Moe Responses

Response to Forum News Service by North Dakota Department of Health Communications
Director Marie Moe (April 1, 2022)
The move towards endemic state procedures includes a move toward how data is
reported for other diseases and conditions. Until recently, the disease surveillance
team had access to more complete testing information because the majority of testing
was being done through the State Laboratory, hospital/private laboratories, community
testing sites, and other entities testing for COVID-19 under a CLIA waiver or certificate.
Home self-administered tests have become more available and are not reportable to the
NDDoH. Compliance with reporting all test results, specifically negative test results from
antigen tests, is burdensome and unevenly reported to public health.
Positivity Rate
There are two key reasons that the surveillance team no longer can calculate the
overall positivity rate accurately as before. The first is the introduction of, and
increased use of at-home tests and the second is that negative antigen tests are
no longer required to be reported.
North Dakota does not require citizens to report the results of at-home tests and
cannot verify at-home test results. Those who test positive are encouraged to
take protective actions to isolate themselves from others and notify close
contacts to quarantine. As the state does not have the data from these positive
cases, we cannot track those that are hospitalized or died. This change also
means that we cannot compare all cases against prior positive test results or
vaccine records, thus affecting the ability to accurately report on reinfection.
The state cannot calculate the percent positive rate as before because all
positives are not recorded (e.g., home tests) and negative results are required to
be reported from NAAT (PCR) tests only, thus there is no denominator for the
calculation of the overall % positivity rate. Positivity metrics from ND data used
for CDC’s transmission levels will not be affected since these data are calculated
from NAAT or PCR test results.
Hospitalization Data & Reporting

With the changes in testing and reporting of data, information from hospital
admission data is more complete than relying on surveillance data.
Hospitalizations of people with COVID-19, not just those hospitalized specifically
for their COVID-19 infection, are important to track as both contribute to hospital
capacity and staffing resources. Additionally, individuals hospitalized in ND that
are not ND residents also contribute to hospital capacity and are not reflected in
case surveillance data.
Death Reporting
Vital records report only the primary cause of death. Surveillance reports include
those deaths as well as those who died and had a positive test and those where
COVID was a contributing or underlying factor.
The vital records information is the official record for deaths in the state. The
move toward endemic procedures as outlined above also applies to the
monitoring and reporting of deaths in the state. Since every COVID-19 case is
not investigated as before, most of the death reports will now be identified by
surveillance personnel through Vital Record death data.
The vital records information is updated monthly and will be provisional for the
current year. Surveillance deaths are reported to CDC and are on the COVID
Tracker dashboard, which is available accessible from the new NDDoH
dashboard via the link to the CDC COVID Community Levels link.
Long Term Care

In regards to long-term care data. Skilled nursing information is required to be
reported on the federal level and continues to be available (COVID-19 Nursing
Home Data - Centers for Medicare & Medicaid Services Data (cms.gov). The
NDDoH spoke with partners that were in agreement with the move to align
reporting with the standard for other diseases for long-term care. Citizens can
request data and information from those facilities as needed.
Disease Control records are subject to NDCC 23-01.3.-07 which reads:
1. Notwithstanding any other law, the state health officer may disclose confidential information
or protected health information to a health care provider or the public if the state health officer
determines that: a. Disclosure of information is required to prevent the spread of disease; b.
Disclosure of information is required to identify the cause or source of disease; or c. Disclosure of
information is required to allay fear and aid the public in understanding the risk of its exposure to
disease. 2. The state health officer may disclose protected health information only to the extent
necessary to accomplish the purposes of this section, and may require any health care provider
receiving confidential or protected health information under this section to keep that
information confidential under written terms.
As we move to endemic, releasing data like LTC by facility is not about

preventing disease or other reasons listed in our CC. This information is available
to the public via CMS and have notices at the door for visitors if they have cases
and are in outbreak status.
The information available on the new dashboard provides insight into the current state
of the disease in communities and statewide. It illustrates new cases by state and
county and also provides enhanced information about hospitalization for COVID and
non-COVID admissions. There are also links to the CDC COVID community levels,
vaccine dashboard and school dashboard which provide even more information for
citizens.
We recognize that the public became accustomed to the reporting of certain data as we
navigated through the pandemic. Collectively we have learned so much about the
disease, how it works and how we can protect our most vulnerable citizens. For years
we have yearned for normal, and now as we move toward living with this virus in an
endemic state, the type of information available and how it is reported will be aligned
with the type of information and reporting that is conducted for other diseases.
Follow-up responses to Forum News Service questions by Moe on April 6, 2022
We refined our dashboard to better reflect the spread of disease and the burden on our
health care system in the state. These changes align with the new COVID-19 Community
Levels and Indicators tracked by the CDC. The CDC is tracking and reporting this
surveillance data and NDDoH is linking to this resource from our dashboard for citizens
to make informed decisions. As previously provided, the vital records information is the
official record for deaths in the state. The move toward endemic procedures also applies
to the monitoring and reporting of deaths in the state. Since every COVID-19 case is not
investigated as before, most of the death reports will now be identified by surveillance
personnel through Vital Record death data. The link to the CDC surveillance information
is available on the NDDoH dashboard page. NDDoH worked with the long-term care
association, who worked with the long-term care facilities about the need for this
information to be published on the dashboard. The consensus was that the need no
longer existed for this to be published on the dashboard. As previously stated, residents
and families can get this information directly from the relevant facility.
FNS QUESTION: Where does the CDC get the number of COVID-19 deaths per week in North Dakota? Is
that figure still tracked by DoH personnel? Is the DoH passing that information on to the CDC?
MOE RESPONSE: NDDoH disease control team collects and reports surveillance data to the
CDC. Additional details were outlined in my original email.
FNS QUESTION: Just to be clear, can residents request case numbers for LTC facilities from the DoH or
only from the facility? If the onus is on the facilities, is there any law requiring they provide the case
figures to requesters?
MOE RESPONSE: This information is available to the public via CMS and LTC may place notices at the
door for visitors if they have cases and are in outbreak status. Facility level case information constitutes a
disease control record, release of specific information would be protected. LTC facilities have internal
protocols for notification and communication with residents and families.
FNS QUESTION: Did the DoH consult any LTC residents when deciding to discontinue publication of case
numbers from facilities?
MOE RESPONSE: The NDDoH consulted with the long-term care association, who works with the long-
term care facilities, about the need for this information to be published on the dashboard. LTC facilities
have internal protocols for communication about COVID-19 with residents and families.

Moe Responses

Uploaded by

Copyright:

Available Formats

Moe Responses

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Moe Responses

Uploaded by

Copyright:

Available Formats

Response to Forum News Service by North Dakota Department of Health Communications

Director Marie Moe (April 1, 2022)

Hospitalization Data & Reporting

Long Term Care

As we move to endemic, releasing data like LTC by facility is not about

You might also like