Solano Public Health Director explains this week’s huge increase in COVID cases

By Roger Straw, Friday, March 11, 2022

Dr. Bela Matyas, Public Health Director with the Solano Public Health Department (Chris Riley/Times-Herald)

In the March 6 Fairfield Daily Republic, reporter Todd Hansen wrote about his phone interview with Solano Public Health Director Bela Matyas: “Solano County expects to receive a significant report of previously unreported cases that were identified through a different testing procedure.”

Sure enough, in the County’s March 7 COVID Dashboard update, Public Health reported a whopping 4,115 previously unreported cases in Solano County, and 71 previously unreported cases in Benicia, unprecedented increases and huge numbers by any measure.

I wrote to Public Health Director Dr. Bela Matyas asking for clarification:

Dr. Matyas –

Please explain the meaning of reporter Hansen’s “different testing procedure.”  What accounts for these dramatic increases?

I agree that the numbers show cases declining. But what these revelations clearly do show is that previous updates were vastly under-reported. Are you going back and updating the dates where these new cases were discovered, showing a higher curve?

How is the public to understand in detail what WAS our experience with COVID over the period when these cases were not being uncovered and reported?

Dr. Matyas gave me permission to share his email explanation:

Hi Roger,

The State’s COVID-19 database, CalREDIE, collects several types of laboratory data for COVID-19, including pcr results, rapid antigen test results and serology results.

According to the State, only the pcr results are counted as confirmed cases, and the State’s total of cases for each county represents these confirmed (i.e. pcr-posititve) cases.

For most of the duration of the pandemic, we have noted that the State’s reported case count for Solano is different from our own count.

In continuing to investigate the reason(s) for this, we recently learned that

      • the State’s count of confirmed cases for Solano included several hundred persons whose only laboratory evidence of disease was a serology for COVID-19 (serology is not approved by the FDA for diagnosis, except for Multisystem Inflammatory Syndrome of Children [MIS-C]),
      • and it included several hundred persons whose laboratory result was a positive rapid antigen test.

Among those with serology results only were 33 residents who had been hospitalized in out-of-county hospitals (e.g. John Muir), and the diagnoses based only on serology were nearly all from mid-2020 through 2021.

As for the cases with positive rapid antigen tests only, it is difficult to discern a pattern to identify which of these were counted as confirmed cases and which were counted as probable cases (and not, therefore, included in the case count for the county). It is noteworthy, however, that over the last several months, use of rapid antigen tests to diagnose COVID-19 cases rather than use of pcr tests has become increasingly prevalent; in fact, in a growing number of circumstances, the rapid antigen test has become the preferred test for diagnosis and is the test recommended by the State.

Based on this, we decided to remove from our county case count those persons whose diagnosis was based on a serology test only, and this included 33 hospitalized individuals.

By contrast, we decided to include in our county case count those residents whose diagnosis was based on a rapid antigen test only.

The resulting math was to:

      1.  Delete 409 serology-only cases (including 33 hospitalized);
      2.  Add 4410 rapid antigen-only cases; and
      3.  Add 114 cases diagnosed over the prior three days (including 3 hospitalized).

The net result, therefore, was an increase of 4115 cases and a decrease of 30 hospitalizations.

With respect to your specific questions below, yes, the previous updates were significantly under-reported (particularly for January and early February). We do go back and update each of the line curves with date-appropriate data every time we post a new update to the dashboard.

I think it’s difficult for the public to understand in detail what we are experiencing when there are significant issues with data accuracy; we still have significant under-reporting of positive rapid antigen tests from long-term care facilities, from home testing and from pharmacy testing.

I hope to publish a local reflection on Dr. Matyas’ rather complicated explanation.  Stay tuned.  – R. S.

>Reference the Solano County COVID-19 Dashboard where you can hover a mouse or click on an item for additional information.  Note the tabs at top for “Summary, Demographics” and “Vaccines.”  Click here to go to today’s Solano County Dashboard.

See also my BENINDY ARCHIVE of daily Solano COVID updates (an excel spreadsheet).  I have also archived the hundreds of full CORONAVIRUS REPORTS posted here almost daily on the Benicia Independent since April 2020.