Florida Health Department Underestimated COVID-19 Cases, Deaths, Due to Technical Problems: State Audit

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The number of COVID-19 cases and deaths reported in Florida from March 1, 2020 to October 1, 2020, by the Department of Health were underestimated due to data collection issues, according to the general report of the state auditor released on June 1.

The report comes after last March, when an investigation by the Florida Department of Health Inspector General (FDOH) found “insufficient evidence” or no evidence to support claims of self-proclaimed whistleblower Rebekah Jones that she had been asked. to spoof COVID-19 data on the state dashboard, according to Inspector General’s Office of the Investigative Report. His claim to restrict access to underlying data was also found to be false, according to that report.

People lined up to receive a COVID-19 test on Wednesday, November 18, 2020, in Opa-Locka, Florida.

People lined up to receive a COVID-19 test on Wednesday, November 18, 2020, in Opa-Locka, Florida.
(Photo AP / Marta Lavandier)

“To assess the state’s readiness to provide essential information needed to respond to the global pandemic, this operational audit focused on COVID-19 data collection and reporting processes at the Health Administration (Agency), the Department of Health (Department) and Emergency Management Division (Division) during the period from March 1, 2020 to October 9, 2020, ”the state auditor’s general report said.

“As described below, the number of entities reporting data, apparently inaccurate or incomplete data reported to the State by those entities, and the lack of effective access controls in the systems used to collect the data, have affected the State’s ability to report with precision the COVID-19 data at the beginning of the pandemic “.


The Florida Department of Health used a data software called the Merlin system, but “did not appear complete or contained anomalies” compared to data from the Bureau of Vital Statistics.

“We compared Merlin’s death records with the Bureau of Vital Statistics death records in which COVID-19 was included as a cause or contributing factor to death and identified differences among the records, “the report reads.

Additionally, the health department records did not always show evidence that COVID-19 patients had been contacted in a timely manner, which was contrary to the state health department’s requirements for contact tracing.

Signage is ready (foreground) in case COVID-19 testing at Barnett Park reaches capacity, as cars wait in line in Orlando, Florida on Thursday, July 29, 2021.
(Joe Burbank / Orlando Sentinel via AP)

The audit found that “for 168,880 of the 729,552 cases, Merlin did not demonstrate that the COVID-19 positive subjects have been contacted or contact has been attempted by the Department “.

Using the individual’s full name and date of birth, the auditor general concluded that 2,495 death records reported in the Merlin software system were not included in the Vital Statistics reports, while 3,082 death records reported in the Vital Statistics data were not included. included in the Merlin data, according to the audit.

“In the absence of complete and accurate information regarding the extent and severity of the COVID-19 pandemic, government officials and the general public may not have had all the information necessary to evaluate the effectiveness of COVID control measures.” 19 and take appropriate action, “the report said.


The reviewer general said that if health department management did not receive a positive laboratory result or if the demographic information on the laboratory report differed from the death certificate, they may not have been able to note for certain that the deceased was the same person listed on the test result.

There were also “data quality issues” with regards to data for the number of COVID-19 cases, regardless of the death logs, but FDOH management said “the data quality issues were due to the having to rely on the data sent by the labs, along with a large number of cases and limited resources to address the problems of accuracy and completeness of the data. ”

The Auditor General found that while FHOH attempted to ensure that some data was accurate and complete, the audit also found “7,718 instances where Merlin lacked follow-up contact attempt dates.”

But FHOD told the Auditor General that “inaccurate contact information and some people’s refusal to speak to the department prevented” their ability to contact all COVID-19 people.

A Florida resident is vaccinated at the Orange County Convention Center drive-thru site in Orlando on Monday, February 22, 2021.

A Florida resident is vaccinated at the Orange County Convention Center drive-thru site in Orlando on Monday, February 22, 2021.
(Joe Burbank / Orlando Sentinel via AP)

State Surgeon General Dr. Joseph Ladapo agreed with the report’s findings with an ongoing action plan to correct it, but further discrepancies in the data are expected, according to WFLA News Channel 8.

“If the COVID-19 test had not been performed, had occurred more than 30 days prior to death, had not been reported to the Department, or could not be matched with a vital statistics record due to data quality deficiencies, the death would not be counted as a [COVID-19] death associated with surveillance included in the Department’s COVID-19 surveillance reports, ”Ladapo wrote.

He noted that “most of the data quality problems the Department encountered during the COVID-19 pandemic came from labs that presented inaccurate or incomplete data,” adding that FDOH no longer recommends county health departments to track contacts for each case of COVID-19.


The Health Administration Agency and Department of Emergency Management noted monitoring and reporting challenges in response to the report, but tightening IT controls was mentioned as a way to improve data management, according to the newsletter.

The report states that the data recorded after the audit period may be subject to future audits.