The Texas Department of State Health Services has seen to it that some 3,600 “probable” coronavirus cases have been removed from the state’s total positive COVID case count.
Before Thursday, the San Antonio Health Department was counting positive antigen tests in their total reported counts of positive COVID cases. The antigen tests are considered “probable,” unlike the more sensitive molecular PCR tests.
“Antigen tests quickly identify people who are currently infected with the coronavirus by detecting proteins from the virus in nose and throat secretions,” says the San Antonio Department of Government and Public Affairs website. “This is the same technology used in your doctor’s office for rapid strep testing. By contrast, a PCR test, looks for genetic material.”
Since San Antonio is only one of three cities in the state to count and collect antigen tests, Texas’ health department asked for the cases to be separated out from PCR tests so the state can have cleaner comparisons by city and county.
The initial news of the drastic downgrade in total positive cases sparked theories of general over-counting of COVID tests.
“The State of Texas today had to remove 3,484 cases from its Covid-19 positive case count, because the San Antonio Health Department was reporting ‘probable’ cases for people never actually tested, as ‘confirmed’ positive cases.- TDHS (Texas Department of State Health Services),” reported Fox 4 anchor Steve Eagar.
“What other departments make this same mistake?” he asked.
The State of Texas today had to remove 3,484 cases from its Covid-19 positive case count, because the San Antonio Health Department was reporting “probable” cases for people never actually tested, as “confirmed” positive cases.- TDHS
What other departments make this same mistake? pic.twitter.com/wYhGWhHl5w
— Steve Eagar (@steveeagar) July 16, 2020
San Antonio Mayor Ron Nirenberg responded in a thread about the antigen test removal, emphasizing that the city does not include “probable” cases of suspected COVID carriers, only those who test positive from the antigen test.
“We do not report repeat positive tests as new cases,” he said. “We do not report spouses/household members of positive cases without a positive test. We do not report patients with COVID-like symptoms as positive cases without a positive test.”
“We’re 1 of 3 cities in Texas that counts and collects antigen tests based on their accuracy and FDA authorization. It allows us to see the full picture,” Nirenberg explained. “The State wants an apples-to-apples comparison with all cities in their reports, so they’re removing antigen counts.”
We're 1 of 3 cities in Texas that counts and collects antigen tests based on their accuracy and FDA authorization. It allows us to see the full picture.
The State wants an apples-to-apples comparison with all cities in their reports, so they're removing antigen counts.
— Mayor Ron Nirenberg (@Ron_Nirenberg) July 16, 2020
On Thursday, the San Antonio government website issued a clarification on the change.
“At the request of the Texas Department of State Health Services (DSHS), Metro Health is now separating COVID cases that were confirmed by a positive molecular test (PCR) from those that were detected by a positive antigen test combined with COVID-19 symptoms, otherwise known as ‘probable cases,'” the city’s website says.
“Antigen tests were approved by the FDA for emergency use on May 8 and July 2, 2020, and they are considered very accurate in detecting the presence of COVID-19 in people with symptoms,” the city said. “The CDC includes positive antigen test results in its national count of COVID-19 cases, as does Metro Health in Bexar County counts. However, the State of Texas does not include antigen test results in its COVID-19 dashboard counts, despite collecting this data from local health departments and reporting it to the federal government.”
Dr. Colleen Bridger said “probable cases” in this case “do not mean ‘maybe’ cases of COVID-19.”
“Antigen tests are FDA approved, and positive tests are highly accurate. San Antonio is one of only three Texas cities collecting and reporting this data per the CDC guidelines, but the State of Texas wants apples-to-apples comparisons between Texas cities,” she added.