Kristina Boedtger and Colin Patrick work out at Historic Fourth Ward Park on May 10, 2020 in Atlanta, Georgia.

Getty Images/Kevin C. Cox

Georgia lifted its shelter-in-place order April 30, and some have hailed it as an example of how to reopen a local economy while containing the coronavirus — but that’s not yet what the data show.

The state’s Department of Public Health has faced criticism over publishing inaccurate or misleading data in recent weeks, and Gov. Brian Kemp’s office has apologized.

Experts have also said coronavirus case counts don’t show what the outbreaks look like in realtime — they’re a snapshot of what the outbreaks looked like two weeks earlier.

As of May 19, Georgia has conducted more than 378,000 coronavirus tests, with 38,000 positive cases. The death toll for the state is 1,664, and more than 7,000 people have been hospitalized.

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Roughly three weeks after Georgia began reopening businesses and lifted its shelter-in-place order, the status of the state’s coronavirus outbreak remains unclear amid a roiling debate over how to interpret recent COVID-19 data, and allegations that state officials have been misrepresenting the number of new cases.

Though Georgia’s Department of Public Health has published data showing what appears to be a significant decline in new cases and deaths, experts have emphasized that the data is both preliminary and incomplete, and suggested that the outbreak appears to be in a plateau — not a decline.

The graph shows that the number  of new, confirmed coronavirus cases has plunged since early May — but the state also added a warning directly under the graph on its website, noting that the data is “preliminary,” and that the “data during the reporting period may be incomplete due to the lag in time between when the case was tested and/or reported and submitted to the Georgia DPH for reporting purposes.”

As of May 19, Georgia had conducted more than 378,000 coronavirus tests, with 38,000 positive cases. The death toll for the state is 1,664, and 7,000 people have been hospitalized, according to state health officials.

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Meanwhile, the state’s residents have already resumed much of their everyday lives. Businesses began reopening late in April, and Gov. Brian Kemp lifted the statewide shelter-in-place order on April 30.

The latest news: Businesses are open, out-of-state visitors are flooding in, and state officials are apologizing for misleading or inaccurate data

On April 24, Georgia allowed businesses such as barbers, gyms, salons, and bowling alleys to reopen, and on April 27, theaters, dine-in restaurants, and private social clubs followed suit. The businesses were required to implement strict social-distancing measures to keep customers safe.

But researchers from the University of Maryland flagged a surge of out-of-state visitors flooding into the state after April 24 — a 13% increase from the average from previous weeks. The experts deduced that the uptick in travel was due to the state’s reopening, and expressed concern that the visitors’ behavior could cause a new surge in coronavirus cases and deaths.

Though Georgia’s data has not yet revealed a surge in cases or deaths, the state’s public health officials have been fiercely criticized in recent days for publishing a misleading graph that appeared to show a steep, steady drop in new COVID-19 cases in the state’s five most-affected counties.

The Georgia Department of Public Health has released a graph of daily coronavirus cases over time, noting that the data from May 5 onwards is incomplete.

Georgia Department of Public Health

But as experts and journalists quickly pointed out, the graph’s x-axis had placed dates out of chronological order in order to display coronavirus case counts in descending order.

Kemp’s office even issued an apology for the graph, and the state’s website has been updated to display the graph with the dates accurately depicted in chronological order.

“The x axis was set up that way to show descending values to more easily demonstrate peak values and counties on those dates,” Kemp’s communications director, Candice Broce, tweeted Monday. “Our mission failed. We apologize. It is fixed.”

As state Rep. Scott Holcomb wrote in a letter to Kemp, “This data is being used to inform state policy and by individuals to assess health risks.”

The mishap has fueled speculation that state official are basing their decisions on flawed, incomplete, or misinterpreted data.

“It’s incredibly important for the data to be as accurate as possible and to be presented in a manner that is not misleading,” Holcomb wrote.

Moes BBQ Georgia restaurants reopening coronavirus

Chandan Khanna/AFP via Getty Images

Coronavirus data has a 2-week lag — that means it’s too early to conclude that reopening works

Preliminary data from public health officials on the number of new coronavirus cases in the state has prompted some to claim victory over the outbreak.

Though it’s tempting to celebrate any optimistic-looking data as a sign that reopening states can help local economies bounce back without worsening COVID-19 outbreaks, it’s still early to draw such a conclusion.

The state’s Department of Public Health has recently released graphs showing a decline in both confirmed cases and deaths. But independent evaluations, including the Atlanta Journal Constitution’s analysis of Georgia’s data, has shown more of a plateau in new coronavirus cases in the state, rather than a decline.

Further complicating the issue is the amount of time it takes to get accurate data and determine a trend. As experts have explained, current coronavirus case counts are not representations of how severe the outbreaks are in that very moment — rather, the case counts show how severe the outbreaks were roughly two weeks earlier.

Georgia restaurant reopening coronavirus

Jessica McGowan/Getty Images

Therefore, Georgia’s optimistic-looking data from recent weeks may be reflecting the success of the state’s lockdown measures, rather than reflecting the success of lifting those measures.

Georgia public health officials have acknowledged a lag in the data — specifically the amount of time between when a person is tested, and when their positive test result is actually reported to public health officials for tracking.

So, in many cases, there could be a roughly two-week delay — or even longer — between a person contracting the virus, and their positive test result getting reported to state health authorities.

According to the US Centers for Disease Control and Prevention, the novel coronavirus’ incubation period can last up to 14 days, though research has shown that the vast majority of patients who develop symptoms do so within 11.5 days of infection.

Then, once a person gets tested, further delays may occur between the test, the notification of a positive result, and the reporting of that positive result to public health authorities.

Georgia has promised that everyone who requests a test can get one, but experts say the state still needs to conduct far more to contain its outbreakA police officer directs cars into a coronavirus testing facility at Georgia Tech Monday, April 6, 2020, in Atlanta.

Associated Press/John Bazemore

As for deaths, there’s an even greater lag in the data since a patient may not actually die of the virus until weeks after they first contracted it, and a further lag could occur between the time of the patient’s death and the moment the death certificate is processed for reporting.

The CDC has said the reporting lag for deaths could range from one to eight weeks, or more, “depending on the jurisdiction, age, and cause of death,” though the CDC also says the average lag is closer to one or two weeks.

The amount of testing is also crucial to consider in the number of reported cases, as positive cases cannot be detected without widespread testing and contact tracing.

Though Georgia has ramped up its testing, and now promises that anyone in the state who requests a test can get one, it’s far from certain that the state’s current testing capacity is accurately depicting the extent of the coronavirus outbreak.

For instance, between April 30 and May 6 — the first week the state reopened — Georgia averaged 8,600 tests per day. Experts from Harvard University’s Global Health Institute said that average was far below the estimated minimum of 25,979 daily tests needed by May 15 to contain its outbreak, according to a data analysis by NPR.

The state has only tested about 3.6% of its 10.6 million residents since the outbreak began.

Georgia may have managed to simultaneously tamp down its coronavirus outbreak and reopen its economy — but it will take more time for the data to reflect that conclusion.

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