In Louisiana, people can analyze how COVID-19 deaths correspond with race and underlying health conditions using publicly reported state data.

In Connecticut and Massachusetts, details on long-term care facility cases are included in state data.

Several states provide heat maps by zip code or city, showing where identified cases of the virus are most prevalent.

But in Arizona, the state health data about coronavirus cases that is publicly provided seems to be just above the bare minimum, based on an analysis by The Arizona Republic of COVID-19 data released daily by state health departments in each state and Washington, D.C.

That should improve in the coming week, because Gov. Doug Ducey issued an executive order Tuesday that requires more data reporting to the state related to COVID-19. The move came after The Arizona Republic reported on growing frustration and confusion about the limited information.

Hospitals now must report daily to the state several new statistics related to positive or suspected COVID-19 patients.

Those include the:

Number of inpatients.

Number of ventilators in use.

Number of intensive care beds in use.

Number discharged from the facility per day.

Number seen in the emergency department per day.

Number of intubations performed per day for respiratory distress.

Estimated number of N95 masks, surgical masks, face shields and surgical gowns used per day.

Publicly reported data inform people’s understanding of the virus, how it is playing out and how they can make the best decisions for themselves, their families and their communities.

The new coronavirus, which causes COVID-19, has spread quickly. It’s a new virus, meaning the manner of its spread is being tracked in real time. That presents challenges for health officials, who are responsible for managing how the state responds to the virus, and for everyday people, who are trying to figure out how to stay safe.

What other states disclose

The Arizona Department of Health Services each morning releases statistics, including total cases, deaths and tests, as well as cases and tests by county, age and gender. This basic portfolio is provided by most other states.

But a number of other states disclose additional information Arizona does not. This includes hospitalization and intensive care unit numbers, deaths by county, cases by ZIP code or city, cases by race and ethnicity, recovered cases and breakdowns of how people got infected.

There are two data points in particular the majority of states provide but Arizona does not: hospitalization numbers and deaths by county. Instead, some counties are individually reporting the number of deaths and hospitalization numbers, while most are releasing little information.

Thirty-five states show hospitalization data on their COVID-19 dashboards and 33 states provide the number of deaths in each county. Arizona’s state dashboard has neither of those points of information.

Trying to compile the information county-by-county proves difficult. The Republic requested hospitalization rates from all 15 counties last week. Eleven counties provided the information, three said they didn’t have the information, and one, Yuma County, declined to provide it.

Even counties are having trouble figuring out these numbers. Pinal County spokesman James Daniels told The Republic last week that 11% of positive cases were hospitalized, 30% were not hospitalized and the county was unsure about the other 59% because of communication gaps between the state-reported information and cases counties are tracking.

In terms of county death numbers, larger counties such as Maricopa, Pima and Coconino report daily death updates. But most other counties do not, making it difficult to understand in which counties the state’s deaths — counted at 73 on Tuesday — happened.

Nine states provide daily case breakdowns by race and ethnicity. Arizona does not do this, either. The New York Times reported that the coronavirus is disproportionately killing African-Americans due to disparities in health resources and access to care. The statistics are preliminary but based on state and city data. Arizona’s data on race and ethnicity remains unknown.

Several states provide downloadable raw data spreadsheets with day-by-day case information. Many have interactive ArcGIS dashboards showing cases across the state. Washington, D.C., provides information on case numbers for public safety and human services personnel. Louisiana, Oregon and North Carolina show numbers on ventilator use.

New Hampshire lists the number of people being monitored for COVID-19 as well as specific places people visited while infected. Ohio and South Carolina present forecast models and projections for how the virus may continue to spread in the states. And North Carolina shows how many outbreaks there are in nursing homes, residential care facilities and correctional facilities.

Other states have struggled to compile comprehensive, statewide data. In California, for instance, individual counties are providing more detailed information while the state dashboard has minimal information. The New York Times described a lengthy process to compile an adequate picture of California’s cases using city and county data, which varied widely in terms of breadth and format.

In Kentucky, little information is provided beyond the overall numbers of cases, tests and deaths. The only other readily available data on the state health department’s coronavirus webpage is a map of cases by county.

Arizona to expand data disclosure

Dr. Cara Christ, the Arizona Department of Health Services director, announced Tuesday the state’s case dashboard on Sunday will expand with more data.

“This data will allow us to better prepare for our peak in cases and it will help us identify a better recovery rate for Arizonans affected by this disease,” Christ said.

The state’s dashboard should include more information than it has so far, Christ said, such as enhanced location data for confirmed cases, more information on deaths and more information on supply distribution. It’s not immediately clear what additional data from the executive order will be added Sunday to the dashboard.

The state doesn’t have the number of those who have recovered from COVID-19 because if the person was tested at a commercial lab and didn’t require follow-up care, their outcome isn’t known, Christ said. Later, the state will match cases against data on deaths, which could assess how many recovered from the illness, she said.

“There’s not a great way to look at what a definition of recovered is,” Christ said.

Eleven states report the number of “recovered” cases or people not required to be isolated on their data dashboards.

Will Humble, executive director of the Arizona Public Health Association, said Ducey's new executive order should help with data collection and, ideally, public reporting. Behind the scenes, the data can help health officials understand where support is needed and which hospitals could be reaching capacity. Now that it’s clear the state will have this information, there’s probably more benefit than risk in reporting it publicly in a non-identifiable way, he said.

Publicly reporting aggregate information, such as hospitalizations and recoveries, helps people make decisions on how to live their lives, but it also contributes more broadly to a sense of public trust, said Humble, who previously served as director of the state health department. If the public trusts their officials and the information they’re receiving, they’re more likely to listen when officials ask for behavior changes such as social distancing, he said.

“I think it’s valuable in the sense that the public appreciates and deserves transparency from the people that they elect and the appointees that work for them,” Humble said.chri

Balancing disclosure with privacy

While the public is hungry for as much information as possible about cases and outcomes in Arizona, there are privacy and confidentiality concerns to weigh when disclosing health information, said Leila Barraza, a professor at the University of Arizona’s Mel and Enid Zuckerman College of Public Health.

“There are definitely considerations to releasing certain information if there's any way it could be traced back to somebody as identifiable,” Barraza said.

Laws such as the Health Insurance Portability and Accountability Act, state confidentiality laws and internal policies may apply to what information can be released and by whom, she said.

Eight states provide numbers drilled down by ZIP code or city. In Arizona, several city, county and state officials filed a lawsuit Friday asking the state to release general coronavirus data to local authorities and the public. The lawsuit asked that “all prior general and non-personally identifiable information” be released, such as the number of positive COVID-19 cases and deaths by ZIP code and date.

Even with ZIP codes, there are different contexts to consider: Releasing information by ZIP code in an urban area may not be identifiable, but in areas with lower populations with fewer cases, it may be, Barraza said.

“Individual ZIP codes might not be advantageous to the public because it's already widespread,” Barraza said.

Reach reporter Rachel Leingang by email at rachel.leingang@gannett.com or by phone at 602-444-8157, or find her on Twitter and Facebook. Reach reporter Alison Steinbach by email at Alison.Steinbach@arizonarepublic.com or by phone at 602-444-4282, or follow her on Twitter @alisteinbach.

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