Performance Audit

Ohio Department of Health COVID-19 Data

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What led to this audit?

In March 2020, schools and business across Ohio were closed in response to the COVID-19 pandemic. Differing views on how to control the pandemic and protect Ohioans sparked many discussions, protests, rumors, and questions about the data being presented to the public. Our office, along with several other state auditors, developed an audit plan to study COVID-19 data collection and management as well as public communications. The intent was to provide a way for states to determine the quality of data used to make policy decisions, determine where best to invest resources to control the virus spread, and give the public confidence in the COVID-19 figures being reported.

What did we find?

We found that there are several areas where the Department could improve transparency, improve operations, and collect more meaningful data. In total, we identified seven recommendations that will assist ODH and local health departments in the public health response to both the COVID-19 pandemic and future epidemic or pandemic events. These recommendations focus primarily on data collection efforts, how and when data is provided to the public, and efforts related to the containment of an infectious disease outbreak.

Key recommendations

  • A true count of test results and positivity rate is not available in Ohio because antigen testing and non-laboratory testing data is incomplete. Antigen tests results were only added to Ohio's count as they became more accurate and available, and negative test results were not counted at the beginning of the pandemic.
  • ODH should give a more accurate indication of active cases, hospitalizations, and test positivity rates on its dashboard. Additionally, the terminology used on the dashboard can be viewed as inconsistent or unclear to non-medical professionals.
  • While ODH counts COVID-19 hospitalizations and deaths in accordance with CDC guidelines, these methods do not differentiate between hospitalizations and deaths caused by COVID-19 and with COVID-19. This guidance conflicts with other federal and global public health organization guidance, which should be studied by ODH.
  • The data system and processes in use at ODH and local health departments, as well as by physicians, hospitals and laboratories, are outdated and could not keep up with volume of cases in the pandemic. This caused backlogs at local health departments and occasional delays in contacting COVID-19 positive residents.
  • Current law permits ODH only a coordinating function among the independent Local Health Districts in relation to case management, limiting its ability to intervene when necessary.