Depending on how you look at the data this week, it’s hard to tell what direction Alabama’s coronavirus numbers are headed.

The Alabama Department of Public Health confirmed just over 5,000 new virus cases for the week ending Aug. 28, the lowest weekly total since June 12. The state now has nearly 114,000 confirmed virus cases since the beginning of the pandemic, with more than 48,000 of those presumed to have recovered and more than 2,000 dead.

But the state also added nearly 3,500 probable cases this week to its tally – the most probable cases ever. There are now nearly 8,500 probable cases listed on the state’s cumulative count.

With this week’s probable cases included in the total count, the state’s numbers actually went up week-over-week, but that’s not the full story.

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To understand what’s happening with Alabama’s numbers, you have to know what these probable cases actually are, and how they’re counted.

According to Alabama State Epidemiologist Sherri Davidson, probable cases should be included in state totals for tracking the coronavirus. She said there are two distinct classifications for those probable cases – and the definition changed some in June.

The previous definition included people who had come into contact with someone who had tested positive for the virus and were displaying symptoms, but who hadn’t had a positive test. The definition, as updated by the Council of State and Territorial Epidemiologists, now includes people who have received antigen tests.

The probable case count also includes anyone who died with COVID-19 listed on their death certificate, Davidson said.

One of the reasons for the state’s recent uptick in probable cases is that changed definition – and the inclusion of antigen test results, which show people who are believed to have recovered and now have antibodies to COVID-19.

Some of the cases we’re seeing now might actually be old. Cases from earlier in the year which were confirmed via antigen test or by other means under the current definition might be reported weeks later, said Davdison, especially as labs and other entities learn of reporting requirements, or as ADPH learns of new places, like nursing homes, that are doing their own antigen testing.

Increased access to these types of tests – including new types of antigen test being approved by the FDA – is also a likely reason for probable case increases. Many places, like nursing homes, Davidson said, which earlier in the pandemic might have been sending people to labs or hospitals to receive traditional laboratory testing – or molecular testing – are now using antigen tests instead. This practice, called point of care testing, has faster results, and requires less transport of patients. The tests are also becoming more widely available, she said.

Because of that, we’re likely to continue to see Alabama’s probable case count go up in coming weeks, as more antigen test results are documented.

But will Alabama continue to see as many probable cases as it saw this week? It’s hard to say. The number of historical cases entering the system is unclear, so the numbers will be important to watch in the coming weeks.

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With probable cases included, Alabama is currently seeing a spike in 7-day average, though that number could be misleading. Davidson emphasized the difference between when a case is reported and when it occurs.

But based on the numbers as they have been reported, with probable cases included, Alabama’s current 7-day average for new cases is 1,222. Without probables, it’s just 722, a difference of 500 daily cases.

Starting in July, shortly after the definition for probable cases was changed, the cumulative total for probable cases went up, but not by much. But recently probable cases skyrocketed, and this week the state saw almost as many probable cases as confirmed ones.

The state shows data when they are reported on its main dashboard, but has a separate Risk Indicator dashboard that’s updated once a week that tries to put cases, deaths and tests in context of when they occurred.

The numbers in this article are based on when they are reported, not when they occurred. Probable case data from ADPH was compiled by Bamatracker.com, a private online dashboard tracking Coronavirus / COVID-19 Cases in Alabama over time.

[Can’t see the chart? Click here.]

The state also passed 2,000 confirmed coronavirus deaths this week – with another 90 probable deaths. Davidson said probable deaths come from the same group and definitions as probable cases.

The situation with probable deaths is similar to that of probable cases. With the probables included, Alabama saw an increase in total weekly deaths this week over last week, from 103 total reported deaths last week to 107 this week. But without the probable deaths, the numbers went down.

That’s because the state reported 17 new probable deaths this week, the most probable deaths in any week since the stat has been tracked.

Where are the probable cases?

Alabama nearly doubled its probable cases this week, and a large percentage of those new probable cases came from Alabama’s largest college towns. According to data compiled from ADPH by Bamatracker.com, Lee County, home of Auburn University, added more than 800 probable cases this week. With probable cases included, the 7-day average for new cases in Lee County is now 144.6, the highest in the state.

Lee County now has more than 1,082 probable cases since the stat started being recorded, compared to 3,091 confirmed cases.

That’s tied with Talladega County for the highest ratio of probable to confirmed cases of any county in Alabama. Talladega has 1,232 confirmed cases and 435 probables.

Tuscaloosa County, home of the University of Alabama, added 439 probable cases this week, second most in the state. No other county was close – Jefferson, home of Birmingham and the most populous county in the state – was a distant third, with 182 new probable cases.

More than a third of the state’s new probable cases this week were added in Lee and Tuscaloosa counties.

Search the table below to find how many confirmed and probable cases your county has.

[Can’t see the table? Click here.]

Jefferson added the most confirmed cases in the state this week with 787. Mobile County added 388, Tuscaloosa added 316, Baldwin added 233 and Madison added 197. All are significantlty lower than the weekly averages a month ago.

Do you have an idea for a data story about Alabama? Email Ramsey Archibald at rarchibald@al.com, and follow him on Twitter @RamseyArchibald. Read more Alabama data stories here.


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