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Discrepancy in COVID-19 numbers arises due to 'probable' cases

WOAI San Antonio logo WOAI San Antonio 7/16/2020 Amanda Henderson
© Provided by WOAI San Antonio

Right now there’s a discrepancy in the numbers reported by Metro Health and those reported by the State Health Department.

The State Health Department has removed more than 3,000 cases classified as ‘probable’ from the Bexar County and state totals, which puts our local cases at over 17,000.

Those are cases confirmed with ‘antigen’ or mouth swab tests.

San Antonio Mayor Ron Nirenberg tried to review the discrepancies on Social Media. 

During Wednesday’s briefing the City announced a case total of 21,546.

That would include those 3,000 antigen cases.

Mayor Nirenberg said, he was not aware those cases had been removed from the state website.

Of those cases, 475 were reported Wednesday. Meanwhile there are seven new deaths reported, which puts our local death toll now at 208.

Metro Health released the following statement:

At the request of the Texas Department of State Health Services (DSHS), Metro Health is now separating COVID cases that were confirmed by a positive molecular test (PCR) from those that were detected by a positive antigen test combined with COVID-19 symptoms, otherwise known as “probable cases.”  Antigen tests were approved by the FDA for emergency use on May 8 and July 2, 2020, and they are considered very accurate in detecting the presence of COVID-19 in people with symptoms. The CDC includes positive antigen test results in its national count of COVID-19 cases, as does Metro Health in Bexar County counts. However, the State of Texas does not include antigen test results in its COVID-19 dashboard counts, despite collecting this data from local health departments and reporting it to the federal government.
“Probable cases do not mean ‘maybe’ cases of COVID-19,” said Dr. Colleen Bridger. “Antigen tests are FDA approved, and positive tests are highly accurate. San Antonio is one of only three Texas cities collecting and reporting this data per the CDC guidelines, but the State of Texas wants apples-to-apples comparisons between Texas cities.”
Antigen tests quickly identify people who are currently infected with the coronavirus by detecting proteins from the virus in nose and throat secretions. This is the same technology used in your doctor's office for rapid strep testing. By contrast, a PCR test, looks for genetic material.
When the FDA authorized the emergency use of antigen tests in the detection of COVID-19, it stated the following:
This latest FDA authorization is for an antigen test, which is a new type of diagnostic test designed for rapid detection of the virus that causes COVID-19. Each category of diagnostic test has its own unique role in the fight against this virus. PCR tests can be incredibly accurate, but running the tests and analyzing 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. Antigen tests are very specific for the virus, but are not as sensitive as molecular PCR tests. 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. With this in mind, negative results from an antigen test may need to be confirmed with a PCR test prior to making treatment decisions or to prevent the possible spread of the virus due to a false negative.
Antigen tests should not be confused with antibody tests, which detect a specific antibody in the blood that indicates the body’s response to a new or recent infection of COVID-19. Antibody tests, which are considered much less reliable that molecular and antigen tests, are not reported in San Antonio Metro Health’s case counts.
In response to the request from DSHS, Metro Health has separated confirmed and probable case counts in the data posted daily to the City’s COVID-19 website.
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