US racial and ethnic data for COVID-19 cases: still missing in action.

On June 4, 2020, the Trump Administration, responding to criticisms regarding the incompleteness of racial and ethnic data for COVID-19 test results (and other demographic data), including as reported by the US Centers for Disease Control and Prevention (CDC), released new reporting requirements. The guidance stated: “this information should be made available in all reporting (including through methods using existing technical infrastructure such as an HIE [Health Information Exchange] to state and local public health departments and subsequently the CDC as soon as possible, but no later than August 1, 2020”.

To our knowledge, no reports have evaluated whether reporting of racial and ethnic data for US COVID-19 cases has improved since Aug 1, 2020. On Sept 15, 2020 (ie, 6 weeks after the data for cases was required by law), we checked the publicly available websites and made the following key findings.

The current CDC demographic tracker for COVID-19 cases first reported data on Aug 28, 2020, at which time 2 263 017 (51%) of its 4 458 258 cases were missing data on race and ethnicity. As of Sept 16, 2020, 2 445 731 (50%) of its 4 880 315 reported cases were missing these data. Mathematically, this means that 43% of the 422 057 cases added between these two dates were missing racial and ethnic data.

The COVID-19 Racial Data Tracker, which uses publicly available data from state and local health departments, as well as the CDC, reported on Sept 13, 2020, that among the 6 448 573 cases recorded (notably larger than the tally reported by the CDC), 37·5% were missing data on race (appendix); for individual states, the range spanned from none (Minnesota, South Dakota, West Virginia) to 100% (New York), with a median of 21%. For ethnicity, the range of percent missing extended from none (Minnesota, South Dakota) to 100% (Louisiana, North Dakota), with a median of 24%. However, several states do not appear to report any ethnicity data at all (West Virginia, Hawaii, New York). As also shown in the supplementary table (appendix), in states that are the home base for leaders of the US Government (President, Vice President, Senate Majority Leader, and Speaker of the US House of Representatives), data on race and ethnicity are missing for upwards of a quarter to over a third of COVID-19 cases.

These findings suggest that compliance with regulations to report data on race and ethnicity for US COVID-19 cases is inadequate and continues to hamper understanding of and efforts to mitigate racial and ethnic inequities in COVID-19.