Starr County announces change to COVID-19 reporting practices

In an effort to standardize data, Starr County is changing the way it gathers information for their daily reports of COVID-19 cases.

Dr. Antonio Falcon

The county’s local health authority, Dr. Antonio Falcon, announced during a news conference Tuesday that there had been confusion regarding the county’s daily reports and, specifically, where the county gets the data compiled in those reports.

“As of today on, the report that I will give from Starr County will be from the Texas department of health dashboard,” he said, referring to the Department of State Health Services. “I think that will give us an easier way to standardize. There may be a little variation but, in general, what that state health department is reporting is what we will be reporting.”

Before Falcon took over as the health authority on Aug. 14, his predecessor, Dr. Jose Vazquez, said he gathered information from several sources on a daily basis.

“I would call the private clinics that were testing, I would call the drive-thru facility on a daily basis several times, I was in touch with the nursing home on a daily basis and I was in touch with the hospital,” Vazquez said. “So there was a list, during the time that I was health authority.”

Specifically, he said there were three private clinics that were testing for COVID-19 in Starr County on top of the county’s drive-thru testing site and the tests conducted at the hospital and the nursing homes.

There were also the mobile testing sites that were run by the Texas National Guard, the Texas Division of Emergency Management and DSHS. However, DSHS sent the test results from those sites to Vazquez every night.

“So it was maybe six to seven different places that we would be in touch (with) on a daily basis to know how many tests were done, how many positive, how many negative,” Vazquez said. “Some of the private clinics, they were sometimes taking longer so I would do it maybe once every three or four days but I was in constant communication with those providers.”

At one point, Vazquez started keeping track of the number of cases reported by DSHS versus the number of cases he had confirmed through the community.

“To give you an idea, when (DSHS) reported we had 120 positive cases in the county, I already knew about 210 or something like that,” he said. “It was taking them days to catch up.”

To ensure they never counted a case twice, Vazquez said they would check the individual’s name and date of birth against the reports sent by DSHS, which typically included previously confirmed cases a few days after he had.

“That’s, once again, how we were able to keep the numbers low because we knew that very day, or the day after, about a positive result, we were already contacting that patient and we were already doing the contact tracing,” he said. “If we had been waiting for (DSHS) to report that case as a positive, it would have been three, four days later and by then, they could have spread to another 10 or 15 people.”

The daily reports often included a number of deaths that were pending confirmation by DSHS.

“There was a lot of difficulty in trying to figure out where the patients were from or when they would expire,” Falcon said during the news conference.

DSHS, however, has since confirmed the residents who died were residents of Starr County and, as of Tuesday morning, the county had a total of 117 deaths due to complications from COVID-19.

Falcon clarified that the state confirmation of deaths among county residents is what accounted for the jump in the total number of deaths in the county’s reports.

On Aug. 17, the county reported a total of 22 deaths and at least 51 pending state confirmation. That jumped to 84 confirmed deaths the next day and then to 105 deaths by Aug. 22. By the following day, Aug. 23, that had risen to its current toll of 117 deaths.

“That’s data from the very beginning of the pandemic,” Falcon said of the recently confirmed deaths. “But they were numbers that were pending and for reason the state had just never certified them.”

In the last 14 days, he added, the county had three deaths.

“So these are all before the middle of August or so,” Falcon said.

Vazquez explained that when a patient dies in the hospital, the attending physician or the hospitalist must complete the record with a written diagnosis, which is sent to DSHS.

DSHS reviews the medical record and if COVID-19 is part of the diagnosis, it is automatically counted as a COVID-19 related death.

“Because you cannot say for sure whether it was or not,” Vazquez said.

That wouldn’t apply in extreme examples, he added, like if the person died in a car crash and also had COVID-19.

“But anything else — most of the time — yes, it will be a COVID-related death,” he said.

In addition to the 117 total deaths confirmed by the state, Falcon said that as of Tuesday morning, there were a total of 2,603 cases of the disease in the county. Of those who tested positive, 1,383 people had recovered and 1,069 were still considered active.

Over the last 10 days, the median number of new cases within the county was 23.

Prior to that, during the first 13 days of August, the median number of new cases was 47.

It’s unclear how the change in the way the county is gathering data has affected the numbers, if at all.

“In general, it seems like the state daily cases are down from the peak several weeks ago as are the fatalities,” Falcon said.

At Starr County Memorial Hospital, he said that in the last 10 days, there had been no deaths in their emergency room and there had been three transfers of COVID-19 patients.

As of Monday, there were five patients on high-flow oxygen, three patients on BiPAP, but there were no patients on ventilators. He added there were 19 COVID-19 beds available.

“Those numbers have all turned very positive and it’s a very good sign for our community,” Falcon said.

RENEWED ORDER

On Monday, Starr County Judge Eloy Vera renewed the county’s stay-at-home order that went into effect Tuesday morning and will last until 11:59 p.m. on Sept. 7.

“It does look a lot better in the county, especially at the hospital and our numbers are going down but that does not mean we’re out of the woods,” Vera said. “We’re still very concerned with a spike happening or anything like that so the reason for the order was to, hopefully, continue to improve on those numbers.”

The order asks all residents to remain at home and encourages all businesses, except essential services, to cease operations unless they can provide curbside, drive-thru, or takeout services.

It also imposes a curfew from 10 p.m. to 6 a.m. for people 17 years old and younger and a curfew from 11 p.m. to 5 a.m. for people 18 years old and older.

In accordance with an executive order issued by Gov. Greg Abbott, gatherings of more than 10 people is prohibited. Also in accordance with one of the governor’s orders, the use of masks in commercial businesses and public spaces when it is not feasible to maintain 6 feet of distance from others.

Falcon agreed with Vera and reflected on how Starr County had done well in containing the spread of the virus early on only to have the number of cases spike in May.

“We don’t want to revisit those days,” he said.

“In my opinion — and again, a lot of us have made a lot of mistakes — I think everybody 55 and over should continue to wear a mask until the day they get vaccinated,” Falcon added. “I know that that may be three months, four months but that and washing hands, and just being very careful with who we around, is what’s going to keep us safe.”