New Hampshire

We are trying to understand the gaps between state-provided testing data and state-level testing data provided by the federal government daily in its PCR testing timeseriesd dataseet: https://healthdata.gov/dataset/COVID-19-Diagnostic-Laboratory-Testing-PCR-Testing/j8mb-icvb

We noticed that, following the appearance a note in the HHS community profile reports (https://beta.healthdata.gov/Health/COVID-19-Community-Profile-Report/gqxm-d9w9) that the federal government was looking into discrepancies between state and federal testing data, New Hampshire's federal testing data became much more comparable to state data than it was before: dropping from 50% difference to almost no difference.

What was the cause of the discrepancies between NH's dataset and the federal data and what fixed the problem?

We have two questions about the information New Hampshire shares with the CDC regarding COVID-19.

1. In looking at the CDC’s Cases and Deaths dataset (United States COVID-19 Cases and Deaths by State over Time. link: https://data.cdc.gov/Case-Surveillance/United-States-COVID-19-Cases-and-Deaths-by-State-o/9mfq-cb36) we notice that New Hampshire has values reported for new probable deaths (‘pnew_death’) however no value is reported for probable deaths (‘probdeath’). For example, on 2/13, the value for ‘pnew_death’ was 6 while the field for ‘probdeath’ was blank.

Can you confirm that New Hampshire is tracking probable deaths and reporting this information to the CDC? And, if so, can share with us the information you have regarding probable deaths over time?

2. More generally, can you tell us about the different mechanisms of reporting cases and deaths to the federal government (voluntary NNDS, aggregate counts process, and line level reporting from the state health department)? We are particularly interested in the aggregate count process as it appears to be the source of the state-level data published by the federal government regularly.

The definition on New Hampshire’s covid dashboard for “Number of persons with COVID-19" included the term “presumptive-positive” for a period prior to 5/16, but has used “positive” since then. What was the intended meaning of “presumptive-positive”, and how does it differ from the “positive” classification that’s been used since then? For full context, on 5/14 the definition for number of persons with covid-19 stated: “Includes specimens presumptive-positive at any laboratory and those confirmed by CDC confirmatory testing.” And on 5/16 it changed to: “Includes specimens positive at any laboratory and those confirmed by CDC laboratory testing.”

Earlier in the pandemic, positive results were considered presumptive and needed to be confirmed by CDC. At some point, FDA approved additional tests types and these tests no longer required CDC confirmation.

The change could have happened before May but we may not have updated our foot notes until then.

I have a question about the "cumulative ICU numbers" figure on the NH dash. The data point has not changed in a week or so. Has reporting paused on that number or has it just not changed?

The ICU numbers haven’t changed. Today we currently have just 9 hospitalizations, total, in the state.

On the Overview page of the New Hampshire COVID-19 dashboard, you report “Total PCR Tests.” Can you please clarify if this refers to the number of unique people tested or the number of specimens tested?

This refers to the number of actual tests not individuals tested.

We only have a record of “Total Persons Tested at Selected Laboratories” from 5/14. Do you have plans to release a full historical time-series for this metric? Furthermore, other states provide their COVID-19 testing and outcomes in machine readable format, but as far as we are aware, New Hampshire does not at this time. Do you plan to release a historical time series of these numbers in formats such as json or csv?

Information regarding testing will be added to the dashboard soon. The entire dashboard can be downloaded (https://www.nh.gov/covid19/dashboard/overview.htm#dash)

General information about NH dash not corresponding to any question I asked

New Hampshire is in a holding pattern as we have additional components of our dashboard not yet finalized. They should help to answer your questions once it goes live.

For both of your total tests figures (“Total Persons Tested at Selected Laboratories” and “Total PCR Tests”), do you perform any deduplication? 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. )?

We’re interested in testing data in units of “testing encounters,” which can be defined as “the number of people who have been tested per day.” Under this metric, if a person is being tested once today and once again the following week, that counts as two tests, however, if the same person has two samples collected at a testing center visit, then that only counts as one testing encounter. Might New Hampshire be willing to release testing encounters? If so, will you be able to provide historical data consistently in a machine readable format?

What is the difference between your daily report and the weekly reported numbers for LTC?

The Dashboard represents all LTCF cases and deaths. The weekly list includes only data from facilities with an outbreak (community transmission occurring within the facility). So adding up the cases and deaths on the outbreak lists won’t capture every LTCF with a case or death

Why did NH revise down their testing numbers from 108862 to 108158?

Yesterday, we reported on total tests run and persons tested for the first time. We are conducted serial surveillance testing at LTC facilities, so our volume is higher given the number of repeat tests of staff and residents. I included the following explanation of that change in our press release yesterday: “DHHS is adding new testing data to the daily update to incorporate results from the serial surveillance testing program at long-term care facilities, which began last week. Previously, the data reflected the number of unique individuals tested. The new data reflects the total number of tests run each day, including repeat testing for individuals. As a result of creating and conducting quality assurance on the separate data sets, the newly-extracted data has led to revisions in the number of person-based test results. The data below represents data on individuals tested and total test volume as of June 22 at 9:00 am.” The change you’ve asked about is due to additional merge data that came through post publication of the data, which removed repeat tests from the category of Number of Persons Tested. The data system used to track COVID-19 merges test results for the same person when the person is tested more than one time. In order to publish data as close as possible to real-time, we are required to pull data at a specific point in time. Depending on the time we pull the data and the time that outside laboratories report data to us, that merging process may not be complete for a particular data set. So any additional data improvements that occur after publication are incorporated into the following day’s update. That is the challenge of working with live data with more than 100,000 data sets. We’d report more accurate data if we waited to until tomorrow to publish yesterday’s numbers, but prefer to provide our residents with data that is as current as possible, even if that means we have to revise the data the following day.

Exact text of question unknown, but was about number of cases within prisons, among healthcare workers, and within the ICU.

Summary of answer per reporter, "He connected me with their weekly summary reports where they are recording: cumulative patients that have been in the ICU (which is not up on our tracking website) and also infections, hospitalizations, and death among healthcare workers. https://www.nh.gov/covid19/news/weekly-summary.htm As of 4/27:

• There had been 82 cumulative ICU patients
• 520 healthcare workers infected, 19 hospitalized, and 2 dead He also connected me with the COVID tracking page for NH correctional facilities https://www.nh.gov/nhdoc/covid/index.html They are recording 11 positive staff and no positive prisoners"

Question about NH's recovery number dropping and wanting to know if it's a revision or a digit flip.