New COVID-19 definitions by the state could raise case counts in Collin County

A probable case of COVID-19 in Texas can now be confirmed by a positive FDA-approved lab result paired with certain clinical criteria or certain epidemiological links. (Courtesy Adobe Stock)
A probable case of COVID-19 in Texas can now be confirmed by a positive FDA-approved lab result paired with certain clinical criteria or certain epidemiological links. (Courtesy Adobe Stock)

A probable case of COVID-19 in Texas can now be confirmed by a positive FDA-approved lab result paired with certain clinical criteria or certain epidemiological links. (Courtesy Adobe Stock)

Revised definitions for probable COVID-19 cases and related deaths by the Texas Department of State Health Services could result in a spike of reported cases of the virus, according to a county official.

Aisha Souri, an epidemiology department official for the county, informed Collin County commissioners of the reasoning behind the state’s decisions at a May 18 meeting.

The definition for a confirmed COVID-19 case has not changed and is determined by a positive polymerase chain reaction, or PCR, test result from a lab, Souri said.

A probable case of COVID-19 can now be confirmed by a positive FDA-approved lab result paired with certain clinical criteria or certain epidemiological links, she said.

However, a probable case can also be determined without an FDA-approved test if someone meets definitions of certain clinical criteria and epidemiological links, Souri said.


“That still gets counted towards the case count,” she said. “It’s different. It’s not confirmed; it’s probable; but it’s still a case.”

Collin County Judge Chris Hill said he is worried COVID-19 cases will spike in a way that does not accurately represent the virus’s spread in the county.

“I fear that this is coming at a time when we’re just now starting to reopen,” he said during the meeting. “If the numbers jump in a false way, it’s going to start to be very concerning to our citizens that we’re actually going backwards.”

The state—which will soon take over contact tracing of COVID-19 cases for all of Texas—is expected to report probable cases separately from confirmed cases, Hill said.

Additionally, a positive PCR test result will no longer be required to determine a COVID-19-related death, Souri said.

If COVID-19 was determined to be a possible cause of death—even among other possible causes—it will be counted as a COVID-19-related death, she said.

“That also has the opportunity for COVID deaths to go up dramatically,” Hill said.

Clinical criteria needed to meet the definition of a probable COVID-19 includes:

  • at least two of the following symptoms: fever that is measured or subjective, chills, rigors, myalgia, headache, sore throat, or new smell and taste disorders;

  • at least one of the following symptoms: cough, shortness of breath or difficulty breathing; or

  • severe respiratory illness with at least one of the following: clinical or radiographic evidence of pneumonia, or acute respiratory distress syndrome and no alternative more likely diagnosis.


Epidemiological links needed to meet the definition of a probable case includes:


  • close contact with a confirmed or probable case of COVID-19;

  • close contact with a person with clinically compatible illness and linkage to a confirmed case of COVID-19; or

  • travel to or residence in an area with sustained, ongoing community transmission of SARS-CoV-2.


Close contact, Souri said, is defined by being within 6 feet for at least a period of 10 minutes to 30 minutes or more depending on exposure.

“There are 15 different options on how you can be classified as a probable case,” she said.

Someone in a location considered endemic, Souri said, satisfies the definition for an epidemiological link for a probable case.

“Right now, Texas has stated that they are considering the state as an endemic area,” she said.

Hill said the state being endemic has a significant impact on COVID-19 case counts in the county. All county residents satisfy the epidemiological link by residing in Collin County, he said.

“If you have a subjective fever and you have a headache and you live in Collin County, you now meet the qualifications to be a probable COVID patient,” Hill said. “It is remarkable how low the standard is now.”
By Elizabeth Ucles
Elizabeth is the reporter for Community Impact Newspaper's Frisco edition. She graduated from St. Edward's University with a degree in Writing and Rhetoric with a journalism concentration and a minor in Spanish in May 2019. Elizabeth covers public and higher education, development and transportation.


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