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Physician calls for more transparency about county's Covid-19 statistics

Responding to a physician's questions about Henderson County's response to the Covid-19 threat, Public Health Director Steve Smith defended the county's transparency in providing information while adding that it will continue to withhold "case and death counts by facilities or locations going forward" because of patient privacy reasons.

In an email on April 6 to Smith and County Commissioner Bill Lapsley, with local media copied, William Vine, a medical doctor and Ph.D., noted that the N.C. Health and Human Services website reports confirmed cases, deaths, completed tests, currently hospitalized, cases over time, ICU beds and the number of ICU beds available, inpatient hospital beds and number available, ventilators and number in use Personal Protection Equipment received and PPE requested.

"Unfortunately, NC DHHS does not report most of this data by county," he said. "Thus, Henderson County should report these details daily, since the data clearly exists. The countywide data are critical for local transparency, understanding and predicting. Is contact tracing being applied to those who visited Cherry Hill Assisted Living? Have hot spots been sought and identified for the other 27 cases in Henderson? When will population testing for viral load and/or serological positivity arrive in Henderson?"

"Henderson County Department of Public Health is only reporting the number of known cases and deaths daily," Vine added. "That effort is woefully inadequate in informing the public about what it needs to know."

Smith responded to Vine 10 days later, on Thursday, and answered his questions one by one.

"I appreciate your patience and the advocacy for expanded information about our status with COVID-19 response," Smith wrote. He added that "we are working now on configuring (more reporting) in a consistent dashboard similar to some other models we have seen posted lately."

Some of Vine's questions had been covered publicly in a live-streamed update during a meeting of the Board of Commissioners on Wednesday.

Here are other questions from Vine's email, with the health director's answers:

Number tested in Henderson County to date.

500 tests have been reported to the health department to date although testing continues everyday. This number includes our testing as well, but does not capture all tests to date since independent providers, out of state labs and others aren’t captured in some centralized way. (State acknowledges this same circumstance with their reporting).

Number of positives.

99 at this moment. We try to report this everyday on our website unless we have a large amount of test results come in all at once. When that happens it can sometimes take us into the next day to go through all of the results and post.

Percent of positives for tests completed.

Can be calculated with the 2 values above although a distortion at this point in time since we aren’t aware of all tests and a significant portion of our testing has been focused in long term care facilities.

Number of Henderson County residents that have been hospitalized with Covid-19 here and elsewhere.

These have been very small numbers to date (single digits or even just one patient at times). Public health nor the hospitals anticipate reporting this for a small jurisdiction since it might lead to identification of an individual. That position has been reviewed with the UNC School of Government and the County Attorney.

Number of ICU beds in Henderson County occupied by those with Covid-19.

NC DHHS does not report ICU bed utilization specific to COVID-19, we won’t either.

Total number of ICU beds in Henderson County and number available for use.

There are 19 ICU beds available in Henderson County. The hospitals do not report the number in use. Remember that beds here are not reserved for Henderson County residents and Henderson County residents can access beds outside of the jurisdiction if needed.

Total number of ventilators in Henderson county, number in use, and number in use for those with Covid-19.

There are 31 ventilators available in Henderson County. The hospitals do not report the number in use. NC DHHS does not report ventilator utilization specific to COVID-19. Same commentary as above for beds (capacity not reserved for local residents and residents not restricted to capacity here).

Have clusters of Covid-19 infections been sought and identified in the County? If so how many and where located?

The only outbreaks to date have been self disclosed by those involved facilities. Brian Center, Cherry Springs and the Laurels. We won’t be providing case and death counts by facilities or locations going forward for the same reasons cited above (it could lead to identification of specific individuals). We are looking at a process to provide case counts by zip code jurisdiction. This has little practical value right now due to the limited amount of testing that has happened to date for the general public.