Georgia’s public health agency counts just one confirmed diagnosis of the novel coronavirus — and only one death — at an Augusta nursing home.

Windermere Health and Rehabilitation Center, however, acknowledges a much grimmer toll. The facility says 74 residents and 20 staff members have tested positive for the virus — and four residents have died.

The state says the coronavirus has killed no residents of Arbor Terrace at Cascade, an assisted living center in Atlanta. In fact, the Fulton County Board of Health said, deaths at the facility rose Tuesday to 15.

These discrepancies reflect the out-of-date, incomplete and sometimes inaccurate data that guides Georgia’s official response to the coronavirus outbreak, which has killed at least 524 people and sickened more than 14,000 others.

The result is an unclear picture of the virus’ severity in Georgia, as well as of its likely trajectory. It’s not just that officials have no playbook for handling the pandemic, as Gov. Brian Kemp often says. It’s that they cannot see the full field of play.

“As an epidemiologist, what I struggle with is … recognizing that our data is not as accurate as it needs to be,” said Dr. Kathleen Toomey, the state’s public health commissioner. “It’s hard to say what the trends are.”

This acknowledgment comes as Georgia crossed a threshold, recording its 500th death in just a month from COVID-19, the disease caused by the coronavirus.

In an average month, according to federal data, 335 Georgians die in accidents, 135 in shootings and 128 in drug overdoses. Already, the coronavirus is outpacing every other cause of death except for heart disease and cancer.

The official count of coronavirus deaths increased by 44 since Monday, while nearly 1,000 more diagnoses were confirmed by laboratory tests. Almost 3,000 people with confirmed cases of the virus are in Georgia hospitals.

Like other senior-care facilities across the nation, Arbor Terrace at Cascade in Atlanta has a large number of residents who are infected with COVID-19, the disease caused by the novel coronavirus. (Jenni Girtman for Atlanta Journal Constitution)
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Since the outbreak began, Kemp has repeatedly said that data, science and the advice of health officials drive his decision making, including his delays in imposing statewide social-distancing measures to contain the virus’ spread. He was among the last of the nation’s governors to issue a shelter-at-home order and restrict business activity.

In a news conference Monday, Kemp praised Toomey, saying she “has worked hard to make sure that when we put information out that it’s verified and it’s correct.”

Gov. Brian Kemp  talks about the coronavirus in Georgia during a press conference outside the state Capitol on Monday, April 13, 2020. Listening is Dr. Kathleen Toomey, commissioner of the Georgia Department of Public Health. (credit: Ben@BenGray.com for the Atlanta Journal-Constitution)
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However, “there’s no doubt that we need and continue to work on getting better data,” Kemp said. The state Department of Public Health cannot identify the race of more than half of the Georgians who have tested positive for the virus, a key data point for understanding the effects on minority communities.

“That data is important to us,” Kemp said. “It’s also concerning, and we continue to work on that.”

COMPLETE COVERAGE: CORONAVIRUS IN GEORGIA

In some instances, flawed data has caused a drastic understatement of the virus’ severity.

Officials on Tuesday released a report on long-term care facilities that was riddled with errors and omissions. The report documented outbreaks in 138 facilities, up from 80 last week. But it made no mention of Summerset Assisted Living in Fulton County, for instance, even though two-thirds of residents and staff there have tested positive for the virus.

The report said at least 89 residents of long-term care facilities have died of COVID-19. But some of the facilities themselves have recorded significantly more deaths than the report captured.

One of those is the Joe-Anne Burgin Nursing Home in Cuthbert, a small town in southwest Georgia. The home’s chief executive, Kim Gilman, said in a statement that 10 residents died after testing positive for the coronavirus — not four, as the state reported. Cuthbert is the seat of Randolph County, where more than 1.5% of residents have tested positive for the coronavirus, the highest rate in Georgia.

Tuesday’s report also exaggerated the outbreak in at least one facility. It said 47 residents of Cumming Health and Rehab in Forsyth County had tested positive for COVID-19. But Jerry Patton, the facility’s administrator, said Tuesday that the disease has been confirmed in only eight patients.

The number might be higher if the facility could test all its residents. But, in the absence of adequate testing, the staff is treating all residents as if they have the virus, Patton said, hoping to limit its spread.

Such inaccurate information only adds to the anxiety felt by families of residents in long-term care facilities, which have restricted visitation over the past month.

Nancy Nydam, a spokeswoman for the state public health agency, said flawed data has not prevented officials from ensuring that long-term care facilities are following strict guidelines to prevent the coronavirus from spreading. Troops from the Georgia National Guard have sanitized 229 facilities — including nursing homes, personal care homes and hospices — in the past two weeks.

The 265th Infectious Control Georgia Army National Guard enters Canterbury Court, a senior living facility in Buckhead, to disinfect the building on April 10, 2020. STEVE SCHAEFER / Special to the AJC
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“We are not depending on numbers on a spreadsheet to determine how we respond to outbreaks of COVID-19 in long-term care facilities,” Nydam said.

Toomey, the public health commissioner, said her agency is adding data to its public website so Georgians can visualize the virus’ impact.

“You’ll see more and more on our website,” she said, including maps of the rate of infection and the rate of death in all of Georgia’s 159 counties. “It enhances the picture that we have statewide. Looking at where the cases are occurring by number doesn’t give you the full picture as looking at the map with rates.”

However, Toomey acknowledged that her agency’s data isn’t always up to date. Before a diagnosis or a death can be reported to the public, she said, information from local health officials, hospitals or coroners must be vetted. She said she is trying to balance speed with deliberation.

“I want to be epidemiologically accurate,” she said, “but I also want to be as transparent as we possibly can be at this time.”