Dashboard Envy: Comparing Humboldt County’s COVID Dashboard With Our Neighbors’–What Information Do They Get That We Don’t?

In the recently unveiled COVID-19 dashboard provided by the Joint Information Center of Humboldt County, new statistics were presented in hopes of better informing the public. With easy to digest visual presentation of graphs, charts, and percentages related to local cases, newly viewable stats on local demographics paint a picture of Humbold’s COVID-19 landscape. While the compilation is lacking detail compared to some neighboring county dashboards- not all dashboards are created equally -the new layout is more informative than the former daily press release of basic numbers, previously the only county-produced source of statistical data available.

The Humboldt County COVID dashboard presents new information not available before including: symptoms of patients, race demographics, data by ‘episode’, cumulative test rates including antibody test rate, and a more precise breakdown in age groups with COVID. The new dashboard includes demographic data that had been limited to a single end-of-week release, but now will be available to view on the dashboard, although still only being refreshed once a week.

A July 6th screengrab of Humboldt’s COVID-19 Dashboard showing symptomology of COVID cases locally. It will be updated monthly.

Data points that Humboldt’s COVID dashboard does not include but some other dashboards in Northern California do include are: current number of cases in comparison to cumulative cases, current hospitalizations or ICU occupancy, use of ventilators, number of patients currently in isolation, number of homeless in isolation or in treatment, demographic data within subsets, number of SNF or assisted living/congregate setting positive cases, comorbidities, employment data, specific city/town caseload, clinical data on homeless COVID patients, data related to surge capacity, and other more nuanced statistics.

Many counties have been able to present detailed information regarding current case trends, in contrast to cumulative data trends, to detail not only the number of cases and respective demographic data, but also to reflect a more accurate hospitalization capacity. Dr. Frankovich stated on June 30th that she considered information about ICU capacity off limits, explaining that Humboldt is too small a community to be able to safely release that information. She stated,

That is just people wanting information that actually does relate to patient privacy, and that we just can’t compromise on- and particularly in small communities -where people are there, it’s you know, you have one person hospitalized in Los Angeles- it doesn’t really hurt to report that. You have a person hospitalized because that’s not identifiable.

When you start to talk about smaller communities, and whether someone’s in the hospital or the ICU or on a ventilator, it starts to become more identifiable about what their diagnosis might be, and so we really walk that edge all the time in public health. People need to feel confident that their information will be protected.

While Humboldt County Public Health Officer Teressa Frankovich has been unwilling to specify the number of ICU beds in the county that are either currently occupied or still available, or even the number of patients being treated in hospital at any given time, many surrounding counties have been disclosing that information without hesitation.

HOSPITALIZATION AND ICU STATISTICS:

Humboldt County’s dashboard, and its daily statistical updates, do not include data reflecting the number of Intensive Care Unit COVID-19 patients. Humboldt’s dashboard also does not show the number of people in hospital care at any given time. This is important data for monitoring what is considered surge capacity for a local hospital system. As the medical industry copes with the influx of patients needing respiratory care, ventilators have been in short supply across the nation, and the only place to find a ventilator in a hospital is with an ICU bed. Many advanced dashboards not only show the ICU capacity on any given day, but some also note how many ventilators have been in use. That information is not included in Humboldt County’s COVID-19 dashboard or any other form of public data release.

Even in counties with fewer cases than Humboldt and equally rural jurisdictions, current ICU and current hospitalization stats are being made public in the interest of public health and safety. This is in contrast to the public information policy upheld by Humboldt County Public Health Officer Dr. Frankovich, who has stated on many occasions that such data will not be released as public information in Humboldt County. Dr. Frankovich maintains that numbers related to current hospital capacity in Humboldt County are too sensitive to release. This is contradictory to many health departments and public information policies implemented by Health Officers across the state, which do disclose statistics regarding current hospitalizations and treatments in general, not specific to any one patient.

Screengrab of part of Humboldt County’s new COVID-19 Dashboard which shows the July 6th updated hospitalization data as a “running total” and does not displaying current versus total over time, as most counties are doing.

Yuba County is one example of a rural county with less cases than Humboldt, where current versus cumulative data collected from COVID-19 cases is presented. In the dashboard for Yuba County, the option is given for the public to view current or ‘over time’ data for testing numbers as well as numbers of case status such as how many people are ‘in isolation’ or ‘hospitalized’ for treatment.

 A July 6th screengrab from the Yuba County dashboard shows that 19 people are currently hospitalized, while a total of 49 have been hospitalized since the pandemic began.  This is out of a total of 414 positive cases within the county since testing was made available in March. 

As it stands, Dr. Frankovich and the Humboldt County Department of Health only release cumulative data, but have encouraged the public to do the math if wanting to know how many active cases are in the county, or being hospitalized. Frankovich was asked by RHBB in a Media Availability on May 20th, “[O]f those with confirmed active positive tests so far, how many are asymptomatic, how many have symptoms, how many are currently in the hospital, and how many are currently occupying beds in the ICU?”

Dr. Frankovich replied, “We don’t comment on people‘s specifics- who’s in the hospital and who is not- but you can certainly look at the total number of individuals of our positives, who’ve required hospitalization just by looking at the hospitalization number.”

By comparison, the nearby counties of Mendocino, Lake, Shasta, and even Del Norte -which are equally as rural as Humboldt and have less COVID-19 cases- are releasing current hospitalization and current ICU data, as opposed to cumulative data.

A screengrab from July 6th of Mendocino County’s dashboard is colorful and small, is also provided in Spanish, and effectively conveys basic information including current hospitalization and ICU numbers, but does not show the total number of people hospitalized over time as does Humboldt County’s dashboard.

In the most recent Media Availability session of July 6th, the RHBB asked Dr. Frankovich if she would reconsider the information release policy as it pertains to COVID-19 currently hospitalized patients, stating in the Q&A, “Mendocino and Lake counties both are very rural like Humboldt, each has fewer total cases than we do as well as smaller populations, and yet they release current hospitalization data. Could you please provide that information or explain why you feel our situation is different than theirs?”

Screengrab of the California COVID-19 dashboard for ICU capacity of Humboldt County, July 6th, which estimates that 11% of ICU beds are available, but also states that the county is “Not on Monitoring List” as a side note.

While Dr. Frankovich acknowledged the changing protocol around disclosures of that type of information in the time of COVID, she was still not ready to produce those numbers directly for public awareness. The Public Health Officer instead referred to the state dashboard which produces estimates of each county’s currently hospitalized COVID-19 patients.

Dr. Frankovich stated,

Well, you know, I think we’ve talked about this before. Public Health has historically had great sensitivity to concerns about revealing people’s identities- basically, publicly stating their confidential health information. I think most of us appreciate the fact that that’s a good idea. You know, that we don’t want our personal health information discernible to our neighbors. And so in small communities, if your neighbor gets hospitalized, and then you hear there’s a new hospitalized COVID patient, sometimes that’s enough to make you go “Hmmm, I think that’s what’s going on here’, that type of thing. And so for that reason, historically again, Public Health has not put out small numbers at a time…
However, COVID seems to be a different environment and information that would normally not be given out however, is, and it’s actually now becoming available at the state level. What we’d like to do actually is, there is a state website that reports sort of on daily hospitalizations, so will make that site available to the public, provide that link so you can see that information if you were interested. It may not be exactly accurate on a day-to-day basis, but it will give people a general idea about hospitalizations.”

Counties in the Northern California region which have included current hospitalization rates in comparison to cumulative numbers (many including ICU occupancy) within their COVID-19 dashboards are: Sacramento, Mendocino, Shasta, Placer, Butte, Del Norte, Lake, Sonoma, Napa, Sutter, El Dorado, Glenn, Yuba, Sutter, Santa Cruz, Monterey, Santa Clara, Marin, San Francisco, San Juaquin, Solano, Alameda, Sacramento, and a few more.

Screengrab of Sacramento COVID-19 dashboard, showing current ICU cases and hospitalizations on July 6th, as well as number of infections currently in congregate living facilities in Sacramento County.

In Sacramento County where the total number of confirmed cases is over 3,000 and the county population is over 1.5 million residents, their dashboard is far more technologically advanced and enviable in terms of detail. Considering the need for emergency room availability and ICU beds to cope with a surge in cases, knowing how much space is available or how many ER visits are occurring can help a community understand the level of risk of potential community spread of the virus.

RACE DEMOGRAPHICS OF COVID PATIENTS:

An exciting addition of information released with the new Humboldt County dashboard is the chart of race demographics of COVID-19 patients, which will be updated once per week. On June 10th, in a Media Availability Q&A, Dr. Josh Ennis replied to RHBB’s question about supplying additional statistics to the public, explaining that some particular data is not currently being collected by county hospitals or by the state, but that race demographics were available and Humboldt was not yet making that information public. Ennis acknowledged that this information was of particular interest to the community, stating that “as far as each of these (data points) goes, we are collecting some more demographics other than just what we’re reporting on. Race is a big one.”

Now, with some additional data about the positive cases being presented, community members are able to get a slightly better picture of what the infection rates are looking like over the long term. There is added insight now that race demographics are now being released. The categories of race breakdown include the usual options of multi-race, other, Latino/Hispanic, Black, Asian/Pacific Islander, Native American, White, and ‘not Latino/ Hispanic’.

While Humboldt’s Latino population makes up around 12% of the county (according to census data), the county’s COVID-19 data reflects a disproportionate exposure among that group, showing that over 22% of those testing positive were Hispanic/Latinos and almost 35% were Latinos/not Hispanic.

Screengrab from California COVID-19 dashboard on July 1st showing infection rates broken down by race and compared to the population’s total percentage, with Latino Californians clearly testing positive for COVID over three times the rate of other groups.

The infection rate among Latinos/Hispanics populations reflected across the state compared to our data in Humboldt County both show that demographic is being impacted at a much higher rate than other demographic groups. The state’s dashboard, which incorporates multiple data sources, is currently showing over 55% of statewide Covid-19 cases are among Latinos, which accounts for only about 39% of the California population. By comparison, though Humboldt’s COVID-19 infections among the Latino community are even higher. We are seeing a rate of infection nearly double their population percentage in the county.

Dr. Teresa Frankovich recognized the effect on Humboldt’s local Latino community, on June 24th stating “We are seeing these communities impacted both in terms often of number of cases as well as complications from cases. Obviously, there may be language barriers, and so we’re really trying to address that and really trying to get information out so that people are aware about what precautions need to be taken, and what they can do if they become ill.”

Screengrab of Humboldt County’s COVID-19 Dashboard showing the chart of race demographics July 7th, 2020.

Considering that public information is a key factor in having an effective community response to the pandemic, public health officials were excited to complete the dashboard project before a serious hospital surge occurred locally. At this point the data is not presented in Spanish as well, in order to accommodate the segment of Humboldt County which does not speak English. There are some informational fliers translated from English to Spanish, but this does not include the data analysis or dashboard.

EMPLOYMENT OF COVID PATIENTS:

In June, Humboldt County Public Health Deputy Dr. Josh Ennis stated, “We are looking at creating a dashboard that is available that can give some of this information for people to look at. Essential workers as well, is something that I know the state is starting to look at- they have a surveillance project ongoing that our county is looking at participating in, and so we hope to have a little more information regarding that as well, to try and find out what occupations or settings expose people to more risk of contracting the disease that haven’t been identified yet.”

When RHBB asked about what type of information might be made public, Dr. Ennis noted that while income and education level would be interesting to know, he said that locally, health officials were not collecting that information, and he was not aware of the state collecting that specific data either. However, some counties had been collecting employment information, and have included that data in their impressive COVID-19 dashboards.

For instance, in Sonoma County, a dashboard not only breaks down race demographics and case severity, but lists the percentages of patients by occupational industry. This can be helpful for the public to understand the outbreak in terms of proximity to their individual routines and potential exposure to industries reflecting greater infection rates.

Screengrab of Sonoma County Dashboard July 6th, showing data on COVID-19 patients’ employment status and industry type.

In Humboldt, many concerned members of the public have called the local COVID-19 hotline (707) 441-5000 asking which businesses or workplaces have confirmed infections, in an effort to avoid these establishments out of precaution. Rather than identify the specific locations of confirmed cases, the data collected about employment is presented by industry type in order to give the public a general idea of which workplaces may be potentially more at risk. While this particular background information regarding employment is not available in many counties across the state, some have been tracking and including this feedback, and more, in easy to understand charts and pie graphs on their COVID-19 dashboards.

HOMELESS WITH COVID:

The only dashboard in Northern California found to include the number of homeless individuals placed in temporary housing for isolation was done by Yolo County, where they noted on June 30 having housed/isolated 124 homeless community members.

Screengrab from July 6th Yolo County COVID-19 dashboard, presenting less common stats such as neighboring counties’ total cases, number of homeless being housed, and a more specific age breakdown than most dashboards.

Some counties in the bay area are including data from the homeless population in their dashboards, even taking note of demographics within that group.

San Francisco has an entire dashboard dedicated to homeless COVID-19 data, showing how many beds are available in this screengrab of July 1st.

In Humboldt County, it is unknown exactly how many homeless people have become infected with the novel coronavirus, but it has been acknowledged that the temporary housing and isolation services offered to them locally have been used. According to the OES, Humboldt County has been isolating unhoused individuals in available hotel rooms while they wait being cleared as ‘recovered’, but it is unknown exactly how many people have been given this housing service.

DASHBOARD CURB APPEAL:

As a resource for public information, dashboards are meant to make complex information simplified and visually digestible for any community member. An enviable dashboard produced by Sacramento County is clear and colorful, and contains multiple types of graphs and data sections, as well as being easy to navigate and understand.

Screengrab from Sacramento County COVID dashboard taken July 1st shows percentages of deaths per sex, ethnicity, and age group.

Although the charcoal background and dark pastels of Humboldt County’s dashboard do a decent job of contrasting the various graphs and charts, the information being presented is often less specific than what is being disclosed by neighboring counties. Granted, some counties don’t even have a dashboard to brag about, so Humboldt County is presenting more data than some areas, such as in Modoc County where not a single case has been confirmed, and Trinity County which has a simple table.

Humboldt COVID-19 Dashboard episode curve chart and transmission pie graph of July 6th.

Dr. Josh Ennis stated recently in a Media Availability that as a county, our rural area is “early in this” and, as Dr. Teresa Frankovich, Humboldt County’s Public Health Officer also stated on June 1st, “We have not seen a surge of COVID yet.”

A new Covid Minute video released by Humboldt County’s Joint Information Center on Monday explains that the dashboard is “a work in progress” meant to empower the community with accurate information related to the county’s disease spread. We’re looking forward, hopefully, to seeing some of the information available in other counties, available here soon.