Antigen Totals Annotations - The COVID Tracking Project


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2	Antigen Test Reporting in Total Tests By State
3	These annotations label each jurisdiction's reporting practices for antigen total testing according to the information available on its website. These annotations are useful in two main ways: 1) As an evaluation of states' transparency around the kinds of testing they include in their totals figures. If a state is labeled as "Unclear," its documentation should be better. 2) To contrast what a state claims to be doing with what it appears to actually be doing. These annotations, therefore, do not necessarily reflect what a state is doing, nor do they reflect all our knowledge of those states' practices. Sometimes, states are unclear on their dashboard, but we have learned whether they include antigen tests in their totals through direct outreach. Occasionally, we receive word that a state appears to be defining its tests in a way that appears to conflict with information it provides on their dashboard. Read our post to learn more about specific examples. Please note that these annotations categorize a state's total testing figures (total individuals tested, total test encounters, or total specimens tested). Information about a state's positive definitions only influences its annotation if we have evidence that the positives are summed with negatives to produce the totals figure. The annotations in this spreadsheet cannot be used to determine whether a state is including probable cases in its case count.
4	Classification	Number of States	Definition
5	Viral RNA only	19	The state specifies that its total tests figures only include viral RNA tests. This includes tests such as reverse-transcription polymerase chain reaction (RT-PCR) tests, reverse-transcription loop-mediated isothermal amplification (RT-LAMP) tests, and any other nucleic acid amplification (NAAT) tests.
6	Antigen and Viral RNA separate	12	The state is reporting viral RNA and antigen totals as separate numbers, even if it also includes a number that sums the two.
7	Antigen and Viral RNA lumped	9	The state is reporting viral RNA and antigen totals as one total number, without breaking them out anywhere.
8	Unclear	16	It is unclear if the state's total test numbers include antigen tests.
9	Principles
10	Testing strategies and FAQs	If a state addresses antigen testing in its testing strategy or frequently asked questions, that does not influence our annotation of the state's reporting practices, unless those strategies explicitly speak to data reporting plans or are referenced by the dashboard. We have observed that there is often a gap between the surveillance strategies states adopt and the actual data they end up reporting to the public.
11	"Molecular," "diagnostic" and "viral" tests	The terms "molecular," "diagnostic" and "viral" are sometimes used by states to include antigen testing in their totals, and are sometimes used to exclude antigen testing. For that reason, if a state calls its tests "molecular," "diagnostic" or "viral" without expounding on the meaning of the terms, we label it as unclear.
12	Process
13	1. Before deciding on a label for each state, a reviewer combed through through data definitions on its health department website.
14	2. After one reviewer decided on an annotation, another experienced reviewer checked their work.
15	3. A third reviewer went through all the research and triple-checked them, then consolidated all our notes into a few sentences on why states received a particular annotation. The date of their review is noted in the "Last Date Checked" column.
16	Credits
17	These annotations were produced by a team of volunteers at The COVID Tracking Project. Thank you to Jesse Anderson, Jennifer Clyde, Matt Dempsey, Elizabeth Eads, Betsy Ladyzhets, Daniel Lin, Michal Mart, Quang Nguyen, Kara Schechtman, Erika Thomson, Nadia Zonis, and other contributors for your tireless work on this and many other data quality efforts.


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2	State	Total Tests Label	Details	Date Last Checked

3	AK	Antigen and Viral RNA lumped	In their testing data FAQ, Alaska writes that "the data on the Testing Dashboard only includes diagnostic tests (viral or antigen tests)."	10/5
4	AL	Antigen and Viral RNA lumped	Alabama defines its total tests on its dashboard as "unique individuals tested with either diagnostic test (molecular or antigen test) that were reported to the Alabama Department of Health."	10/5
5	AR	Antigen and Viral RNA separate	Arkansas provides a breakdown of PCR and antigen testing on its dashboard on the "Tests" tab.	10/5
6	AS	Unclear	American Samoa does not mention antigen testing on any of the sources we use to get its number (outreach to their health department, their website, and its Facebook page).	10/5
7	AZ	Antigen and Viral RNA lumped	Arizona includes both antigen and PCR testing in "Total COVID-19 Diagnostic Tests" figure on its dashboard, according to a footnote.	10/5
8	CA	Unclear	California's dashboard defines its total test results as "cumulative tests reported by all labs" with no further information on the type of tests.	10/5
9	CO	Viral RNA only	Colorado labels its tests as "Cumulative COVID-19 PCR Test Data" on its dashboard.	10/5
10	CT	Viral RNA only	Connecticut's "COVID-19 Summary" section on its COVID-19 data tracker page calls its total tests "COVID-19 PCR Tests Reported."	10/5
11	DC	Unclear	DC calls its totals numbers "Total Overall Tested" and "Total Residents Tested" on its dashboard without specifying the type of test.	10/5
12	DE	Unclear	Deleware calls its total tests "Testing Totals in State of Deleware" on its dashboard without specifying the type of test.	10/5
13	FL	Antigen and Viral RNA lumped	Florida's daily state report specifies that its "Persons Tested" number "includes PCR and antigen test results."	10/5
14	GA	Viral RNA only	Georgia reports "Total PCR/Molecular" tests on its dashboard, clarifying in its Data FAQ that it is using "molecular" as a synonymn for PCR.	10/5
15	GU	Antigen and Viral RNA separate	Guam's daily situation report PDFs, accessible from this page, include " total molecular tests" and "total antigen tests" broken down.	10/5
16	HI	Viral RNA only	The "Lab Testing" section of Hawaii's dashboard has a footnote that says figures are "based on electronic laboratory reporting of Nucleic Acid Amplification tests."	10/5
17	IA	Antigen and Viral RNA separate	Iowa provides breakdowns of PCR and antigen testing for "Individuals Tested" on the "Positive Case Analysis" section of its dashboard.	10/5
18	ID	Viral RNA only	On the "Laboratory Testing" section of its dashboard, Idaho provides PCR test counts for both "tests performed" and "Idahoans tested."	10/18
19	IL	Antigen and Viral RNA lumped	Illinois' "Total Tests Performed" are defined on its dashboard as representing "molecular and antigen tests performed"	10/19
20	IN	Antigen and Viral RNA lumped	Indiana says on its dashboard that "Total Tests Administered" represents "the distinct number of individuals who have taken a PCR or antigen test for COVID-19."	10/5
21	KS	Antigen and Viral RNA lumped	On the "Testing Rates" section of its dashboard, Kansas says its "People Tested" figure represents "any Kansas resident that was tested for the Sars-CoV-2 virus by a diagnostic tests (e.g., PCR, antigen)."	10/5
22	KY	Antigen and Viral RNA separate	Kentucky separates PCR and antigen testing out on its dashboard.	10/5
23	LA	Viral RNA only	Louisiana reports "confirmatory tests" on its dashboard, which it defines on the "Other Information" tab of the dashboard as tests that identify "severe acute respiratory syndrome coronavirus 2 ribonucleic acid (SARS-CoV-2 RNA) in a clinical specimen" using a "molecular amplification detection" technique.	10/5
24	MA	Antigen and Viral RNA separate	In its daily dashboard PDF, accessible from this page, Massachusetts provides figures for "Total Molecular Tests Administered" and "Total Individuals Tested by Molecular Tests," explaining in its definitions that molecular tests represent PCR tests, and "Total Individuals Tested by Antigen Tests."	10/6
25	MD	Viral RNA only	Maryland explains that the "Testing Volume" figure on its dashboard represents "the static daily total of PCR COVID-19 tests."	10/6
26	ME	Viral RNA only	Maine reports "Molecular Testing" in the "All Reported COVID-19 Tests in Maine" table of its dashboard. It notes that molecular testing "includes PCR, isothermal and NAAT methods."	10/6
27	MI	Antigen and Viral RNA lumped	Michigan reports "Diagnostic tests," which it specifies includes both NAAT/RT-PCR tests and antigen POC tests in a note on the side of its dashboard.	10/7
28	MN	Antigen and Viral RNA separate	Minnesota's definition for its testing figures, under the "Testing" section of its dashboard, breaks down "completed antigen tests" and "completed PCR tests."	10/14
29	MO	Antigen and Viral RNA separate	Breakdowns of PCR, antigen and serology testing are available in the "Detail: Testing" section of Missouri's dashboard, under "Test Results by Test Type."	10/7
30	MP	Unclear	The Northern Mariana Islands' tests are called "Total Tests" on its dashboard, with no further information provided.	10/7
31	MS	Antigen and Viral RNA separate	In the "Statewide Combined Testing" table of its dashboard, Mississippi breaks out PCR and antigen testing figures.	10/7
32	MT	Viral RNA only	While Montana's dashboard does not specify what kinds of testing its "Total Tests" figure represents, a graph midway down the Demographics section of its COVID website refers to SARS-Cov-2 PCR testing, with a total matching the dashboard's.	10/7
33	NC	Antigen and Viral RNA separate	North Carolina reports "Total Tests" on the Testing section of its dashboard broken down by PCR and antigen after September 22, 2020.	10/7
34	ND	Unclear	None of North Dakota's testing definitions on its dashboard specify the type of testing used for its three totals figures.	10/7
35	NE	Unclear	Nebraska reports a "Total Tested" figure on its dashboard without specifying whether it includes antigen testing.	10/7
36	NH	Viral RNA only	New Hampshire reports "Total Performed Tested At Selected Laboratories, Polymerase Chain Reaction (PCR)" on its dashboard.	10/7
37	NJ	Viral RNA only	New Jersey's dashboard reports "Total PCR Tests Reported."	10/7
38	NM	Unclear	New Mexico reports "total tests" on its dashboard without specifying the type of test.	10/7
39	NV	Unclear	The "Technical Notes" section on page 10 of Nevada's dashboard specify that the testing data reflects "molecular only" without providing a definition for "molecular."	10/7
40	NY	Unclear	New York reports "Total Persons Tested" on its dashboard with no clarification on the type of testing.	10/7
41	OH	Unclear	Ohio reports "diagnostic tests performed" on the "Key Metrics" section of its dashboard without clarifying what kind of test qualifies as diagnostic.	10/7
42	OK	Antigen and Viral RNA lumped	Among the laboratories reporting in its linelist of testing data, Oklahoma's most recent report includes a lab called "IN HOUSE- ANTIGEN TESTING MACHINE," suggesting they include antigen tests in their totals.	10/7
43	OR	Unclear	Oregon does not indicate whether the "Total tested" number on its dashboard includes antigen testing.	10/7
44	PA	Viral RNA only	Pennsylvania reports "Total PCR Tests" on one of its COVID data dashboards.	10/7
45	PR	Unclear	In its Bio Portal reports periodically released to journalists, from which we receive its testing data, Puerto Rico reports "pruebas moleculares registradas" ("registered molecular tests"). It is unclear whether this category includes antigen tests.	10/7
46	RI	Unclear	Rhode Island's data notes do not specify whether their total testing figures include antigen.	10/7
47	SC	Antigen and Viral RNA separate	South Carolina reports "Viral (molecular)" and "Antigen" test "grand totals" on its county-level dashboard, under the "Testing" tab, and clarifies in its Testing Type Information page, linked from its data homepage, that they are using the terms "NAAT," "molecular," and "viral" synonymously.	10/7
48	SD	Unclear	South Dakota does not clearly label whether the "Total Persons Tested" or "Total Tests" figures on its dashboard include antigen tests. However, reporting on their progress for monthly goals for PCR and antigen tests, South Dakota reported completing 95,543 antigen and PCR tests in September, compared to 75,577 tests as reflected in its "Total Tests" figure, suggesting but not confirming that "Total Tests" reflects PCR testing only.	10/7
49	TN	Viral RNA only	Tennessee's "total" test figure on its dashboard PDF is equal to the sum of "PCR Positive" and "PCR Negative."	10/7
50	TX	Antigen and Viral RNA separate	Texas lists "total antigen tests" separately from "total molecular tests" on its Test and Hospital data dashboard, specifying in its "Data Definitions" tab that "molecular" refers to NAAT.	10/7
51	UT	Antigen and Viral RNA separate	Utah's dashboard notes that it is currently including both PCR and antigen tests in its totals counts. It also provides two graphs, entitled "Number of People Tested by Date" and "Total Tests by Date," which break out antigen and PCR tests.	10/7
52	VA	Viral RNA only	Virginia's dashboard calls its totals field "Testing Encounters PCR Only."	10/7
53	VI	Unclear	The US Virgin Islands' testing figures are simply called "Tested" on its dashboard.	10/7
54	VT	Viral RNA only	Vermont specifies in its weekly summary reports that it does not include antigen testing in its totals figures.	10/7
55	WA	Viral RNA only	Washington's definition for "Total Tests" on the main screen of its dashboard, accessible by clicking "Learn More," defines the figure as representing "total positive and negative molecular tests." A September 30 press release announcing the release of positive antigen tests contrasts antigen tests with molecular tests, clarifying that WA is using the term to refer to viral RNA tests.	10/7
56	WI	Viral RNA only	Wisconsin's summary dashboard has a note that it "provides the cumulative total number of people tested using diagnostic, confirmatory polymerase chain reaction (PCR) test or nucleic acid amplification tests (NAT) that detect the genetic material of SARS-CoV-2, the virus that causes COVID-19. No antigen or antibody test results are included in this section."	10/7
57	WV	Viral RNA only	West Virginia's dashboard calls its total testing figures "confirmatory lab tests" and specifies in a hover that those tests are PCR.	10/6
58	WY	Viral RNA only	Wyoming's data definitions specify antigen tests are not included in its "resulted tests" figures.	10/7