Florida’s well being division undercounted COVID-19 circumstances, deaths, because of technical points: state audit

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The variety of COVID-19 circumstances and deaths reported in Florida from March 1, 2020, to Oct. 9, 2020, by the Division of Well being had been underreported due to knowledge assortment issues, in keeping with the state’s auditor common report printed on June 1.

The report comes after this previous March when a Florida Division of Well being Workplace (FDOH) of Inspector Normal investigation discovered “inadequate proof” or no proof to assist self-proclaimed whistleblower Rebekah Jones’ claims that she was requested to falsify COVID-19 knowledge on the state’s dashboard, in keeping with Workplace of Inspector Normal Investigative Report. Her declare she was directed to limit entry to underlying knowledge was additionally discovered to be false, in keeping with that report.

People lined up to receive a COVID-19 test, Wednesday, Nov.  18, 2020, in Opa-Locka, Fla.

Individuals lined as much as obtain a COVID-19 check, Wednesday, Nov. 18, 2020, in Opa-Locka, Fla.
(AP Picture/Marta Lavandier)

“To judge the State’s readiness to offer important data wanted to answer the worldwide pandemic, this operational audit centered on COVID-19 knowledge assortment and reporting processes on the Company for Well being Care Administration (Company), Division of Well being (Division), and Division of Emergency Administration (Division) through the interval March 1, 2020, by October 9, 2020,” the state’s auditor common report stated.

“As additional described, the variety of entities reporting knowledge, obvious inaccurate or incomplete knowledge reported to the State by these entities, and the shortage of efficient entry controls within the techniques used to collect knowledge, impacted the State’s potential to precisely report COVID-19 knowledge at first of the pandemic.”


Florida’s Well being of Division used a software program knowledge referred to as the Merlin system, nevertheless it “didn’t seem full or contained anomalies” when in comparison with knowledge within the Bureau of Very important Statistics.

“We in contrast Merlin loss of life information to Bureau of Very important Statistics loss of life information the place COVID-19 was included as a trigger or contributing issue of loss of life and recognized variations between the information,” the report stated.

The well being division information additionally did not at all times present proof that COVID-19 sufferers had been contacted in a well timed method, which was towards the state’s well being division necessities for contact tracing.

Signage stands at the ready (foreground) in case COVID-19 testing at Barnett Park reaches capacity, as cars wait in line in Orlando, Fla., Thursday, July 29, 2021.

Signage stands on the prepared (foreground) in case COVID-19 testing at Barnett Park reaches capability, as automobiles wait in line in Orlando, Fla., Thursday, July 29, 2021.
(Joe Burbank/Orlando Sentinel through AP)

The audit famous “for 168,880 of the 729,552 circumstances, Merlin didn’t proof that the COVID-19 optimistic people had been both contacted or contact was tried by the Division.”

Utilizing the person’s full identify and date of delivery, the auditor common concluded that 2,495 loss of life information that had been reported within the Merlin software program system weren’t included within the Very important Statistics reviews, whereas 3,082 loss of life information reported in Very important Statistics knowledge weren’t included within the Merlin knowledge, per the audit.

“Absent full and correct data associated to the extent and severity of the COVID-19 pandemic, authorities officers and most of the people could not have had all the data essential to assess the efficacy of COVID-19 management measures and take acceptable actions,” the reviews stated.


The auditor common stated if the well being division’s administration didn’t obtain a optimistic lab end result or if the demographic data on the laboratory report differed from the loss of life certificates, it might haven’t been capable of definitively notice that the person who died was the identical particular person listed on the check outcomes.

There was additionally “knowledge high quality points” concerning knowledge for the variety of COVID-19 circumstances, unbiased of the loss of life information, however FDOH administration stated “knowledge high quality points had been because of must must depend on knowledge being despatched from the laboratories, together with the big variety of circumstances and restricted assets to handle knowledge accuracy and completeness points.”

The auditor common discovered that regardless that FHOH did attempt to ensure some knowledge was correct and full, the audit additionally discovered “7,718 cases the place the dates of follow-up contact makes an attempt had been lacking from Merlin.”

However FHOD informed the auditor common that “inaccurate contact data and the refusal of some people to talk with the division hindered” their potential to contact all COVID-19 people.

A Florida resident gets vaccinated at the drive-thru site at the Orange County Convention Center in Orlando, Monday, Feb.  22, 2021.

A Florida resident will get vaccinated on the drive-thru web site on the Orange County Conference Middle in Orlando, Monday, Feb. 22, 2021.
(Joe Burbank/Orlando Sentinel through AP)

State Surgeon Normal Dr. Joseph Ladapo agreed with the report’s findings with a plan of motion in progress to appropriate it, however added knowledge discrepancies are anticipated, in keeping with WFLA Information Channel 8.

“If COVID-19 testing was not carried out, occurred greater than 30 days earlier than the loss of life, was not reported to the Division, or couldn’t be matched to a Very important Statistics file due to knowledge high quality deficiencies, the loss of life wouldn’t be counted as a [COVID-19] related surveillance loss of life included within the Division’s COVID-19 surveillance reviews,” Ladapo wrote.

He famous “most knowledge high quality points the Division skilled through the COVID-19 pandemic originated from laboratories that submitted inaccurate or incomplete knowledge,” including FDOH not recommends county well being departments do contact tracing for each COVID-19 case.


The Company for Well being Care Administration and the Division of Emergency Administration famous monitoring and reporting challenges in response to the report, however strengthening IT controls was talked about as a manner to enhance knowledge administration, per the information outlet.

The report stated knowledge recorded after the audit interval may be subjected to future audit.