Arizona

Until now, AZ deduplicates to unique individuals by test type (e.g. counted once for serology, once for PCR), so that the PCR-only number reflected unique individuals. But now, AZ has changed its PCR-only number to reflect “diagnostic” testing which is defined as PCR and antigen. Does that mean that individuals are being double-counted in that figure if they tested on PCR and antigen? Or has the deduplication policy changed to support the launch of that new statistic?

An individual who tests positive on both PCR and antigen testing will only be reflected once on the dashboard.

Why does “Cases/Total COVID-19 PCR Tests” produce a higher percentage (about 16%) than “PCR Percent Positive”? (listed as 12%)

Percent positivity is calculated from the total number of individuals who test positive divided by the total number of individuals tested by test type based on reporting through Electronic Laboratory Reporting (ELR). The majority of reports of COVID-19 are received through ELR, but there are some laboratories that are currently only reporting positive individuals through fax and other mechanisms. These individuals will be included as cases, but will not be reflected in the percent positivity number. We are continuously working with labs to report through electronic means, but - for this reason - the percent positivity cannot be calculated as cases divided by tests.

There is also a hover function on the percent positive by week graph on the Laboratory Testing module of the dashboard. When you hover your mouse over individual fields, the total number of tests reported electronically is displayed, along with the total number of positive tests reported electronically. This provides additional clarity on how the percent positivity rates are calculated.

09/04/20: On the ADHS COVID-19 Data Dashboard, your metric for total tests is “Total COVID-19 Tests” - can you clarify whether “Total COVID-19 PCR Tests” refers to specimens Does cases count unique people or unique individuals? Do you perform any de-duplication to reach the “Total COVID-19 Tests’“value? If so, how? (i.e. instances swabbed, day, week, or recording only one positive test per person, but multiple negative tests for the same person)? If the same person gets different test results on different days, would you report the 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?

09/17/20: If an individual gets tested via a PCR test 3 times on different weeks, and the test result is negative each time, would the “Total COVID-19 PCR Tests” record this as 3 tests or 1 test?

On the ADHS COVID-19 Dashboard, "cases" represent unique individuals. Additionally, laboratory testing data is deduplicated by patient and test type. If someone continues to test positive, which we are aware that some people do, they are not being counted multiple times in either the case or the laboratory data. A unique person will only appear one time by each test type. If someone is tested by PCR and then serology, they would appear once in each test type for percent positivity purposes.

If the same person gets tested by PCR multiple times with the same result then it will only be counted once. As previously noted, Arizona's laboratory testing data is deduplicated by patient and test type.

Do you have plans to release the alternative to what you’re currently reporting (ie; If the metric refers to all tests/specimens, will you release the total number of individuals tested)?

Do you have plans to release a full historical time-series of all testing and results? Other states provide their COVID-19 testing and outcomes in machine readable format, but as far as we are aware ADHS does not at this time. Do you have plans to release all testing and results data in a machine readable format (i.e. csv or json)?

We are also 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. 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)?

Other data formats or additional data elements are not available at this time.

Which metrics that you report were impacted, or could be impacted by recent HHS procedure changes?

Hospitals are still required to report to ADHS under the existing Executive Orders, and the required elements for reporting to ADHS have not changed due to the HHS procedural change.

Can Arizona specify where you are counting multiracial individuals?

If an individual identifies as multiracial, they will be reflected in the "Other" category in the ADHS surveillance system.

Are you conducting antigen testing? Are these testing results reported on the state site? How many tests have been conducted?

The Arizona State Public Health Laboratory is not currently conducting antigen tests. However, antigen testing is being utilized by other labs and some providers across the state. ADHS is working with these labs to integrate our electronic reporting mechanisms, so that this data can be included on the Data Dashboard.

Are you performing pool testing? How is this testing reported?

We are not performing pool testing at this time.

Why does AZ have incomplete race/ethnicity data and will it improve?

The vast majority of reports received by ADHS come in through Electronic Laboratory Reporting. Race/ethnicity should be reported by commercial laboratories if the information is available to them. Unfortunately, this data is not always available and may not be included in the initial reports received by the Department. Executive Order 2020-48 requires hospitals to report individual patients hospitalized with COVID-19, including demographic information on race/ethnicity. We anticipate that this data may improve overall race/ethnicity data for hospitalized patients. The Department continues to evaluate additional ways to fill in race/ethnicity for non-hospitalized patients, including using the Health Information Exchange. Please note that these measures are not fully implemented at this time.

Can Arizona separate out numbers for LTC residents vs. staff; also ask for breakdown of cases in individual facilities.

Regarding Long-Term Care Facilities, all of the available data can be found in the Congregate Settings with Positive COVID-19 Cases page on the Data Dashboard. We do not currently report information on staff vs. resident cases for individual facilities.

The information about congregate settings is labeled as "Number of Facilities" - does that refer to the number of cases in LTC Facilities or the number of LTC Facilities with cases?

"Congregate Settings with Positive COVID-19 Cases" dashboard represents the number of congregate settings with confirmed COVID-19 cases - not the number of cases.

Can you give #'s for positive cases and deaths in residents of AL and LTC facilities and same for staff?

Lastly, we are not reporting separate case/death data for residents vs. staff in long-term care facilities at this time.

Can Arizona report Asian and Native Hawaiian/Pacific Islander as separate race categories, as defined by US Census 2010?

Labs and healthcare providers report this data to us in the current format through their systems, so we are unable to further delineate race/ethnicity categories.

All of the available data for COVID-19 can be found on our Data Dashboard at azhealth.gov/covid19. Currently, race and ethnicity data for Asian and Native Hawaiian/Pacific Islander is housed under the same category, and we do not have the additional information necessary to further separate these groups.

5/30: Can Arizona specify which race categories they count under the grouping labeled "Other, non-Hispanic?" 8/5: Can Arizona specify which race categories they count under the grouping labeled "Other, non-Hispanic?" (It would be very helpful if you could provide information more specific /concrete than "may include any race that is not specified by the other listed categories")

The "Other" race category may include any race that is not specified by the other listed categories.

We do not have the information necessary to further define “Other, non-Hispanic.”

• Are the reported total PCR/antibody tests referring to people or specimens? On an related note, how does the percent positive number calculated for each test type?
• How long has AZ started antibody testing? Were any of the number of total tests reported prior to 5/8 contain any antibody tests?