Why is VDH Stockpiling Cases as Unknown Race?

By Carol J. Bova

The Northam administration started expressing concern about the disparity of racial impacts of COVID-19 as early as March. But the number of confirmed cases with race/ethnicity listed as “Unknown” has grown to 20,886, or 24% of all cases. How is such a huge gap in the data even possible?

Here’s the chronology:

March 11: The administration formed the Health Equity Workgroup (HEWG). “The HEWG was built into the initial forming of the COVID-19 Unified Command structure as directed by Dr. Norman Oliver, the Virginia Commissioner of Health. states the website.

April 8: Governor Ralph Northam said that race was unknown for 54% of COVID-19 cases. Health Commissioner Norman Oliver said that some private laboratories and private medical providers were not reporting the data. Said Northam: “We’re exploring ways to make sure that they do.”

April 20: The Virginia Department of Health (VDH) did not report race or ethnicity for 3,130 or 34% of all reported COVID-19 cases.

May 12: Lieutenant Governor Justin Fairfax sent a letter to Northam to create a statewide COVID-19 task force to address racial disparities in certain under-served communities, citing “alarming and glaring racial disparities” regarding COVID-19 data within the African-American and Latino communities.

May 12: VDH did not report race or ethnicity for 8,022 or 30% of all reported COVID-19 cases.

June 4: The Department of Health and Human Services (HHS) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, required “every laboratory that performs or analyzes a test that is intended to detect SARS-CoV-2 or to diagnose a possible case of COVID-19” to report the results from each such test to the Secretary of the Department of Health and Human Services (HHS) through existing public health data reporting methods, to state or local public health departments using existing reporting channels to ensure rapid initiation of case investigations by those departments. Reporting of these data elements was to begin as soon as possible but no later than August 1, 2020. Reporting should occur within 24 hours of results being known or determined, on a daily basis.

June 18: Northam held a bilingual press conference to talk about the disproportionate impacts of the virus on black and Hispanic communities.

June 18: VDH did not report race or ethnicity for 13,817 or 24.3 of all reported COVID-19 cases. (The Latino category was added June 14, and the number of cases with unknown race dropped by 3,245.)

On July 27, VDH did not report race or ethnicity for 20,886, still 24.3% of all reported COVID-19 cases.

Distributing the almost 21,000 unknown race cases would make a dramatic change in the proportion of cases by race. Unknown amounts to 140% of total black cases; or 107% of total white cases, or 82% of all Latino cases. Until VDH identifies the racial composition of those unknown cases, no one can say with any certainty how any racial/ethnic group has been impacted by the virus.

The void in the data prompts a series of questions.

  • Why hasn’t VDH or the Health Equity Work Group acted on this?
  • Would the results not fit the political agenda of the Northam administration?
  • Would the numbers be more in line with the population?
  • Would they show even greater disparities?
  • Why hasn’t Governor Northam or Health Commissioner Oliver followed through and done something about the number of Unknown race reports?
  • Why hasn’t VDH insisted on it already since HHS is requiring labs to include the patient age, race, ethnicity, sex, residence zip code and county with other required info on test results by August 1?

Carol J. Bova is a writer living in Mathews County.

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29 responses to “Why is VDH Stockpiling Cases as Unknown Race?”

  1. Nancy_Naive Avatar

    I suppose,… Well, I suppose it’s possible that Loving v. Virginia has had a measurable effect. But, given average victim’s age, that would be too soon. Maybe next time?

  2. Steve Haner Avatar
    Steve Haner

    You can direct the lab to report the data, but you cannot force the tested person to provide the data, and of course the number of people under “more than one category” continues to grow. Do you look in the car window through your face shield and through their mask and take a guess and put that on the form? It’s probably at the mass testing sites where the line is left blank most often.

    Is is possible the push to gather that data is one reason testing is getting so slow?

    This is a totally false and useless narrative. This bug kills lots of people, all kinds of people, all over the world, and the list of preexisting health issues that put the mark of death on your door is well, well known. Obesity and related conditions are high on the list, along with COPD or asthma. Cardiac issues. You can get very sick without those, but are unlikely to die. This is another situation where Sweden is proving useful: The whitest of the white Europeans are not showing signs of immunity there! Is Finland’s death rate lower than Sweden’s based on demographics? Uh, no.

    1. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      I suspect Steve is right.

      Likely a growing number of sensible Americans refuse to check their “race” on all the hideous race forms they are given, stereotyping them forever as if America is a fascist country, where race determines your worth, fate, and privilege, and identity.

      What a horrible question. What an irrelevant question, this race question. It’s only purpose is mischief. Plus it’s insulting. Plus it’s destructive, a question mean to divide us, set us against one another, and to allow us to be manipulated by others.

      So, for example, Chicago now is said to be three cities, black, white, and Hispanic, each one now a Balkan mini state warring against one another.

      We must stop this madness.

      Thus refuse to answer the vile question on all the forms in the hope of taking the wind out of the sails of race-baiters like Al Sharpton and Ralph Northam and their ilk.

    2. djrippert Avatar

      Typical Virginia Democrats. Refuse to mandate that the data be collected but feel free to make statements like this:

      “May 12: Lieutenant Governor Justin Fairfax sent a letter to Northam to create a statewide COVID-19 task force to address racial disparities in certain under-served communities, citing “alarming and glaring racial disparities” regarding COVID-19 data within the African-American and Latino communities.”

      As far as Swedes vs Finns – the Finns actually have a different ethnicity than Swedes / Norwegians / Danes. While there is plenty of debate, one school of thought is that people from Finland have a notable Turkish ethnicity. Certainly the Finish language is far different than the Nordic languages of the other countries in Scandinavia. This is important to the COVID19 discussion because the unique genealogy of Finnish people is at the source of 39 diseases known as Finnish heritage diseases. Whether this makes for different COVID19 outcomes is anybody guess but a comparison between Sweden and Norway would probably be more useful.


      1. LarrytheG Avatar

        re: ” Typical Virginia Democrats. Refuse to mandate that the data be collected ”

        other states and the CDC don’t have similar issues?

        What’s the bottom line with regard to Sweden and Finland with regard to COVID19 – regardless of ethnicity or race?

        Did Sweden’s approach work better?

        1. djrippert Avatar

          I’m sure other states have similar issues. Steve is right in saying that it’s hard to force people to declare their race for many reasons. Some might even lie (See also: Fauxchontas / Lieawatha). The question is whether those states which don’t have accurate data have Lieutenant Governors (twice accused of forcible rape) claiming that there are “alarming and glaring racial disparities” based on substantially incomplete data.

          My only point about Sweden is that it should be compared to Norway or Denmark from an ethnicity basis. As for whether Sweden’s plan worked …

          Here is what I see as a fair analysis published recently –


          1. LarrytheG Avatar

            Really? The questions about race are tied to the LG?

            How do we judge this kind of thinking? It’s totally bizarre but it apparently is brought up that way by more than a few?

            it’s inexplicable.

            The article? yep – the truth is not so black & white but there are more and more doubts that Sweden had a better strategy.

      2. Nancy_Naive Avatar

        Re Finland. Could be worse. Louisiana.

      3. There’s a good article exploring the reasons for the Finnish genetic diseases at https://www.discovermagazine.com/the-sciences/finlands-fascinating-genes Because of the unique factors of their origin and relative isolation, the Finns have contributed a lot to the understanding of genetic influence on developing certain diseases, sometimes to the point of a single allele. There are measurable genetic components to autoimmune diseases, and current research points to that in obesity and diabetes. Where Steve Haner discounts the genetic influence toward developing heart disease, asthma, and diabetes, the work done in Finland (and elsewhere) shows a genetic predisposition to environmental triggers for those conditions.

        1. LarrytheG Avatar

          There are numerous genetic differences that are also hereditary.

          My understanding is that here are higher incidences of Sickle Cell disease which is actually developed in response to malaria – and then inherited.

          And most of us remember the rules for marriage licenses and being tested for certain diseases… no?

          These are legitimate public health issues and collecting information with regard to ethnicity and race – is appropriate for that purpose alone.

          For instance, from that data, we are informed as to which diseases should be prioritized for research.

          The fact that collected data might be used for a wrong public policy reason is not good reason to not collect it though we do argue about it. e.g.

          1. To correct Larry’s misinformation:
            Sickle cell anemia occurs when two parents with recessive genes both pass on copies to a child. Malaria worsens sickle cell anemia, it does not cause it or change the genes.

          2. I thought sickle cell genes confer an adaptive immunity to malaria. That’s why the genes survived in West Africa despite the obvious disadvantage of the resulting anemia.

          3. Jim, CDC says, ” Inheritance of this mutated gene from both parents leads to sickle cell disease and people with this disease have shorter life expectancy. On the contrary, individuals who are carriers for the sickle cell disease (with one sickle gene and one normal hemoglobin gene, also known as sickle cell trait) have some protective advantage against malaria.”

            Sickle Cell Anaemia and Malaria
            Mediterr J Hematol Infect Dis. 2012; 4(1): e2012065.
            “On the other hand, patients who are homozygous for the sickle gene and therefore suffer from sickle cell anaemia (SCA) are highly susceptible to the lethal effects of malaria. The simplest explanation of this fact is that malaria makes the anaemia of SCA more severe; in addition, in SCA there is often hyposplenism, which reduces clearance of parasites.”

          4. OK, so, one sickle-cell gene are good (if you are exposed to malaria), while two sickle-cell genes are bad. Got it.

          5. Yes, Larry. Misinformation. Your own reference says the same thing. In Jim’s shorthand, one copy of gene is good, two copies, bad.
            One copy no SCA and protection against malaria.
            Two copies you get SCA and no protection. Clear enough?

          6. LarrytheG Avatar

            What Larry said: ”
            There are numerous genetic differences that are also hereditary.

            My understanding is that here are higher incidences of Sickle Cell disease which is actually developed in response to malaria – and then inherited.”

            not misinformation Carol – you are parsing words then accusing bad motives… In fact, Jim had the same impression.

            shame on you.

            What the Article I referenced said:

            “How sickle cell protects against Malaria

            Sickle cell disease (SCD) affects millions of people around the globe and is the 4th leading cause of deaths in children in many developing countries. It causes a number of health problems, such as attacks of pain, anaemia, swelling in the hands and feet, bacterial infections and stroke. Sickle-cell contributes to a low life expectancy in the developed world of 40 to 60 years.

            The disease results in abnormal haemoglobin – the oxygen-carrying protein found in red blood cells – giving the blood cell a rigid, sticky, sickle-like shape that hinders its oxygen-binding properties. These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body. A blood and bone marrow transplant is currently the only cure for sickle cell disease, but only a small number of patients are eligible. For the rest, there’s no cure but effective treatments can relieve pain, help prevent problems associated with the disease and prolong life.

            70 years ago, researchers found a genetic connection to the anatomical abnormalities seen in blood cells. A mutation seemed to be causing the moon-shaped blood cells. The most severe form of the disease occurs when two copies of the mutation are inherited. However, patients with one sickle cell gene, referred to as sickle cell trait, usually do not have any of the signs of the disease and live a normal life, but they can pass the trait on to their children.

            As with all inherited genetic diseases, you’d expect natural selection to weed out a gene that has such unpleasant consequences but with sickle cell disease, that doesn’t seem to be the case. Indeed, as of 2015, about 4.4 million people have sickle cell disease, while an additional 43 million have sickle cell trait. So what makes the disease stay in the human population?

            Researchers found the answer by looking at where the disease was most prevalent. As it turns out, 80% of sickle cell disease cases occur in Sub-Saharan Africa or amongst populations having their ancestors in this region, as well as in other parts of the world where malaria is or was common. There was a long standing theory that the sickle cell trait – having only one sickle cell gene – didn’t cause discomfort and provided a bonus trait of preventing patients from contracting severe forms of malaria. Later confirmed – associating sickle cell to a 29% reduction in malaria incidence – this working theory would explain why the mutation stuck around in evolution. In 2011, researchers used mice to confirm the assumption.

            Miguel Soares and Ana Ferreira of the Gulbenkian Institute of Science in Oeiras, Portugal, and colleagues found that haem – a component of haemoglobin – is present in a free form in the blood of mice with sickle cell trait, but largely absent from normal mice. By injecting haem into the blood of normal mice before infecting them with malaria, researchers found it could help guard against malaria. The mice did not develop the disease. Their results also showed that the gene does not protect against infection by the malaria parasite, but prevents the disease taking hold after the animal has been infected. “

          7. Heredity is genetics.. how many ‘copies’ of each parent’s genes the offspring gets. Gene changes don’t happen in response to a disease (like malaria).
            SC trait = one copy and no disease. SC disease = two copies one from each parent.
            You don’t need to reprint the article you need to read it until it sinks in:
            “. There was a long standing theory that the sickle cell trait – having only one sickle cell gene – didn’t cause discomfort and provided a bonus trait of preventing patients from contracting severe forms of malaria. Later confirmed – associating sickle cell [trait] to a 29% reduction in malaria incidence – ” /finished

          8. LarrytheG Avatar

            No you’re wrong and really just looking to cause trouble.

            I was primarily discussing sickle cell as a disease that people have that is inherited and that is a comorbidity with COVID19.

            There are other diseases like this also in the bigger scheme of things.

            You jumped on one part of this that really was not the main point. Even Jim was thinking the same.

            I’m on to you gal and it does not reflect well.

  3. TooManyTaxes Avatar

    The United Nations recognizes 5000 ethnic groups. Delegate Luke Torian got a bill passed that requires people stopped by the police to report their race and ethnicity or, if refused, the officer to make a determination. Needless to say, neither race nor ethnicity is defined in the statute. Nor does there appear to be any training planned. Based on the reporting of race for COVID 19 testing, how well is that going to work?

    Good thing the media worships the Democrats.

  4. LarrytheG Avatar

    FYI – ” Research to Improve Data on Race and Ethnicity

    The United States Census Bureau has a long history of conducting research to improve questions and data on race and ethnicity. Since the first census in 1790, the Census Bureau has collected information on race/ethnicity and the census form has reflected changes in society and shifts that have occurred in the way the Census Bureau classifies race and ethnicity.”


  5. ksmith8953 Avatar

    Like masks, some people consider it an infringement on their rights to have facts about their race tracked. For example, Asians, who have been erroneously accused of spreading the virus. Or Blacks who would not want the same erroneous issue of falsehoods about the spread of the virus. Does it change any facts? No. The same number had the virus and/or died from it.

  6. LarrytheG Avatar

    They may but such collection of that data is important for a variety of reasons and my suspects is that the “rights” folks are the same ones who decry masks, not smoking in businesses, seat belts, motorcycle helmets ,etc.

  7. The other thing I notice in my Pittsburgh home town, they get for each zip code, number of deaths (just 1 death in my home town), number of cases, and number of tests performed. I do not think we get the deaths per zip …yet another big secret in Virginia?

    1. MAdams Avatar

      PA’s dashboard has been heads above VA’s even from the beginning. I too am from PA (NW), and have family still there. So I’d check information about both states tone the daily in the beginning.

    2. TBILL: You can download cases and tests by zip code, but not deaths. (Fewer than 5 cases are suppressed.)

      The Localities tab on the VDH Dashboard gives counties and cities, cases, hospitalizations and deaths.

      1. Here there seems to be many elderly and fair share of group/nursing homes and there is one death in the whole town.

        Implication my town in NoVA, if we knew the number of deaths and where they happened (group/nursing homes) the number of other deaths in the suburban community might be very small.

  8. LarrytheG Avatar

    I dunno. We’re getting them by county within the health district… and would not be surprised if done by zip also.

    One thing to be aware of on testing and that is that it’s done by a number of different organizations and I wonder if there is a standard form everyone uses – like a VDH form or a CDC form…etc…

    The thing about data – is that it does inform – and because it does, there is an insatiable appetite for it as well as criticism when it does not fully satisfy!!!

    These days people want more. They want data mining and data fusion but there are perils to slicing and dicing data that requires folks who are schooled in “data”.

    lies, damned lies, statistics, and DAMNABLE data!

  9. Just for background, the categories VDH tracks are Asian/Pacific Islander, black, Latino, Native American, Other Race, Two or more races, and white. What’s interesting is that the unknown for hospitalizations is 223 total; for deaths, 74. So if VDH used those two measures, the unknown in total cases wouldn’t matter. It’s the insistence on assigning disparity levels based on partial numbers that’s a problem.

    The slightly above population percentage for 495 black deaths (23.8%) may be explained by the number from urban locations with a higher black population than rural areas and occupations in service industries. Hispanic total deaths of 231 is 11.1%–about the same as the percentage of the population, especially when you consider a number of European origin “Hispanics” consider themselves white.

    So the whole issue of disproportion and disparity is exaggerated, and more likely, is a result of socio-economic conditions, regardless of race.

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