Florida missed 17% of COVID deaths early in the pandemic, had incomplete info on cases, auditor says
Florida health officials missed thousands of COVID-19 deaths in 2020, had incomplete information for millions of tests and spent millions of taxpayer dollars on testing that lacked vital data, according to a state report released Monday.
From September 2020 through November 2021, the Florida Auditor General’s Office examined nearly 11.3 million laboratory test results and nearly 730,000 coronavirus cases documented statewide in 2020 from March 1 to Oct. 8.
The investigation found 3,082 COVID deaths reported by physicians that the state Health Department did not include in its official counts. Those victims would have pushed the state’s reported death toll on Oct. 8, 2020 to 18,336, up from the official count of 15,254.
The victims the auditor discovered account for 17% of that new total.COVID comeback:Much of Florida at high risk of straining hospitals; indoor masks urged
A majority of the 5.5 million-plus COVID test results — 51.5% — lacked information about the race of those tested. About 59% lacked ethnicity information. Hispanic people are Florida’s largest ethnic group.
By mid-May 2020, 25% of Hispanics and 20% of Black people tested positive for the virus, compared with about 11% of whites, The Palm Beach Post found in examining nearly 200,000 test results the Health Department had not made public in which individuals reported their race or ethnicity.
Labs that got more than $5.4 million from the state in July and August 2020 did not include information such as ID numbers or dates for COVID tests administered. As a result, a number of test results did not make it into public state reports.
Just 38% of a sample of 2,600 tests conducted by three unnamed state-contracted labs returned results.
The Florida Division of Emergency Management oversaw state-led testing sites. The director at the time, Jared Moskowitz, is now running for Congress as a Democrat in a district spanning southern Palm Beach County and northern Broward County to replace outgoing Democratic U.S. Rep. Ted Deutch.
Moskowitz declined to comment on the state auditor report, directing questions to current Emergency Management Director Kevin Guthrie, who did not return a phone call Tuesday afternoon.
State COVID reporting:Florida to update COVID-19 data less frequently than all other states
The investigation found that the state Health Department routinely failed to analyze the integrity of test results. So auditors checked the results by looking at Florida NFL teams because of the predictability of their testing regimen, requiring players in training camps to take three COVID tests before entering their team’s buildings. Players also were tested daily during the regular season.
Compared to the Buccaneers and the Jaguars, the Health Department collected far more test samples from the Dolphins, usually from more than 80 players between July 19 and Sept. 27, 2020.
The audit could not find 39 players’ test results in the state Health Department database for one game day. The department said results for players without a Florida address were sent to their state of residence. That state was supposed to forward the results to the Florida Department of Health, but that may not have always happened.
“A part of me feels like so much of this is due to initial incompetence and lack of prioritization,” said state Rep. Anna Eskamani, an Orlando-area Democrat.
The state did not conduct contact tracing for about 23% of the nearly 730,000 COVID cases auditors analyzed. Contact tracing is done by health authorities to identify, assess and manage people who may have been exposed to the disease to prevent further transmission. And 14,233 of those infected people had no phone number or email address attached to them.
“Whenever you travel to other states, there's much more of a contact tracing, Eskamani said.
“It is possible that pandemic conditions led to more death certificates being completed by physicians or medical examiners who had limited knowledge of the patients and by officials facing significant workload pressures,” a report commissioned in 2020 by Republican House Speaker Jose Oliva of Miami Lakes said in October that year.
But the missing 3,000-plus fatalities state auditors found were recorded by the state Bureau of Vital Statistics, collected from physicians. Although doctors determined COVID to be a main cause of those deaths, the state Health Department does not plan to include them in Florida’s death toll.
The Bureau of Vital Statistics COVID-19 death tally comes from death certificates. The Health Department's count is more restrictive.
If COVID testing was not performed, happened more than 30 days before a death, was not reported to the department, or could not be matched to a bureau record because of “data quality deficiencies,” the department did not count the fatality in their official statistics, it said in its response to the audit.
“This is why you shouldn't underfund government agencies,” Eskamani said, referring to the state Health Department.
From 2010 to 2019, the state cut the department’s budget from the equivalent of $57 for each Florida resident to $34, a report by The Associated Press and health policy nonprofit Kaiser Family Foundation found. Its workforce fell from 12,422 full-time equivalent workers to 9,125.
Palm Beach County-area state House Reps. Mike Caruso, a Republican, and Emily Slosberg-King, a Democrat, who sit on the chamber’s Pandemic and Public Emergencies Committee, could not be reached Tuesday for comment.
“When you fire the most qualified people and treat them the way I was treated, nobody wants to work for you,” former Health Department data manager Rebekah Jones said. The department fired Jones in May 2020, she contends, because she refused to manipulate coronavirus data.
The department conducted an internal investigation and acknowledged in a report released May 26 that Jones’ supervisors ordered her to temporarily remove COVID-19 data from public view, which happened after The Palm Beach Post first reported that state data showed the disease was infecting people as early as January 2020.
After reading about the fatalities unaccounted for in Health Department statistics, Jones said, “If this is what's missing from the first six months when deaths were relatively low, what do you think was happening in 2021 during (the delta variant) when we were the worst state for deaths?”
Chris Persaud is The Palm Beach Post's data reporter. Email him at email@example.com.