable to the disease, raise questions about the veracity of all other reporting. How are public health officials and individuals supposed to make informed decisions from incomplete information?
Though confirmed coronavirus cases in those age 60 and older make up only a quarter of the total in Maryland, they represent the majority of the deaths from COVID-19: 87%. And most of those are occurring in nursing homes and related facilities. The state’s data showed about half of the deaths occurring in such places, while the Sun analysis suggests it’s more like two thirds. Underreporting the figures minimizes the impact of coronavirus in Maryland.
It’s also insulting, coming as it does after families and media already had to go to battle to get any information released publicly about COVID-19 inside such care facilities. Heather Shek, assistant director of the state health department’s Office of Governmental Affairs, initially told Mr. Dance in April, via a letter denying a public information act request, that such “disclosure serves no public health purpose.”
Days after Mr. Dance wrote a story about the denial, Gov. Larry Hogan announced that the state would begin sharing facility data online. “Keeping Marylanders informed and being transparent with the facts continues to be at the heart of our response to COVID-19,” the governor said in a statement.
That’s some good talk. But the walk? The underreporting suggests there’s not as much to it — until someone calls out the discrepancy.
On June 17, the state released new numbers, and it appears they’ve made some changes following the Sun analysis; the figures are more in line with those the paper compiles. But they’re also not complete. Frederick Health and Rehabilitation Center, for example, is reporting just nine total cases among staff and residents, and zero deaths. Yet back in April, when the state first released its nursing home data (nearly two months after the governor declared a state of emergency), Frederick Health reported 46 cases and 13 deaths from COVID-19 — and that was six weeks ago. Either a miracle occurred since then, or those numbers aren’t total.
Some of the discrepancy can be chalked up to sloppy record keeping and imperfect self-reporting from the facilities. Ms. Gordon and Mr. Dance’s analysis found multiple instances of facilities falling off the list one week (because they had no new cases within 14 days) and reappearing another, and small changes to listed facility names that could lead to an inconsistent count. A disclaimer on the website notes that “Data are based on facility reports to MDH, which may be revised if additional information becomes available.”
But that’s certainly not an explanation to be comfortable with, any more than a lack of transparency is.
The most recent numbers announced by the state show that nursing home cases fell by 14% in seven days, from 6,400 cases in the week ending June 10, to 5,500 cases as of June 17. That should be news that we all celebrate, especially knowing that testing capacity is increasing. But instead, we’re left with an uneasy feeling: Can the data be trusted?
The Baltimore Sun editorial board — made up of Opinion Editor Tricia Bishop, Deputy Editor Andrea K. McDaniels and writer Peter Jensen — offers opinions and analysis on news and issues relevant to readers. It is separate from the newsroom.