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Why COVID-19 testing information at the zip code level can be both helpful and harmful

CDC employee tests positive for coronavirus
Posted at 4:12 PM, Apr 03, 2020
and last updated 2020-04-03 16:12:39-04

COLUMBUS, Ohio — As COVID-19 test results increase across the state of Ohio, so do the ways to analyze and categorize the data. While a zip code is important to track where the virus is present, it can also lead to misleading conclusions and hurt patient anonymity, according to Ohio Department of Health Director Dr. Amy Acton.

Lack of widespread testing
Some of the more populated metropolitan areas of Ohio have been releasing COVID-19 data at the zip code level, which has prompted many to ask the same of the state. Acton said that data is helpful, and they’re looking at it, but it doesn’t tell you everything.

“It can look like you have a hot spot, but remember, what we’re telling you are cases—cases of folks who happen to be tested,” Acton said. “The majority of Ohioans, even when they’re being told by their physicians they have COVID-19, they’re not being tested, and so a hot spot might not be a hot spot.”

Acton said a place that looks like a hot spot on a map created with the data provided might be more of a reflection of the amount of testing available in the area.

“We have to be very careful how we interpret this. On a given street, we know that a lot of people might be asymptomatic but actually have the disease, or about to show symptoms of the disease, and using these case numbers doesn’t show you who’s now better,” Acton said.

Privacy issues
Focusing on zip code data can also take away an individual’s privacy.

Acton said that some zip codes in the state of Ohio may have fewer than 100 people, so to share testing information at the zip code level in those places could expose a person's identity, which could be a violation of the rights issued under the Health Insurance Portability and Accountability Act (HIPAA).

“We’re trying always to balance people’s individual private information with trying to share with you everything we know as we know it,” Acton said. “So please know that we’re in conversations, we’ll be sharing more and more layers of zip code.”

Acton is holding discussions with local health departments and her team to determine the best way to provide much-needed information in a way that does not disclose patient information, and that information will likely be able to be disclosed when more testing is made available and the results come in.

Acton followed up her explanation with a reminder to Ohioans about what the stigma of being sick during this pandemic can mean for a person.

“Remember, if someone is sick on your street or in your neighborhood, we needn’t fear each other. We really need to use all the guidance we have as the governor and I have shared with you about how we protect ourselves and how we help someone who is ill,” Acton said. “How do we help each other when we’re down? If you know about people sick in your neighborhood the first question should be ‘How can we help?’”

RELATED: Cuyahoga County releases updated map showing COVID-19 cases by zip code

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