York City health officials struggle with COVID-19 data
A lack of staff with backgrounds in epidemiology and data analysis has left the York City Health Bureau struggling to study, interpret and release to the public a pile of COVID-19 data it has collected, city officials say.
Other than the state Department of Health, just 10 municipalities have their own health departments: Allegheny, Bucks, Chester, Erie, Montgomery and Philadelphia counties; and the cities of Allentown, Bethlehem, Wilkes-Barre and York.
All but two of them — York City and Wilkes-Barre — have organized their COVID-19 data and rolled it out to the public through an interactive online dashboard. Even Bethlehem, a city with 32,000 more people than York and virtually the same budget, managed to create a public dashboard.
“The health bureau doesn’t have staff that are regularly devoted to epidemiology and data analysis work,” said Craig Walt, community health services supervisor for York City's health bureau. “Our staff were very much focused on program implementation.”
But public health experts say the city's lack of reporting only feeds public distrust about local policy.
“When you’re not being transparent about that data, it opens up other questions about how you’re framing and how you’re thinking about decisions,” said Beth Blauer, executive director at Johns Hopkins University's Centers for Civic Impact. "It's the crux of that trust."
At the beginning of the pandemic, York City's bureau had to pull aside about 11 employees who had skills in those fields. But even today, they aren't solely devoted to it — and the entire bureau only has 18 employees, Walt said.
The impact of those staffing issues surfaced this past week, after The York Dispatch requested spreadsheets detailing daily case increases and infection rates dating back to April, when case counts began to pick up in the city.
The newspaper was told that the bureau does not retain databases with that information.
Dr. Matt Howie, medical director of the health bureau, did, however, supply seven- and 14-day rolling averages that offer a glimpse into how cases are trending either upward or downward in the city.
Other information, such as daily case increases and case counts dating back to April, were not available, nor were historical infection rates and incidence rates.
Compiling and publicizing that additional data would be a burden on the bureau's staff, Howie said, because it mostly focuses on contact tracing and case investigation and still has to take care of nonpandemic duties.
"This becomes a challenge for us logistically," Howie said.
Officials in Wilkes-Barre, the only city other than York City with a health department that lags in data collection, did not respond to inquiries for comment, but data about daily cases or a dashboard were not available on the city's website.
Blauer said that it wasn't uncommon for smaller health departments to be caught flat-footed with a lack of instrumentation to regularly compile and share data during a pandemic.
However, with a 2020 budget of $2.6 million, York City still falls behind two municipalities that provide dashboards while receiving less or just as much funding and serving a significantly larger population.
A majority of York City's health budget is funded by state grants, donations and the Albert Weyer Community Health Fund.
The city of Bethlehem's health department budget is virtually the same as York's, but it serves 76,000 residents compared with York's 44,000.
In the two other cities with health bureaus, Wilkes-Barre's health budget comes in at $1.6 million while serving 40,000 people and Allentown's budget comes in at $4.1 million while serving 121,000.
County health departments had significantly higher budgets, and they often offer a wider range of services.
For example, the Montgomery County Health Department's budget was $10.7 million. Philadelphia's budget totaled $645 million, by far the most of all counties.
Regardless, some datasets, such as information about daily case increases, infection rates and other categories, are vital to ensure public trust, Blauer said.
“One of the biggest lessons we’re learning is not only is it really valuable for people who live in cities such as York (to have granular data), but also health data in general there,” she said. “There is a demand to have it more localized."
The York Dispatch has since requested daily infection rates, case increases and case totals in York City dating back to April under the state's Right-to-Know Law.
City officials hope that information could become public soon, as the bureau plans to use some of the several million dollars in state funding to hire staff specializing in data analysis and epidemiology, Walt said.
It also is in the process of using those funds to create a COVID-19 dashboard similar to what the state Health Department and eight municipal health departments in the state already have.
Still, York City isn't alone in experiencing issues with data.
Even at the state level, Gov. Tom Wolf's administration has been under consistent criticism for how it has handled data during the pandemic.
For example, it wasn't until a wave of public pressure that the Pennsylvania Health Department released racial data.
Even its existing data has also experienced issues, with the department in April purging hundreds of cases from its death toll as it attempted to sort "presumptive positive" deaths from confirmed deaths.
And the importance — and accuracy — of data may be as important as ever as schools begin to reopen.
York City School District, which will have online-only classes through October, made the decision to keep its doors shut after reviewing state and federal agency guidelines as well as viewing local data.
But it also was able to collect some of its own data, releasing a survey that showed that 70% of district parents wanted their child to attend school in a virtual setting, said spokesperson ShaiQuana Mitchell.
"We want to make sure we are taking all the information provided to us coupled with our own district needs and data to help make an informed decision with the health and safety of our students and staff being at the forefront of our decision-making," she said.
Meanwhile, some districts that have started the school year with in-person instruction, such as South Western and Northeastern, have already begun to have issues.
Both districts over the past week announced COVID-19 cases in their buildings.
At South Western, Superintendent Jay Burkhart on Sunday night announced the district will be shutting its doors for a week after its second COVID-19 case was confirmed at Baresville Elementary.
Editor's note: This article has been updated to reflect the correct budget amount for the Montgomery County Health Department.
— Logan Hullinger can be reached at firstname.lastname@example.org or via Twitter at @LoganHullYD