Alabama currently has the highest coronavirus positivity rate in the country.
Data from the Alabama Department of Public Health shows that the percentage of reported COVID-19 diagnostic tests that are currently positive is 35%. The next closest state, Iowa, takes 31 percent.
Alabama’s positivity rate has been high for much of the pandemic, reaching almost 50 percent this month. But as cases here and across the country declined after the post-holiday increase, Alabama’s rate remained the highest.
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Alabama’s 7-day average for new cases of the virus has increased slightly in the past few days, after dropping dramatically in mid-January, but an increase in cases does not explain the state’s positive rate.
There are two components that make up the positivity rate – new cases and the number of reported tests. In Alabama, and in many other states with high rates, the lack of testing is helping to increase the numbers.
As of January 27 – the last day for which state data was available for all states – Alabama had an average of 2,776 new virus cases per day and tested only 7,914 people per day. This year, so far, Alabama has reported 232,035 new tests – or about 5% of the state’s population. This is the fifth lowest percentage in the country.
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Each of the six lowest states, testing as a percentage of the population, is among the top six in terms of the positivity rate. These states are Alabama, Idaho, South Dakota, Iowa, Kansas and Pennsylvania. It is no coincidence – the lack of tests directly leads to a higher rate of positivity.
But there is another reason why these states may be at the top or bottom of those lists.
In Alabama, the test is counted by the number of individuals taking the test, not by counting each test used. It is one of four states to do so this way, according to data compiled by the COVID Tracking Project. The other three are South Dakota, Idaho and Kansas – each also close to the top in positivity rates. Several other states – including Pennsylvania and Iowa, partially report test data by individuals.
For example, a health worker in Birmingham could be tested once a week, but the data would only enter the Alabama system once. This difference in reports may mean that the test numbers for these states are being underestimated.
At the beginning of the pandemic, the World Health Organization recommended that governments target a positive rate of less than 5 percent to remove some restrictions.
ADPH said on Thursday that it does not expect its numbers to be affected excessively by people who repeat the tests.
“Since repeat testing has not been recommended since July 2020, patients should not take more than one test,” said state health assistant, Dr. Karen Landers, in an email to AL.com. “Thus, ADPH reports the number of individuals tested.”
And there are other potential problems with Alabama test data. All laboratories across the state that perform virus tests are required to report their data – both positive and negative test results – to ADPH. It is possible, and perhaps even likely, that some are not doing so.
In Fayette County, a small county in northwest Alabama, the rate of positivity, calculated from reported tests and reported cases in the past seven days, is 72.7 percent – the highest in Alabama. There were an average of 18.9 people tested per day reported in the last week in Fayette, and ADPH reported 13.7 cases per day during that period. But on some of those days, the state reported more new cases than tests carried out.
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Because of the various problems with Alabama test numbers, it is difficult to say what the actual positivity rate is. Page 10 of the ADPH coronavirus panel lists the positivity rate per week and limits the data to laboratories that report positive and negative tests. For the week ending January 23, the chart shows that Alabama performed 142,000 tests, with a positivity rate of 13.1%.
But many national organizations – including Johns Hopkins and Becker’s Hospital Review – cite the 35 percent positive rate. The difference can be problematic, since the positivity rate has been used as a key statistic in determining things like when to ease social distance restrictions and when to institute travel warnings.
Do you have an idea for a data story about Alabama? Send an email to Ramsey Archibald at [email protected]and follow him on Twitter @RamseyArchibald. Read more Alabama data stories On here.