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California

Coronavirus Dashboard Frequently Asked Questions (FAQs)

 

Have a question about the Yuba-Sutter COVID-19 dashboard? Check these FAQs with your questions pulled from social media, and answered by Sutter County Epidemiologist, Dr. Robert L. Herrick-- who also updates the dashboard each day.


Where does the data on the dashboard come from?

We get information about tests and test results from multiple sources: labs, medical providers, testing centers and hospitals. We also get them from multiple sources: electronic databases, emails, phone calls and faxes. These also come to different places: the respective health department offices and the joint department operations center themselves.

We sort all of this information and send to the operations team a list of who’s newly diagnosed. The operations team then investigates and sends us back the results. From this, we determine who has symptoms, when they started, and how they got COVID. The operations team also collects information about hospitalized patients daily, and we track who is in the hospital, who is in the ICU, and when they were discharged. The operations staff also identify those who were recovered.

From this, we then report data on the dashboard every day, seven days a week.


Who gets counted on the dashboard?

With one exception, all data on the dashboard is for Sutter and Yuba County residents ONLY.

We only report COVID cases in Sutter and Yuba County residents. We only report the hospitalizations for Sutter and Yuba County residents. We only report Sutter and Yuba County residents who died. We only report Sutter and Yuba County residents who recover.

The exception is the total tests performed here. That also counts residents of other counties who get tested here, because that is a measure of our testing capacity. Every other number only refers to Sutter and Yuba County residents.


Why in the last few days we've had very few results come back? Are they not posting the negative cases they receive back?

The systems we use to get information are designed to highlight positive results. That makes sense, because positive tests spur public health action. That’s somebody we need to call, see how they’re doing, make sure people who are exposed are put into quarantine, etc.

As the volume of tests increased statewide, they were further streamlined to ensure positive results don’t get forgotten or hidden amongst a large number of negative results. That means it takes a lot more staff work to identify and report negative results. To find negative results, we have to actively search these systems, identify what’s new and what’s already reported. Data team members have a list of tests we know have been done, and then they have to search for those results. That takes time.

Some days, when we’re very busy or short-staffed, we have to prioritize processing positive results or interviews with patients over looking for negative tests. So there will be delays in reporting negative results. This happens most frequently on the weekends, so you’ll often see only a few results reported on a Saturday or a Sunday.


Do the tests include antibodies?

We only report PCR tests, the nasal swabs. Why?

A PCR test is diagnostic. It gives us a time frame to work from. Between that and your symptoms, if you have them, we can identify when you might have been exposed, who might have been exposed by you, and how long you need to be in isolation.

Antibody tests don’t allow us to diagnose disease. All they do is tell us that you might have been exposed. They don’t tell us when. Antibody tests are also a lot more variable in how good they are than PCR tests, especially when only a small proportion of the community have had COVID.

Now that may change as we go forward, better tests are developed and we get a better understanding of how COVID works. But, right now, PCR tests are the gold standard for who has COVID, and so that’s what we report on the dashboard.


Can you explain what are false positives, false negatives, and the difference between the two?

A false positive means the lab test says you have the disease when you don’t.

A false negative means the lab test says you do not have the disease when you do.


How many people are hospitalized with COVID and how many are hospitalized due to COVID?

We get that question a lot. People assume that the hospital is trying to "increase" COVID-19 hospitalized numbers. That's not true.

Even if you do not have the typical symptoms of difficulty breathing, coughing, and shortness of breath, if you test positive for COVID-19 and present to the hospital you are contagious and can put at risk the doctors and nurses working to care for you. Knowing whether you are infected with COVID-19 or not allows the doctors and nurses to immediately wear the necessary personal protective equipment (PPEs) so that you don't infect them. Remember, these are front-line medical workers, who day in and day out are risking their lives to interact with the infectious and the ill. Please provide them with the respect that is their due.

Plus, COVID-19 isn't a disease that only harms the lungs. It can stress out your entire body, leading to generalized inflammation. Inflammation leads to lots of other severe, harmful damage including strokes, heart attacks, kidney damage, and liver damage. COVID-19 can damage essentially every part of your body so just because you don't have a cough, shortness of breath or difficulty breathing, you can still have COVID-19 and be infectious.


Why are the numbers on the dashboard different than the numbers and the National COVID site?

Different dashboards collect and report information about COVID in different ways, and over different time frames.

In California, information about COVID begins at the local health department, what we call the local health jurisdiction. Usually, that’s the county where the patient lives. That health department gets the lab report, does the investigation, and controls the spread. We’re the tip of the spear, and that means we have the most up-to-date data. We’re also the closest to it.

Counties then report to the State through the State’s disease reporting system. The CA dashboard is usually reporting the same data a few days after we do. Part of that is time for us to investigate and clear things up, and part are the inevitable delays that come from 61 different jurisdictions reporting individually and the state analyzing it.

State data is then reported to the CDC. That also takes time. Now, some of the national dashboards, like Johns Hopkins, draw directly from county dashboards, so they’re only a day behind us usually.

Different dashboards also count data differently. For example, our dashboard reports based on what county you live in. If you’re hospitalized on the moon, we count you. The state dashboard counts hospital patients based on the county the hospital is in. So our dashboard shows X for Sutter, since they’re our residents, and the state dashboard shows 0, since they’re not hospitalized in Sutter County.


Why are people recovering at such slow rate when I thought it only took two weeks to recover we should be seeing higher numbers being recovered?

Generally, patients are considered recovered ten days after they develop symptoms, assuming they are getting better. Obviously, patients who are hospitalized are going to take longer than that. We generally try to check in with patients before we report them as recovered, to make sure they are actually getting better. That can add a couple days if they’re not checking in or not doing better.

We’re also working through our old records, in case we have some patients who recovered but may not have been reported. We’ll update our numbers as we identify those.


How can there be more "confirmed cases" in a day than "results received"?

It is an artifact of how we report data over time.

We report data for Yuba and Sutter County residents only. We also work very diligently to report everyone who tests positive once and only once. However, sometimes as we talk to someone diagnosed with COVID, we discover they live outside Yuba and Sutter Counties. Sometimes, we also discover they may have been previously reported. When this happens, we go back and remove them from the data we report.

So, sometimes, it looks like we have more cases than results, because people add the new results to what our cumulative total was the day before.


If a person tests positive more than once, are they counted more than once in positive numbers?

Generally, no. People who test positive for COVID often get multiple tests. Those tests are all part of the same disease incident, and so we only report them once.

Now, sometimes we do get duplicate reports, such as people with different spellings of their name, or different addresses. We work very hard to identify and remove those duplicates. But, as a rule, we only report one instance of COVID once.


Can you provide the actual mortality rate?

Mortality rates have a very specific meaning – it’s deaths from a given cause from the population. What people mean when they say mortality rate is actually case fatality rate: how many people who get COVID will die? That’s very difficult to calculate right now. It’s easy to identify how many people have died of COVID. But we don’t really know how many people have had it.

Locally, we have had 7 deaths and 939 cases as of Thursday, July 23, 2020 (when these FAQs were drafted). That’s a case fatality rate of about 0.7%, or about seven times deadlier than the flu.


Is there a way to track how many leave the hospital versus go in? I noticed for example some days the amount currently hospitalized goes down but total goes up which leads me logically to think some are sent home and new cases enter same day.

That’s a great idea. We track it internally, and are working to add that and average hospital stay to the dashboard in the next set of improvements.


If out of county patients are in our hospital for COVID, is that number counted against us?

No. The state looks at factors like a county helping those in need when examining the watch list, and they do not penalize us for being a good neighbor.


How do we get off the watch list?

The key number is less than 7 new cases per 100,000 people per day over 14 days.

What does that mean? For Sutter County, that’s easy. We have a little more than 100,000 people in Sutter County, so we need to get down to less than 7 new cases per day for two weeks.

Yuba County is a bit smaller, with around 77,000 people, so the math is a bit more complicated. It’s closer to less than 6 new cases per day over a two-week period.


I am wondering if when someone tests positive and are asymptomatic, do they move to the symptomatic count if symptoms develop?

Yes. We see that a lot. We will get the initial lab report, and note they don’t have symptoms. And then we will interview them, and they’ll say they have symptoms, or their symptoms began after they got tested. Then we move them to the symptomatic column.

That’s a major reason why the symptomatic and asymptomatic numbers change rather frequently. We learn more from talking to people with COVID, and update the data.


Where are people contracting COVID from?

By far, most COVID transmission is called “contact with a known case.” That means we’re able to link them to someone else they were around prior to getting sick.

The most common example is the people you live with. It makes sense. We don’t wear masks at home. We don’t social distance at home. We cook for each other, we eat together, we watch television together, we talk to each other. We spend a lot of time with the people we live with, closer together than six feet. That’s the most common source of COVID transmission. It’s also the hardest to stop, since many people can’t isolate themselves easily, and the people we live with can be exposed days before we get symptoms and thus learn we’re sick. That’s why protecting yourself against COVID when outside the home is so important.

Other common sources are small parties and get togethers. Unfortunately, we saw a lot of new cases after Father’s Day, and we’re going to see more from the 4th of July. Again, a party is normally great fun, but it’s dangerous right now. Lots of people, close together, for long periods of time.

We also see a lot of COVID transmission in the workplace. Again, it makes sense. We’re around the same people, in close proximity, day after day. Again, it’s why COVID protections are so important, and why so many businesses are now doing COVID symptom checks. It’s also why it is very important to stay home from work if you have COVID symptoms.


Can asymptomatic people spread COVID?

Yes. COVID is sneaky like that. People with no symptoms can spread COVID-- nearly 20 percent of cases are asymptomatic. People can also spread COVID before they get symptoms. That is why facial coverings are so important – you may not know you have COVID.