Auditors Find 3,000 COVID Deaths Missing From Florida's Records

A new report has laid bare a string of failings during the first year of the pandemic that meant thousands of COVID deaths went uncounted in Florida.

The investigation by Florida Auditor General Sherrill Norman reviewed the records of three official bodies; the Agency for Health Care Administration, the Department of Health, and the Division of Emergency Management. The state's pandemic performance was assessed from March 1 to October 9, 2020, and the findings were published this week.

According to the report, auditors found that Florida's data was so flawed that officials were unable to monitor whether their policies were effective in controlling the virus, with COVID tests not being returned, crucial data such as patients' ethnicity missing from records, and poor contact tracing that left potentially infected people free to unknowingly spread the virus.

Additionally, auditors discovered deaths from the disease had been undercounted. More than 3,000 COVID-19 fatalities recorded by doctors did not show up in the state's record of deaths.

"An important measure of disease severity is the number of reported deaths associated with the disease," the report said. " Accurate reporting of COVID-19 associated deaths is vital to assessing the severity and impact of COVID-19 and determining the efficacy of infectious disease control measures."

Auditors said after cross-referencing state records through its Merlin recording system with figures from the Bureau of Vital Statistics, it found "3,082 death records in the Vital Statistics data that could not be systematically matched to death records in the Merlin data based on the individual's full name and date of birth."

While auditors noted that they were able to establish some errors were caused by typos and data entry errors, they said the inaccurate death count made it difficult for the state to see if its plan to fight the spread of COVID was working.

"Absent complete and accurate information related to the extent and severity of the COVID-19 pandemic, government officials and the general public may not have had all the information necessary to assess the efficacy of COVID-19 control measures and take appropriate actions," the report said.

Covid-19 patient in hospital
A report released this week said that auditors in Florida found a number of issues with the state's COVID-19 data, including missing data on deaths in the state. Pictured, medics prepare to turn a COVID-19 patient onto his stomach in a Stamford Hospital intensive care unit (ICU), in the early days of the pandemic on April 24, 2020 in Stamford, Connecticut. Getty Images

State auditors also reviewed a sample of tests taken at five state-run testing facilities over the course of a week and found that for three of the testing sites, data indicated that 2,593 tests were administered, but just 996 test results were reported to the Department of Health. The stats mean that more than 60 percent of tests were never returned. It's unclear whether the individuals were contacted with their results, and whether the tests were positive or negative.

The audit also analyzed the COVID test profiles of 5,539,899 people, and discovered that key demographic data was often missing; for example, auditors found that 58.9 percent of the records did not include the individuals' ethnicity. That information was crucial at the time as scientists were monitoring whether the disease affected people of various ethnicities differently. Other records were found to be missing patients' ages, gender, or addresses.

It took auditors more than a year, from September 2020 through November 2021, to wade through the various data in order to compile the report. The opening summary of its findings said "the number of entities reporting data, inaccurate or incomplete data reported to the state by those entities and the lack of effective access controls in the systems used to gather data, impacted the state's ability to accurately report COVID-19 data at the beginning of the pandemic."

One recommendation made by the auditors was that the state needed to "take steps to ensure the accuracy and completeness of information regarding reportable diseases and outbreaks such as COVID-19."

Covid-19 testing laboratory
A new report released this week found that testing sites in Florida did not report complete testing data to the state during the pandemic in 2020. Pictured, a clinical support technician examines viruses from swab samples at a coronavirus testing laboratory. Getty Images

The three agencies were all given the opportunity to respond to the audit, and their replies were included.

"We appreciate the efforts of you and your staff in assisting to improve our operations," Florida Surgeon General Joseph Ladapo said.

In breaking down the auditors' findings, Ladapo said the state Department of Health is working to ensure that the state has the most accurate testing data.

"It should be noted that most data quality issues the department experienced during the COVID-19 pandemic originated from laboratories that submitted inaccurate or incomplete data," he said. "Challenges included receiving data from many new laboratories and other facilities with limited experience in reporting test results to the department prior to the COVID-19 pandemic. The department continues to work with laboratories to ensure that COVID-19 test result data is reportedly timely and accurately."

Department of Health spokesperson Jeremy Redfern told the Miami Herald that the Auditor General's report was itself flawed, saying that "some of the conclusions come from (the auditors') misunderstanding of the purpose of different datasets." He added that "the report does not address the huge advancements we've made in modernizing our reporting systems."

In her reply, Florida Agency for Health Care Administration Secretary Simone Marstiller pointed out the agency used existing resources and systems originally designed for weather disasters to begin collecting COVID data quickly, but the systems had never been intended for that purpose and were consequently not "agile" enough when data requirements changed as the pandemic progressed.

"The agency worked alongside licensed health care providers in reporting accurate data," Marstiller said. "However, data is only as accurate as the person who is submitting it into the system."

In his response to the report, Kevin Guthrie, the director of the Division of Emergency Management, said: "Due to the scale and scope of the COVID-19 activation and the multitude of state and private entities supporting state-led testing, the Florida Division of Emergency Management was reliant on the Florida Department of Health for all data reconciliation of patient confidential records. As the Florida Department of Health has the statutory requirements for monitoring infection disease reporting, the Division's focus was on the ability to provide testing to as many Floridians as possible and to provide logistical support for the overall COVID-19 response efforts."

Newsweek has reached out to Florida Governor Ron DeSantis for comment on the audit.