Coronavirus

Thermometer company: Florida compares only to NYC in spike in fever data

A company that makes Internet-connected thermometers has found “widespread atypical illness” throughout Florida that can’t be explained by the late flu season and, public health experts warn, it may be a sign that coronavirus infections may be more widespread in the state than previously reported.

Kinsa Health, a San Francisco-based company that has sold or given away thousands of smart thermometers to households in Florida, has the power to track in real-time people’s fevers as soon as they test for them. The thermometer data serves as an early warning of illness, and the company has used it to track the spread of the flu in Florida and around the country for six years.

As the novel coronavirus has spread, Kinsa Health has tracked a “strong correlation” between confirmed COVID-19 cases and illness that cannot be explained or attributed to seasonal flu across Florida, potentially indicating the spread of the virus is faster than the U.S. Centers for Disease Control and Prevention was reporting it, said Patrick Phillips, head of data science for Kinsa Health.

“Related to other states, Florida is a class of its own,’’ he said.

Nita Nehru, spokeswoman for Kinsa Health, said the thermometer data shows “that Florida is actually two times as severe in illness right now for what we would expect in a normal flu season based on the illness signature of a geography.

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“Some of this activity may be due to a late resurgence of H1N1 flu, but it is definitely also picking up COVID,’’ she said.

A spike in ER visits

Meanwhile state data shows that as health officials have struggled to expand testing for COVID-19, the disease caused by the novel coronavirus, more people are showing up in Florida’s hospital emergency rooms with fever and cough. For the past two weeks, hospital emergency room visits for cough and fever have risen steadily statewide and in South Florida, the state epicenter of the COVID-19 outbreak, those cases have gone up even more than the state average, surveillance data published by the Department of Health indicates.

Philips said that by comparing the data from the Florida Department of Health to the company’s fever data, the increase in “atypical illness” is “certainly not limited to Miami or South Florida.” (Note: The Miami Herald and Tampa Bay Times have not seen the company’s raw data.)

While Florida’s public health response has relied on confirmed positive cases of the infection, state and local officials focused on closing public places and restaurants and urging people to isolate in the virus hotspots of Miami-Dade and Broward counties.

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Absent evidence of more COVID-19 clusters, Gov. Ron DeSantis has waited days to take equally aggressive steps in other parts of the state. On Friday, he announced the widest mandatory statewide restrictions to date, closing restaurants to in-person dining but allowing them to remain open for delivery. On Tuesday, he ordered all bars and nightclubs to be closed for the next 30 days.

Mark Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health, said during a phone call with reporters Friday that the reports of Kinsa Health smart thermometers, showing unusually high fever activity and data from emergency departments in Florida, as first reported in the New York Times, caught his attention when he was watching television Thursday night.

“That should be indicative that something is very strange,” Lipsitch said. “ ... It’s not cold season. It’s very, very late for flu season. It’s a fairly safe assumption, although not certain, that a significant proportion of that disease is COVID-19, so I think treating it as though that were the case would be very wise.”

The Times reported that “ Kinsa’s interactive maps have accurately predicted the spread of flu around the United States about two weeks before the CDC’s surveillance tool, the weekly FluView tracker. “

The pattern has played out in Florida during the coronavirus outbreak. Days before South Florida became a COVID-19 hotspot, the company’s thermometer data indicated an unusual rise in fevers in South Florida.

The company has since tracked the reported cases of the infection and, using its historical data about the patterns of flu and illness in Florida, it subtracted out the projected cases of flu to come up with a category it calls “atypical illness,’’ Nehru said.

An animated map produced by the company shows that COVID-19 cases followed its tracking of atypical illnesses.

“Something unusual is happening that we need to investigate,’’ she said.

“Right now, Florida and New York City are the most severe we are seeing in the United States, and that should be a calling card for either the state or federal government to say, ‘Hey we need resources devoted to this,’ ’’ she said.

The company’s data and analysis

Nehru emphasized the Kinsa Health map is not confirmed COVID-19 cases but the evidence of elevated illness, which appear to be “unusually high levels in Florida,” and may be leading indicators of more infections.

“The most import thing Florida can do right now is take social distancing measures,’’ she said.

Lipsitch, the Harvard epidemiologist, agrees that the signs point to Florida officials implementing social distancing measures “in an intensive way” in order to build up hospital capacity for an inevitable surge of new cases.

“Florida obviously has a large number of elderly people who are going to be at risk for severe outcomes,” he said.

The thermometers connect to a cellphone app that transmits the fever readings to the company. Users can also enter other symptoms and the app provides general advice on when to seek medical attention.

Kinsa Health sells its thermometers at Target, CVS, Amazon, and the company’s website and also distributes them for free through the FLUency school health program, an initiative to help primarily Title 1 schools stop the spread of illness.

Mary Ellen Klas can be reached at meklas@miamiherald.com and @MaryEllenKlas
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