When a visitor comes to Moab and starts experiencing symptoms of COVID-19, they can go to Moab Regional Hospital to get a free test. However, they will have to wait a few days for their results to come back, by which time their vacation may already be over.
When a visitor in such situations tests positive, where should that case be marked? Should it be marked where they tested positive, or their place of residence?
The standard approach, according to Southeast Utah Health Department Director Bradon Bradford, is to count the person where they permanently reside. Locally, exceptions are made when a person with the coronavirus receives care in Moab for “an extended period of time,” according to Bradford; in that case, their positive test result gets marked down as part of Grand County’s tally.
“Unless we’re taking care of them, their investigation will be conducted by their home health department; we won’t have access to their information,” Bradford said. “That health department should then notify their contacts or notify us about potential exposures.”
As of Tuesday morning, July 8, the health department’s tally of COVID-19 cases in Grand County was 21, all of them in county residents. As of ‘Tuesday, the hospital had administered 27 positive test results, according to Bradford.
“[How we are counting cases] is a standard protocol and is also reflected in the fact that we are counting three or four cases whose home address is in our area but who have been residing elsewhere before and during illness,” Bradford said. “It’s not perfect, but that’s how it’s set up.”
By Moab’s nature as a tourism destination, the number of visitors who come through the city relative to the number of permanent residents is high, compared to other cities and counties in the U.S. This means the area can see a disproportionately high number of people who test positive for the coronavirus at the city’s local testing location but who are not counted as Grand County cases.
Due to this and other challenges with counting the number of visitors who have COVID-19, the per-capita case count in Moab skews lower than what it would if testing for the coronavirus was fast and universally available.
All of this makes the number of new daily cases in Moab an imperfect proxy for how well-controlled the virus is locally and how much risk locals face. However, at this point, this counting quirk is not too concerning for Bradford.
“At this point, I am not concerned about underreporting in Grand County,” he said. “It’s only been within the last week or so that we’ve had a significant number of individuals test positive that did not live in Grand County. Since we started testing, I think we’ve had one or two others that were from out of the area that also returned home immediately.”
Other testing-related effects likely have a far greater impact on the reported number of positive test results in the area. Recent data from a study by the U.S. Centers for Disease Control and Prevention inidcate that the actual number of COVID-19 cases in Utah is 11 times higher than the number of positive test results the state reports.
A more localized, ongoing study estimating the prevalence of the virus in Moab by counting viral particles found in city sewage also suggests that the number of positive test results reported by the health department undercounts the actual number of cases, though by how much remains unclear.
While tallies of hospitalizations and deaths attributed to the coronavirus provide an indication of the most fundamental toll the virus is exacting, the grievous nature of the disease is such that individuals have gone days, weeks and in rare cases months before ultimately succumbing to it.
Case rates, despite statistical imperfections, continue to provide one of the most real-time, reliable measures of risk posed by the pandemic.