Texas failing to count thousands of rapid Covid test results in official case total, report says

Department of Health Services says antigen positive's not included as they are only 'probable'

Texas is failing to include thousands of rapid coronavirus tests from the state’s official case total, likely providing an inaccurate impression of the outbreak in the state, a report has said.

The government’s official coronavirus data reports 442,014 infections in the state, however, a report by The Houston Chronicle has suggested that these numbers do not include all Covid-19 patients.

State officials are excluding rapid 30-minute antigen tests used in doctor’s offices, hospitals, and stand-alone clinics from their public total, the newspaper said.

An analysis by the outlet using statistics from 11 Texas counties that publish statistics on these tests results separately suggested that the infection count could be underestimated by at least tens of thousands of cases, and likely even more.

The Department of State Health Services (DSHS) told KTRK that the rapid antigen tests provide “probable”, not positive cases, and therefore it does not include probable cases in overall totals and that this is in line with Centres for Disease Control guidelines.

“The cases that feed into our positive test results, those that we’re showing on the website, are those by polymerase chain reaction (PCR). It’s a test that looks for the virus’ genetic material,” spokesperson Chris Van Deusen told the broadcaster.

The US Food and Drug Administration (FDA) approved the antigen test in May under an emergency authorisation but noted that the tests are considered to be less reliable than results from PCR tests, sometimes providing false-negative results.

“PCR tests can be incredibly accurate, but running the tests and analysing the results can take time. One of the main advantages of an antigen test is the speed of the test, which can provide results in minutes. However, antigen tests may not detect all active infections, as they do not work the same way as a PCR test,” the FDA wrote.

“This means that positive results from antigen tests are highly accurate, but there is a higher chance of false negatives, so negative results do not rule out infection.”

The Chronicle said that conflicting guidance from the Texas Department of State Health Services created confusion among local health departments about what test results should be reported, leading to a backlog of antigen recording and the deficit in state information.

The DSHS told KTRK that it was not trying to suppress information but give an accurate impression of the state of the outbreak in the state.

“We always want to share the most accurate and reliable information we can,” Mr Van Deusen said.

“That’s what helps inform our response to the virus and what we know helps inform local officials and individuals as well. People rely on this to make decisions about their families, about what they’re doing, about their businesses. And so it’s incredibly important.”

Officials and experts have said they believe all positive results should be included within the overall numbers.

“I think we should count all of the tests,” Democratic Congressman Al Green told KTRK.

“I’m disappointed to hear we are not counting these tests. I know of some of these facilities where these rapid tests are taking place and I know of persons who have gone in and they have found that they were positive. That rapid test was a valid test and it has saved lives.”

Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston said reporting both results from antigen and PCR tests “gives you a better idea of what’s happening in the community.”

The state has seen s surge in cases throughout June and July, reporting over 15,000 positive cases of the disease in one day at the height of its peak, according to a case tracker by The New York Times. Almost 8,000 people are reported to have died in the state from the disease.