PDPHE using alternative data sources to improve COVID-19 reporting after test site closure

The Pueblo Department of Public Health and Environment is observing alternative data sources to monitor COVID-19 in the community after closing a community testing site last month.

The site, located at the Pueblo Mall, closed Dec. 30 due to a decreased demand for on-site testing. The site administered thousands of tests, including 3,821 over a nearly three-month stretch during the fall.

During a Dec. 28 meeting of the Pueblo Board of Health, PDPHE Public Health Director Randy Evetts said the site’s pending closure two days later would result in fewer tests being reported to PDPHE, thus producing a less accurate picture of Pueblo County’s positivity rate and case numbers in the weeks ahead.

When asked what the department is doing to return to a level of accuracy it had for some of its earlier COVID-19 reporting, Evetts said in an email that PDHPE “continues to monitor other data sources, which tell us what is happening in our community.”

One of those data sources includes wastewater testing, which is done weekly and measures the extent of COVID-19 in that water sample in each basin. The data is a front-end indicator that informs the department whether disease is increasing or decreasing in Pueblo, Evetts said. The virus can appear in stool before someone shows symptoms.

Local health departments can use that information to increase resource capacity, identify COVID-19 variants of concern or re-evaluate public health policy if cases increase, according to the state health department website.

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That data has become a strong reference point to monitor the extent of COVID-19 spread in Pueblo, said Sara Joseph, public information officer for PDPHE. The county’s positivity rate, which is often used by health departments to determine the spread of COVID-19 in a community, has become a less effective data point since there is less PCR-based testing, she said.

“If everybody who was doing at-home COVID-19 testing was reporting it to public health, we would have a better representation of how many cases we have in our community,” Joseph said. “(But not everybody is), so that’s why we’re looking at wastewater. If COVID-19 is being picked up (at high levels) in the wastewater, that means in the next two to three days, a lot of people are going to be symptomatic or they’re starting to show symptoms now.”

The amount of COVID-19 cases in Pueblo that are detected using wastewater data has declined over the past month. PDPHE detected 88,853 wastewater virus particles for the week ending Jan. 15 and reported 55 confirmed cases of COVID-19. It detected 320,174 particles on Dec. 25 and reported 148 cases.

Wastewater data is the first data source Puebloans see when they look at the department’s COVID-19 dashboard, which also shows data on the county’s positivity rate, which, despite its reduced effectiveness, remains a data point that can help determine the spread of COVID-19 in a community.

“Testing has declined, so we’re not getting the full picture we used to get,” Joseph said. “It’s still giving us a picture, but not a good or detailed picture that wastewater data or hospitalizations give us.”

The department also continues to monitor COVDID-19 hospitalizations, Evetts said, which inform them of the severity of current COVID-19 variants and how each age group is impacted. Those types of hospitalizations at Parkview Medical Center have declined this month and averaged four per day during the week ending Jan. 15, according to county-level data. The data also showed that Parkview experienced double-digit daily hospitalizations for all of November and most of December.

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Hospital capacity is another factor the department considers when deciding which steps it should take next, Evetts said.

PDPHE’s monitoring of other data sources comes as a new Omicron variant — XBB.1.5 — accounted for nearly half of confirmed U.S. COVID-19 cases between Jan. 15 and Jan. 21, according to data estimates from the Centers for Disease Control and Prevention.

The XBB.1.5 variant is spreading quickly, as it accounted for 26.5% of cases in the U.S. the week ending Jan. 7, but it isn’t believed to carry a mutation that would make people's symptoms more severe, according to the World Health Organization, which recently released a risk assessment report on the strain with the data it had at that time.

WHO did assess, however, that “XBB variants are the most antibody-resistant variants to date.” Dr. Ashish Jha, the White House’s COVID-19 response coordinator, wrote in a Twitter thread that people who had a COVID-19 infection before July or received a vaccine update before September will “likely have very little protection against a XBB.1.5 infection.”

The variant hasn’t dominantly circulated in Colorado. In Region 8, which includes Colorado, Utah, Wyoming, Montana and South and North Dakota, XBB.1.5 accounted for 18.8% of cases between Jan. 15 and Jan. 21, according to the CDC — that was an increase from the 7.1% of cases it recorded in that region for the week ending Jan. 7.

“The current virus strains have been more transmissible but less severe overall in terms of their impact on individuals. So a large number of cases is not cause for great concern,” Evetts said.

PDPHE’s latest COVID-19 reporting showed that its seven-day positivity rate had declined since mid-November when it was 18%. That decline matched statewide trends, and as of Jan. 23, Pueblo’s positivity rate was 4%, a drop from about 7% recorded in December and 6% in early January.

The state’s seven-day positivity rate, as of Jan. 18, was 7.4%, a 0.5% decrease from the week before.

Pueblo’s transmission level as of Jan. 18 was “substantial,” according to the CDC, with a case rate of 62 per 100,000 people. More than two-thirds of counties around the state at the time had a similar or higher level of transmission.

Pueblo’s move to a “substantial” level of transmission is a drop from the “high” transmission the CDC recorded for the county in December.

As of Jan. 19, no counties in Colorado were considered high-risk, according to the CDC. Puebloans can order free at-home COVID-19 tests by visiting covid.gov/tests. Each U.S. household is eligible to receive four free tests.

Chieftain reporter Josue Perez can be reached at JHPerez@gannett.com. Follow him on Twitter @josuepwrites.

This article originally appeared on The Pueblo Chieftain: PDPHE using alternative data sources to improve COVID-19 reporting