How Ohio undercounted 4,100 COVID deaths

COLUMBUS, Ohio (WSYX) — The director of the Ohio Department of Health said Thursday that an error leading the state to undercount as many as 4,100 COVID-19 deaths came down to a single employee, who became overwhelmed by a deluge of deaths in November and December.

The miscounting echoes similar incidents in Indiana, Washington and Texas during various heights of the pandemic, when each of those states also released sudden spikes in COVID death data. According to Ohio's health director Stephanie McCloud, the issues are exacerbated by technology that is not made for "real-time reporting," leading to manual data entry which can lead to errors.

The error in the Buckeye State, according to McCloud, begins with the way the state compiles COVID data death from two sources: the Bureau of Infectious Disease, and the Bureau of Vital Statistics.

Infectious Disease gathers data from centers that directly deal with COVID and its resulting mortality, including hospitals, health departments, long-term care centers and other treatment facilities. Those centers report their COVID mortality directly to the state each day.

The Bureau of Vital Statistics, which handles death certificates, reports deaths on a delay of one to seven months — due to situations when verification of COVID deaths is slower, such as at-home deaths, autopsies and other situations that may include hospitals and treatment centers.

To ensure the two data sets don't result in double-counted deaths, the Ohio Department of Health must manually "reconcile" the death counts with each other, in a process that comes down to one person. McCloud says beginning in October, that person began to run behind on death data, but did not alert supervisors. The error was discovered in the first week of February, during a routine employee training and evaluation.

"We have made some changes within the department, we have brought in additional resources to address the need to get these updated quickly," McCloud said on Thursday. "Obviously, the fastest way to do this is to manually do the reconciliation that should have been done, and having many hands make light work."

McCloud said an administrative review of the error has begun, and there were no details to share on discipline for the incident. Separately, she laid some blame for the error on technological limitations of a system built long before modern data delivery.

"We would definitely like to see some improvements, and some upgrading in our technology systems," McCloud said, noting she addressed the issue in her 2022-2023 budget proposal. "It would have been wonderful at the outset to have a technology solution for this."

Ohio's chief medical officer, Dr. Bruce Vanderhoff, said the public acknowledgment of the error should reassure Ohioans that health officials are "deeply committed" to data accuracy, and willing to admit when they make a mistake.

Vanderhoff also said, along with Gov. Mike DeWine, that knowing more accurate data two months ago would not have changed their approach.

"We have never relied on a single measure to inform us about the severity of illness, or the patterns of this virus' activity," he said. "I remain very confident in the recommendations we made, the guidance we've provided."

DeWine did not address the undercounting any further at his coronavirus briefing on Thursday, content to let the health department handle the questions on it.