The urgent calls from doctors to the county department of health began in mid-October, shortly after skyrocketing coronavirus cases had brought a state-imposed lockdown to the community north of New York City.
“Some patients are refusing testing because they do not want D.O.H. bothering them,” a doctor said in a message for the county health commissioner on Oct. 13.
A day later, a caller to a state complaint hotline said in a message, “I would also like to report that there is a widespread effort from the community’s leadership to discourage Covid testing.”
Two weeks after a flurry of similar messages, the positivity rate in Kiryas Joel, an ultra-Orthodox Jewish village in Orange County, plummeted from 34 percent — the highest in the state — to just 2 percent. Last week, citing “dramatic progress” on the rate, the governor eased restrictions in the zone.
The course of events in Orange County has raised deep suspicions among some health experts about the reliability of the data, reflecting broader concerns about whether top officials in New York and around the country are tracking the outbreak in ways that may not accurately capture how much the virus is spreading.
Epidemiologists suggest that officials should rely on many factors when making decisions about reopening, including interviews with health care providers, hospital admission rates and contact tracing, as well as the positivity rate, which is the percent of people who have tested positive over a particular time period.
In New York, senior officials say they use all that data, and refer to the positivity rates as merely a lead measure and shorthand.
Still, the positivity rate has become the de facto gold standard of publicly highlighted measures. For example, Gov. Andrew M. Cuomo, Mayor Bill de Blasio and other officials in New York repeatedly refer to the rate in pronouncements and news releases to give the public a sense of how efforts to combat the virus are going.
The concern over misleading positivity rates has come to a head in regards to Kiryas Joel, also called the Town of Palm Tree, a densely populated Hasidic village of 26,000 people that is about 50 miles north of New York City, and among the poorest communities in the state.
In Orange County, the local health commissioner, Dr. Irina Gelman, said she was concerned about easing restrictions because she had serious doubts about whether the suggested decline in virus cases was real. She said that even though more people in the ultra-Orthodox community were reporting to doctors with symptoms or exposure to the virus, fewer of them were agreeing to be tested, reducing the positivity rate.
“This is an alarming trend,” Dr. Gelman said. “Refusing tests, clearly, makes it very difficult as far as gauging the infection prevalence rate within the community.”
“To go from a 34 percent positivity rate down to a 4 percent positivity rate when the “micro-cluster/ hot zone” schools did not actually shut down — and just converted to “child care”— is something many