After the standard daily recitation by state Commissioner of Health Jan Malcolm on global, national and statewide COVID-19 case and fatality numbers — a process meant to convey urgency about the illness — state director of infectious disease Kris Ehresmann said that the state had changed the way it would release COVID-19 hospitalization data.
Until then, a person could log on to MDH webpage each day and learn how many Minnesotans were hospitalized with the illness overall, and how many were in the ICU. The numbers have been as high as the 600s and 300s, but have dropped in an encouraging fashion since the middle of summer. This week, they were hovering at around 250 total, 114 in the ICU.
“We’ve been collecting and reporting hospital data in multiple ways over the course of the pandemic,” Ehresmann said during the Wednesday, Sept. 23, briefing. “It’s a big undertaking for both our staff and the staff at hospitals. As the pandemic has evolved, it has become clear that the two elements of hospital data that we feel are most important in our understanding of COVID are hospital capacity and disease severity.”
Ehresmann went on to say that the state would begin reporting daily and cumulative admissions, to better reflect “severity and capacity.” Then it was on to COVID-19 and trick-or-treating. No one had any questions about the new data reporting policy.
But it turns out people actually read the health department’s daily Situation Report, and notice when you take something away. Given the adversarial mindset that has developed in places around COVID-19 and the state government, the decision to swap hospitalization for admissions data looked like something darker — the snuffing of good news that hospitalizations were dropping.
When a reporter pointed out the change on social media, at least one state representative smelled a rat.
State Rep. Mary Franson of Alexandria, who describes herself as “fighting to free the people I represent from a communist governor,” in her Twitter bio, asserted that the change was made because “the ICU numbers are no longer ‘scary’ enough to control the people.”
Well, the ICU numbers are no longer “scary” enough to control the people. It’s all about “cases” and we know “cases” mean absolutely nothing.
— Rep. Mary Franson (@RepMaryFranson) September 24, 2020
Health officials listed more mundane reasons for the change, however, both yesterday and today.
In addition to the work required of hospitals and MDH staff in compiling daily patient counts, they said, hospital beds were sometimes occupied by nonresidents with COVID-19, patients left out of the daily totals. They said that the governor’s surge capacity dashboard already keeps track of total ICU usage in relation to ICU capacity. And they said that the severity of the disease was better depicted through the proportion of cases admitted to the hospital.
“This is more useful than the number of people who are in the hospital at any given time,” Ehresmann said. “Although we (formerly provided) data on the number of people in the hospital and in the ICU each day,” she said, “that (was) combining two concepts: new admissions and length of stay.”
Epidemiologists are always looking for a better way to follow the numbers so that they describe the problem. So it was a problem-description change, albeit one that looked to some like the hiding of information that undercuts the messaging.
“Since the State Emergency Operations Center already tracks (hospital capacity) on the dashboard, it was better for us to focus on severity of disease for our Situation Update page,” MDH spokesperson Andrea Ahneman said in an email.
“Admission data actually gives a better sense of severity of disease, and is very useful when making decisions in the response — it is already something looked at for the dial-back measures.”
“In order to best understand severity of disease,” Ehresmann said, “we want to look at the proportion of cases admitted to the hospital.”
Ehresmann said health officials will soon add additional data on hospitalizations in the regular Thursday web report, “to better describe what we know about cases that require hospitalization.” This data will include length of stay for hospitalizations in ICU.
Also on Thursday, health officials reported an additional 995 cases and three deaths from COVID-19. Waseca County recorded 46 cases for the day.
The deaths were among residents of Olmsted, Ramsey and St. Louis counties, and two were residents of long-term care.
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- Minnesota Department of Health COVID-19 hotline: 651-201-3920.
- COVID-19 discrimination hotline: 833-454-0148
- Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.