California undercounting COVID-19 cases due to ‘serious’ technical issue, counties say

Health officials in multiple California counties say the electronic system used by most local health departments statewide to report data on infectious diseases is currently experiencing “serious” technical issues, resulting in coronavirus cases being significantly undercounted.

The California Department of Public Health confirmed the undercounting in a Tuesday morning update to its data dashboard, after individual counties including in the Sacramento area and Southern California reported earlier in the week that they’d been made aware of the problem.

“Due to issues with the state’s electronic laboratory reporting system, these data represent an underreporting of actual positive cases in one single-day,” the note attached to the CDPH graph on daily lab-confirmed case increases reads.

The glitch comes at a critical moment for California. Faced with a surge of new COVID-19 cases statewide in June and July, Gov. Gavin Newsom last month rolled back some of the state’s earlier business reopenings, and also began requiring people to wear masks in public places. Lacking up-to-date data on new cases, however, it may be harder to get a precise snapshot of how well those orders working.

Monday’s statewide data update saw just 5,739 new cases reported and Tuesday’s was even lower at just over 4,500 new cases. Those numbers would represent the two lowest single-day increases since July 5, as well as a relatively abrupt turnaround for numbers that had been spiking steadily since mid-June. California has surpassed 519,000 total lab-confirmed cases, even with the undercount. The state also reported 113 new fatalities Tuesday, bringing the state’s all-time COVID-19 death toll to 9,501.

The state did not say how many days have been affected by this issue nor did it estimate the scale of the undercounting. But individual county health officials have suggested the underreporting has noticeably affected the accuracy of their own available data in recent days.

The electronic system in question is called CalREDIE, and it is used by nearly all of California’s local health offices to track disease data and transmit it between those local offices, laboratories, health providers and the state, according to the CDPH website.

“We’ve discovered some discrepancies,” state Health and Human Services Secretary Dr. Mark Ghaly said of the data problems during a Tuesday COVID-19 update, streamed as a Zoom teleconference. “We’re working hard and immediately to reach out to the labs that we work with to get accurate information ... so we can feed that to our local county partners, that we can validate and make sure our numbers are accurate.”

Ghaly attributed the glitches to the high volume of COVID-19 case data “testing the capacity” of the state’s data collection system. He said he didn’t know when the problem would be fixed, but that in the meantime the state is working with individual labs to enter accurate data manually.

Sacramento and Placer counties added disclaimers to their COVID-19 data dashboards, with Placer doing so Monday and Sacramento adding the warning Tuesday morning, amid a few days of reporting comparatively low numbers for new cases.

Placer’s warning statement atop its data dashboard advises: “Please note that CalREDIE, the statewide electronic disease reporting system, is experiencing serious unresolved processing delays.

“As such, new cases presented here are likely an underestimate of true incident cases being reported. This impacts many of our statistics, including case rates and percent increase estimates.”

Sacramento County health officials wrote: “The state’s electronic disease reporting system has been experiencing issues processing incoming reports. Therefore, recent data published on the Sacramento County Public Health COVID-19 dashboards are likely to be an underestimate of true cases in the county.”

The disclaimers came after both counties had reported significantly fewer new case totals in recent days than they did throughout most of last month. Placer reported 13 new cases each of Sunday and Monday, and Sacramento County increased its tally by a little more than 50 each of Sunday, Monday and Tuesday. For each county, daily new case counts had routinely been triple those figures or more for much of July.

Although the technical problems are affecting daily data, Ghaly said Tuesday the state primarily relies on longer term statistics, particularly 7-day and 14-day averages, to assess the state’s progress on battling the virus. Those statistics are somewhat affected by the delays, too, Ghaly said, but still give a more accurate picture of the disease’s progression.

Daily variations in data, such as regular slowdowns in reporting over the weekend, have been a factor since the beginning of the pandemic, Ghaly said, which is why the state relies on the longer-term statistics.

Gov. Gavin Newsom said Monday that recent declines in cases show the state has been “able to get a handle” on the pandemic via social distancing and business closures his administration re-implemented last month. Newsom based his optimism in part on the 7-day and 14-day case averages, but also on declining hospitalization and ICU rates, which are not affected by the data glitch, Ghaly said.

“We feel confident that (California numbers) are beginning to stabilize, as the governor mentioned yesterday,” he said.

Sacramento County health chief Dr. Peter Beilenson told The Bee on Tuesday that the state says it will try to send more accurate data to the county in a spreadsheet format, and that CDPH provided no time frame for the CalREDIE problem being fixed. Placer spokesman Chris Gray-Garcia said in practice, the county has been reporting fewer cases each day since last Friday, but officials have no sense of how severely they’re underreporting cases.

The state hasn’t told the county when it’ll resolve the situation, but when it does, Placer County could see an inflated surge as a backlog of old cases from tests conducted in the last few days and weeks are finally reported, Gray-Garcia said.

Health officials in Orange and Riverside counties also recently reported running into issues with the state database, which Riverside public health director Kim Saruwatari said Monday in a prepared statement was creating “a significant lag in how the information is being fed into the system.”

Because of this, Saruwatari said she’s “anticipating significant increase in case reporting (later) this week.”

Riverside’s statement says CDPH informed the county of the issue late last week via email, and confirmed to the local health office Monday that it had “urgently escalated this issue to leadership.”

The CalREDIE reporting issue does not appear to be affecting data on hospitalizations or death figures at the state or county levels.

“(T)he scale and scope of data being collected in response to COVID-19 is unprecedented,” Folmar wrote. “This has required the state to expand the capacity and capabilities of our systems.”

Folmar also confirmed hospitalization and ICU admissions are “collected through a separate system, not CalREDIE.”

The Bee’s Alexandra Yoon-Hendricks contributed to this story.