Delaware

1. On Delaware's dashboard, a note indicates that Delaware is still using the April 5, 2020 (link: https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020/) CSTE case definition for probable cases. Is this correct? If so, why hasn't Delaware switched to using the updated August case definition?

2. In addition, do your total test counts on the dashboard include antigen tests?

Delaware is indeed using the August case definition. I didn’t realize we still had a notation on our data tracker that referenced the April case definition, so we will make sure to have that fixed asap.   I will double check your question about total test counts. I believe we are following the standard set by the CDC for that as well, but I want to double check for certain.

Delaware reached out to us

On behalf of Drs. Rattay (Delaware State Health Officer) and Offutt-Powell (Delaware State Epidemiologist), I am requesting your assistance in changing the way percent positive is reported on your testing tracking website for Delaware. Currently you are reporting the number of cases divided by the number of persons tested (“person-based” percent positive)  We would appreciate you reporting it as the number of cases divided by number of negative tests plus number of positive tests (“test-based” percent positive).Delaware has recently developed the capacity to capture the test-based percent positive. We are currently reporting both versions of this statistic, as demonstrated in the screenshot below.Our request stems from our recent attempts to emphasize “test-based” percent positive as a more valuable daily measure at this stage of the epidemic. Should you have any questions about this request, please feel free to contact me.

We noticed that on 10/12, you began to release a “Total Tests” number in addition to “Total Persons Tested” on https://myhealthycommunity.dhss.delaware.gov/locations/state. Does “Total Tests” refer to the total number of specimens tested? We are currently assuming the following statements are true. To verify whether our understanding of "Total Tests" is correct, would you confirm the statements below?

1. If a person was tested on Monday and then tested again on Friday, that person’s tests would cause the “Total Tests” number to increase by two.
2. If a person was swabbed twice in one day and both swabs were tested, those two swabs (specimens) would be counted as two tests and therefore increase the “Total Tests” by two.
3. That repeat positives are counted: If a person who had previously tested positive re-tested positive on a subsequent day, that new test (or tests) would be counted towards the "Total Tests" number.
4. That negative results after a positive are counted: If a person who had previously tested positive re-tested negative on a subsequent day, that new test (or tests) would be counted towards the "Total Tests" number.

_We are currently assuming the following statements are true. _To verify whether our understanding of “Total Tests” is correct, would you confirm the statements below?1. If a person was tested on Monday and then tested again on Friday, that person’s tests would cause the “Total Tests” number to increase by two.** Yes** 2. If a person was swabbed twice in one day and both swabs were tested, those two swabs (specimens) would be counted as two tests and therefore increase the “Total Tests” by two.Not if they got the same test type twice on the same day. Delaware is a dual reporting state, which means that we receive results from both providers and labs. We currently find duplicates by looking for unique combinations of:

**   :public_health_case_id,** **   :specimen_type_code,** **   :specimen_type_description,** **   :specimen_type_free_text,** **   :specimen_collection_date,** **   :test_performed_code,** **   :test_performed_code_systemSo if the same specimen TYPE was collected more than once on the same day and used for the same test it would count as a single test. If two different tests were run on the same day for the same person, they would still count as two tests.3. That repeat positives are counted: If a person who had previously tested positive re-tested positive on a subsequent day, that new test (or tests) would be counted towards the “Total Tests” number. Yes**4. That negative results after a positive are counted: If a person who had previously tested positive re-tested negative on a subsequent day, that new test (or tests) would be counted towards the “Total Tests” number. Yes. Other than the deduplication of the same test reported multiple times in the same day described in 2. we count each test separately.

We are currently interpreting total persons tested as referring to the total number of individuals tested. Is this correct? If so, do you have plans to release the total number of tests conducted?

Do you have plans to release a full historical time-series of all testing and results? We have been capturing the total test results in total persons tested since 5/13. Do you plan to release a historical time series of that number? Will this historical data set be available consistently and in a machine readable format like (i.e. csv or json)?

Do you perform any deduplication to reach the total persons tested? If so, how? (i.e. instances swabbed per day/week; recording only one positive test per person, but multiple negative tests for the same person; etc.)? When reporting testing results, if the same person gets different test results on different days, would you report raw results as part of the daily positives or do you apply any kind of logic such as reporting only the first negative or positive result per individual?

We’re also interested in testing data in units of “testing encounters”, which can be defined as “the number of unique people who have been tested per day.” Are you willing to or are you planning to release testing encounters? If so, will you be able to provide historical data consistently under a machine readable format (i.e. csv or json)?

Is Delaware performing pool testing? If so, how is this testing reported? What types of tests is the state using?

We are not performing pool testing in Delaware.

Is Delaware conducting antigen testing? Are these testing results reported on the state site? How many tests has the state conducted?

We are not currently using point-of-care antigen tests in Delaware, but we are exploring it as a potential resource.  DPH is working with the pharmaceutical industry to identify supply chains and availability.

How does Delaware define long-term care / what types of facilities are included under that heading?

For the purposes of reporting out long-term care related COVID-19 data, we include nursing homes and assisted living facilities.

And re the LTC data released in Friday press releases; when did DE start collecting that data? Or another way of asking: When is the data cumulative since? (if that makes sense)

The data is captured as part of our epidemiological surveillance data and is cumulative since March 11, 2020. That does not necessarily mean we had positive cases in long-term care facilities since March 11, but all of our case data is cumulative since we announced our first COVID-19 positive case on that date.

Could DE separate Asian and Pacific Islander? Could DE separate Another and Multiple?

As far as I know we do not plan to separate the race demographics data further, but I can pass the feedback on to our epidemiology group for consideration.