Featured | The Murky Waters of Ventura County’s COVID 19 Numbers

By Phil Erwin and Debra Tash

Last year we attempted to discover the true impact of COVID 19 on the number of deaths in the County of Ventura.  Stonewalled at first, we did finally discover that the County is not the lead agency in this type of data collection.  January 4th 2021 was the last time the County reported comorbidities for those who succumbed to COVID.  Further the breakout statistic for these deaths is mixed in with “other” causes, at least, for public searches on the state level and that the reporting of such deaths apparently are not always backed up with laboratory evidence.  The County does not add these probable deaths to their COVID totals.

The Search begins

On December 4th of 2020, we sought clarification of the reported stats from Dr. Robert Levin, Ventura County’s Public Health Officer.   We asked Dr. Levin to advise us as to how many patients had succumbed to COVID and non-COVID causes during the COVID tracking period.   We considered this a valid request considering the profound impact the lockdowns and associated restrictions had on local businesses and the residents of Ventura County.

Dr. Levin responded that same day with the names of three County Health employees whom he felt would be helpful in responding to our query.   However, we had not received any further response after three days, so we repeated our request on December 7th.  We sent this under the California Records Act, expanding the scope to include the following data:

• COVID Hospitalizations and ICU beds for November and December 2019 (Editor’s note, the pandemic was just beginning during those months so that is why we asked for these numbers)
• Total # of hospital beds and ICU beds in the county, and the numbers of each occupied by patients with COVID 19, and with maladies other than COVID 19.
• Deaths in the county during the tracking period of the COVID 19 pandemic, March of 2020 to present. List them by causes and the number that occurred, including suicides.   
• Deaths during the same period in 2019 by cause and number.
• Any data your department can provide that proves that either the business sector or family gatherings are responsible for the increase in positive tests.
• How many of those positive tests are people with actual COVID symptoms

One week later, on December 14th, Ms. Ashley Bautista, the County Public Information Officer, denied our request “… it has been determined that the public interest is not served by diverting staff and resources away from emergency response to immediately respond to this request.”  She then cited Gov. Code, § 6255, which states, “The agency shall justify withholding any record by demonstrating that the record in question is exempt under express provisions of this chapter or that on the facts of the particular case the public interest served by not disclosing the record clearly outweighs the public interest served by disclosure of the record.”

We did not understand how staff reporting statistics we felt should already be readily available, and that were used to set public policy, would somehow interfere with the County’s “emergency response.”  We believed residents were owed the truth about the real impacts of COVID on the County’s health statistics.  So we mailed a formal request to the County Health Office for information under the California Records Act on December 15th.

We continued to press our request for what we felt were basic health statistics of importance to our readership and our community.  By April, when we still had not received a response from the County, we again contacted Ms. Bautista.  The case numbers were rapidly decreasing and it seemed the emergency should no longer be preventing the County from reporting statistics to the community, which was the sole purpose of our repeated requests.  Given the reluctance of the County to respond in any meaningful way, we informed Ms. Bautista that we would be publishing the entire e-mail exchange, so the public would be fully informed of our efforts on their behalf, and the County’s apparently reluctance to be transparent on this issue.

The County, after five months of inquiry, begins to provide data

It was at this time that Ms. Bautista finally responded with actual statistics.  She sent us the chart below which shows the statistics of death by various causes during the three years prior to the COVID pandemic, as well as the pandemic year of 2020 and January of 2021.  Ms. Bautista noted that “…almost all deaths increased…”, and that the figures for self-harm deaths tend to increase over time as the toxicology results can take months to come in.  Finally, she informed us that the deaths coded as due to COVID were included in the “OTHER” category, noting there was a 57% increase in the OTHER category over the average for the previous 3 years. 

We asked for further clarification because it made little sense to include COVID deaths, which local and state decision makers used, into the catch-all “Other” category.  If that category had, indeed, gone up during the pandemic, what other causes were included? 

Ms. Erin Slack MPH, an epidemiologist with the Maternal, Child, and Adolescent Health Programs out of Oxnard, attempted to clarify the complex reporting system used by the state regarding the COVID deaths.  As you can see below not all deaths are confirmed to have succumbed from the virus.  Some of the death certificates have COVID as the cause but there was no laboratory evidence.  Those were deemed “probable” and were purportedly not counted by the County.  

“In order to understand the death data, it is also helpful to understand the reporting process.  Here are the steps that we take to ensure accuracy of our data.

VCPH Vital Records receives a pending death certificate through Electronic Death Registration System that has COVID listed in the chain of events or other significant conditions.

Vital Records staff searches the CalREDIE, (Link added: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/CalREDIE.aspx) our communicable disease surveillance system, in order to determine if the decedent had a confirmatory test for COVID. 

If we do not have record of the laboratory test, then they request it from the person registering the death certificate and ask our outbreak teams to see if they have a confirmatory lab.

If we are not able to obtain a confirmatory lab, then we have the following options:

Ask the certifier to obtain post mortem testing on the decedent to confirm COVID.

Ask the certifier to remove COVID from the death certificate or amend to probable or suspected COVID.  They do not always comply with our request.

Once the death certificate has been finalized, the certificate is sent to one of our Epidemiologists to update the communicable disease surveillance system to ensure the demographics are correct and link the mortality (death) data to the morbidity (case) data.

At the same time, the data from the death certificate is transmitted to the National Center for Health Statistics (NCHS) to determine the final cause of death based on what is listed in the chain of events and other significant conditions.  If COVID is listed in the chain of events, it is likely it will be the final cause of death.

The Epidemiologist will report out the death in one of two ways (see this document COVID Deaths_VCPH  for more information).  Only confirmed deaths are reported out on the PowerBI dashboard. 

Confirmed Death  – Confirmed PCR test and COVID listed in the chain of events or other significant conditions on the death certificate.

Probable Death – Presumptive laboratory evidence and COVID listed in the chain of events or other significant conditions on the death certificate.  Or, COVID listed in the chain of events or other significant conditions on the death certificate with no confirmatory laboratory evidence.

Not every Ventura County residents dies in our county; there are many residents that die in another county where they do not have the same process in place.  So, we often receive reallocated death certificates from other counties where COVID is listed on the death certificate but we do not have any confirmatory laboratory evidence of infection.  In that case, we use many investigative techniques to obtain the lab or end up reporting out the death as a probable death (not included in our death count).

If you look at the data table below, you will see that we had 7,627 deaths from January 2020 – January 2021 (based on date of death and not date of report and NCHS code = 111).  This is a bit higher than what Ashley had sent previously because it was pulled today instead of a month ago.  Sometimes it takes over a month for a final death certificate to be registered, and we were seeing big delays during the surge.  Of those 7,627 deaths, we reported 760 of them as being COVID associated meaning that COVID was listed in the chain of events or other significant conditions on the death certificate.  Of those 760 that we reported from January 2020 – January 2021, 658 or 86.6% ended up having COVID listed as the final cause of death (ICD – U071).  The remaining 102 had a different final cause of death even though COVID was listed somewhere on the death certificate; you can see during the surge in December/January deaths were more likely to be coded to COVID.  All deaths coded to COVID as the final cause of death would show up in the “Other” category for leading causes of death that was sent along previously.

During that same time period, we had 100 deaths where COVID was listed on the death certificate but we had no laboratory evidence reported to the health department, so those deaths were reported out as probable in our communicable disease surveillance system.  Again, during the surge, this was more likely to occur.

In a May 7th 2021 email Ms. Bautista informed us that the County is not where the raw data is reported. Quoting from that email: “All deaths that occur in the county are reported directly to the state Electronic Death Registration System (EDRS) The same process was in place prior to Covid, and there have been no changes to the process during the pandemic.  So how could they vet it per Ms. Slack’s analysis?  We followed Ms. Bautista’s suggestion after we asked why the numbers from her releases and spreadsheet didn’t match Ms. Slack’s and did a press request to the California Department of Public Health Department on accessing the state’s data on the COVID numbers.  The CDPH responded with the links below.

CDPH RESPONSE: Please see State Dashboard in the links below. You can also see total deaths for any specific date in our daily News Releases

Tracking COVID-19 in California State Dashboard – Daily COVID-19 data

County Map – Local data, including tier status and ICU capacity

Data and Tools – Models and dashboards for researchers, scientists and the public

Blueprint for a Safer Economy – Data for establishing tier status

COVID-19 Race & Ethnicity Data – Weekly updated Race & Ethnicity data

Cases and Deaths by Age Group – Weekly updated Deaths by Age Group data

Health Equity Dashboard – See how COVID-19 highlights existing inequities in health

We did do an analysis of one month, February 2021 through these portals.  February Summary FEB Deaths by Cause.

We found there were 9 days that were missing from the data, weekends and holidays where nothing was reported and did not seem to be adjusted on the first business day following the weekends and holidays, at least at the state level. And since the state includes COVID with all “Other” deaths, neither the state nor the county really explained how their catch-all category supports the existing/changing public health policies. 

Our attempt to reach a conclusion

Taking all this into account the waters appear to be even murkier then when we first asked.  January 4th 2021 was the last time Ms. Bautista reported comorbidities for COVID deaths.  This clouds the picture in not taking into account whether COVID was the cause or a contributing factor. Please note, we were never given an answer to our original question since the numbers were now mixed in with unknown causes in a category labeled OTHER as provided by Ms. Bautista and Ms. Slack. The County never was the lead in collecting this data, though they didn’t inform us of this until months later.  Hospitals and coroners report to the state through the CalREDIE system. It appears Ms. Bautista merely downloads a presorted dataset. Though this, too, is unclear since she never responded to our query on what she used to access the information given to local decision makers and what the public received in her daily press releases. Ms. Bautista separated the COVID numbers in those releases but we were not able to break out the numbers with the links given us by the CDPH.  We just do not have the time or money to do an in-depth dive into the raw data, if it is even available to the public.

What does beg an answer is this: if the number of COVID deaths was accessible to the County all along, since it appears they could sort data to pull out those numbers for their press releases and briefings, why did they stonewall us in December? We were only seeking a simple year to year comparison to discover whether or not other causes of death dropped or stayed relatively the same. This would have helped all of us understand the true impact of COVID.

There are two unsettled lawsuits against the County on this very issue.  The cross-complaint filed by Godspeak Calvary after the County sued the church for opening during the Health Department lockdown is still active.  That lawsuit is in the discovery phase and so far the County has not produced any of the 120 documents requested by the church’s attorneys.  The other suit was filed by the First Amendment Coalition for lack of transparency with the data Access To COVID-19 Data In Ventura County.

All we can do is provide what was given to us, and let you decide if our local Health Department has been forthcoming with the public.

Phil Erwin is an author, IT administrator and registered Independent living in Newbury Park. He would like to support some Democrat ideals, but he has a visceral hatred for Lies and Damn Lies (and is highly suspicious of Statistics.) That pretty much eliminates supporting most Democrats, and a bunch of Republicans to boot.

Debra Tash is Editor-in-Chief of Citizensjournal.us, past president for Citizens Alliance for Property Rights, business executive and award-winning author, residing in Somis.

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