As mentioned in previous posts the practice of changing the way that coronavirus cases and deaths are counted makes it difficult, if not impossible to track trends in the course of the pandemic. These distortions are made even more prominent by creating incentives to increase COVID diagnoses, as for example by differential reimbursement for treating COVID cases. As mentioned previously, there may be rationales that favor erring on the side of inclusiveness versus erring on the side of certainty, but the fact remains in either case that the process is one that is friendly to error.
It would be helpful if the agencies responsible for coronavirus record-keeping would make a couple of very basic accommodations:
1. Report separately those diagnoses that are supported by PCR testing, those that are supported by antibody testing, and those that are supported by neither.
2. Report separately those who were diagnosed with COVID and subsequently hospitalized, and those for whom the sequence was the other way around.
3. Report those who have more than one coronavirus test, with the result pattern; e.g. negative-positive, positive-negative, negative-positive-negative, etc.
4. For those admitted to the hospital after diagnosis, report the amount of time that elapsed between these events.
5. Report suspected hospital-acquired infections.
6. Report positive cases that were not associated with a documented fever.
7. Report cases according to whether patients continue to work outside of the home, i.e. in grocery stores, hospitals, etc.
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