The Florida Department of Health’s Covid-19 numbers are not always quite what they seem. And the lack of transparency is skewing the numbers being reported–not by much, but significantly enough that 11 percent of cases are not being tagged to individual counties. For a small county like Flagler, where there are still no official reports of a confirmed case, it may be the difference between an existing case and an officially unreported case.
Flagler County may well have one, two or three confirmed cases of coronavirus. If those cases were confirmed in non-Flagler County residents who happened to be in Flagler County, you will not know about them locally: the numbers will not be reported as part of Flagler County’s tally. In other words, if a St. Johns County or Broward County resident is being treated locally for a Covid-19 case, the Department of Health will not say so, nor will the health care facility where that patient is being treated.
And current Department of Health rules are such that DOH officials are barred from reporting those numbers locally, Flagler Health Officer Bob Snyder said.
“That is not being released by the Department of Health, at least right now, that is not being released by the DOH,” Snyder said this evening. The protocols “could change,” he said. But for now, cases are not being reported according to geography–only according to the patient’s official residency. “The county numbers, that’s by the person’s residence by county, so it is reflective of, ‘I live in Flagler County, I live in Volusia County.’”
Local residents’ concerns is with geography: how many cases are actually in the county, since the patient’s own county of residence or nationality is at that point not as relevant as the confirmed presence of one or more cases in the community. The Department of Health’s tally does not reflect that concern as much as it does a statistical focus to count overall numbers accurately.
Conversely, if, for example, a patient was being treated for Covid-19 at Baptist Hospital in Duval County after traveling there, but is a resident of Flagler County, then that case “would be reflected under Flagler County’s numbers,” Snyder said. But the health department will not disclose that the person is in Duval, or in a county other than Flagler, thus creating yet an other layer of confusion or obfuscation.
In other words, the first confirmed case of Covid-19 in Flagler County could very well involve a Flagler resident who is not at present in the county. Again, local residents would be deceived about the physical presence of such a case, since it would not be in the county. And individuals could just as well be in treatment at a local treatment facility for Covid-19, but the fact will not be reflected in Flagler County’s numbers because the individual’s official residence is not in Flagler. Nor will treatment facility or Department of Health officials disclose the fact.
“We are not at that point yet of full confirmation and disclosure to share that as of right now,” Snyder, a former AdventHealth administrator (when it was Florida Hospital Flagler) said. “We do not comment, neither does the hospital nor the health department, comment on the status or the situation involving any patient in any hospital, let alone our AdventHealth Palm Coast hospital, to protect the privacy, the confidentiality of patients in general.”
It remains unclear how the Health Insurance Portability and Accountability Act known as HIPPA, which includes patient-privacy provisions, is being violated when the Department of Health discloses the mere fact that a person in the county has been confirmed to have Covid-19, though the person is not from that county. Yet that person’s status is being reported by the Department of Health as part of that person’s county of residency’s overall tally of cases–but DOH is not specifying the person’s geographic location.
As of today, the Department of Health’s official tally for Florida cases is 137, according to its latest figures on a revamped web page. That tally shows zero cases in Flagler. But the department reveals on a different page that the state actually has 155 cases. The difference of 18 cases is the difference between Florida residents and non-residents, even though those 18 cases are in Florida counties. One or more of those cases could well be in Flagler–a county with enthusiastically open arms for tourists and non-county visitors. As numbers have increased almost exponentially, claims have increased that the numbers in St. Johns and Flagler may not necessarily be what they are. Volusia County officially has six cases, according to the Department of Health.
Adding further to the complications and obfuscations: six Florida residents diagnosed out of state “are not reflected on the Florida map,” the Department of Health specifies.
So Florida Department of Health somewhat Kafkaesque Covid-19 census rules essentially go like this: If a non-Florida resident is diagnosed in Flagler, you will not see that number reflected in Flagler’s tally. And the Department of Health will not say where that patient is actually from, because the patient doesn’t actually exist, statistically, locally. If a Flagler resident is diagnosed in any of the 49 other states or the District of Columbia, you will not see that number reflected in Flagler’s tally, but the state will include the overall number of Floridians infected elsewhere. It just won’t tell you where they happen to be. The department will tally up the “total case overview,” which on Monday stood at 155, and which includes “positive cases in Florida residents and non-Florida residents tested in Florida.”
So existing rules of disclosure allow Snyder to make this emphatic, technically accurate but potentially deceptive statement: “We do not have a Flagler County resident that is confirmed with the coronavirus at this moment in time. That is all.” Potentially deceptive, because he will not say–he is not allowed to say–if there is a non-resident currently in the county, who has tested positive for the virus.
Snyder, of course, is not at fault. As disclosures go, he has consistently erred on the side of disclosure in his years at the head of the Flagler Health Department. Nor are any of his 66 colleagues across the state allowed to say what the net numbers are in their own county. “We’re under strict rules,” Snyder says.
FlaglerLive reported this morning that an employee at AdventHealth Palm Coast had reported that there was a Covid-19 case there, a case never confirmed by local officials. More officially, the company managing the hospital’s emergency department reported that some of its own medical personnel as well as AdventHealth Palm Coast personnel had been placed on quarantines.
The disparity between officially reported numbers through the Department of Health, and reports on the ground, including reports by the hospital’s own ER managers, appear to undercut transparency in at least in one notable regard with the Department of Health’s numbers. Snyder would neither confirm or deny the the case at AdventHealth when asked Sunday, and again on Monday, describing himself as “appalled” that a hospital employee would disclose the possibility. But it was a hospital contractor who disclosed the quarantines, in an official email to numerous hospital officials and first responders. (Flagler County Commissioner Joe Mullins at this evening’s commission meeting uttered falsehoods in the same breath as he was urging residents to follow reliable information: “There’s a huge emphasis on counting the people that have it and the people that are dying,” he said, noting accurately that there’d not been a “focus on a lot of people that are recovering from this,” before claiming that “I’ve had people say the local media here said we had a confirmed case at Advent,” which was flatly not accurate.)
Over the weekend, Volusia County Sheriff Mike Chitwood, disagreeing with the Department of Health’s approach, opted to disclose the towns and the number of people under observation for Covid-19–not their names or addresses–saying the department was not disclosing enough information to allay public concerns.
The state Department of Health from here on will be releasing Florida and county numbers every day at noon and 6 p.m., according to the rules outlined above. Snyder said he would seek to find out directly from officials in Tallahassee whether the protocols of disclosure might change in the days or weeks ahead.