Hawaii Island CDC Hospitalization Level Errors

CDC's inadequate error checking fails to identify obvious data error, forcing masks at Hawaii Volcanoes National Park

After two weeks of publishing erroneous hospital data for Hawaii County that led to a CDC Covid level of High, triggering required masking inside federal buildings on the Big Island, the CDC has now corrected the data, and the island’s Covid level is back to Low.

Will CDC ever realize that their error checking algorithms are inadequate?

Hawaii Volcanoes NP Requires Indoor Masking and Cancels Indoor Programming

On Friday, November 17, CDC’s weekly Covid levels were published, and Hawaii County, which is the island of Hawaii (aka “The Big Island”), went from Low hospitalization to High hospitalization. As a result, on Monday, Nov. 20, Hawaii Volcanoes National Park Service announced on Twitter that indoor programs would be canceled and masking would be required indoors. The indoor mask requirement is due to a Biden Executive Order (EO 13991) issued Jan. 20, 2021, which requires masks on federal property when CDC hospital admission levels are high in a county. (It’s unclear why the national park also canceled indoor programming due to the hospital level change.)

The only problem? The data was highly suspicious. Based on a quick review of available data from a variety of sources, I felt confident at the time saying there was a “high likelihood” that the data was wrong. The CDC web site showed 75 new admissions from the most recent week, and a 733% increase in hospitalizations over the prior week, meaning the prior week had 9 new admissions. That kind of jump from 9 to 75 is extremely unlikely, and hospitalization data from the the State of Hawaii Covid dashboard showed a much lower rate of new admissions with a 7-day average of 7/day for the entire state of Hawaii (and Hawaii County has only 15% of the state’s population).

The Next Week…

A week later, on November 27, the CDC’s weekly Covid level update still had the island at High. The CDC web site said there were 42 new admissions from the most recent week, and a 600% increase in hospitalizations over the prior week. That would mean the prior week had only 6 new admissions (versus the 75 that was reported at the time). This suggested that the prior week’s data had been corrected and revised down from 75 to 6. Unfortunately, the CDC failed to consider that the 42 for the latest week was also incorrect. And again, the State of Hawaii Covid dashboard showed a much lower rate of new admissions. So, despite obvious data errors, the mask mandate continued at Hawaii Volcanoes State Park.

When I tweeted about this error for the second week in a row, Phil Kerpen (@kerpen) accessed the CDC’s facility level dataset to find where the error was coming from. It turns out, Ka’u Hospital incorrectly reported 69 new admissions for the week of Nov. 5, and 40 new admissions for the week of Nov. 12. The data file confirmed my suspicions that the earlier week had been corrected to remove the 69 erroneous admissions, but the latest week was not corrected.

Ka’u Hospital facility-level data from CDC, as of Nov. 27

Prior to these weeks, Ka’u Hospital had never reported more than 3 admissions in a single week, and the hospital only has around 20 beds! Proper data analysis and error checking should have been able to identify these obvious issues. A Twitter user called the hospital and informed the person in charge of this data collection of the situation so that it could be corrected. If not, who knows how long the CDC would have let this go on.

The footnotes on the page state that they review the data for errors and remove outliers, but clearly they are not doing a good enough job of this if a 20 bed hospital that has never reported more than 3 Covid admissions suddenly spikes to 69 admissions. If that’s not an outlier, what is?

“While CDC reviews these data for errors and corrects those found, some reporting errors might still exist within the data. To minimize errors and inconsistencies in data reported, CDC removes outliers before calculating the metrics. CDC and partners work with reporters to correct these errors and update the data in subsequent weeks.”

CDC Level Finally Corrected

On Friday, Dec. 1, the CDC’s weekly Covid level update finally has the island back at Low, with only 4 new hospital admissions for the entire week. This is shown as a 100% increase, meaning the previous week was revised down from 42 to 2 new weekly admissions on the island.

For two weeks, CDC published erroneous data that mandated indoor masking at a national park, and for some reason, caused indoor programming to be canceled. Now that the Covid level is back to Low, the mask mandate should be automatically lifted as of today (Monday, Dec. 4). Will indoor programming resume? Or was there something else behind that decision, and they just blamed it on the hospitalization level? So far, they have not posted an update to their Facebook or Twitter accounts.

For the past two weeks while they were in the High level, public health officials in Hawaii surely knew there was no concerning increase in hospitalizations. In fact, now that the data has been corrected, we can see that hospital admissions are falling in the state.

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Final Thoughts…

The CDC has shown time and time again they are completely unaccountable for their bad data. I emailed them twice about this issue (once each week that it was wrong), and I got no response at all — not even an acknowledgement that they received my message. In the past, I’ve usually gotten replies — at least auto-replies acknowledging receipt.

The Biden Executive Order requiring masks on federal property according to CDC recommendations should end. But also, if the CDC is going to publish hospital admission levels like this, they simply must improve their error handling, as well as be responsive when issues are identified by outsiders.