Texas' true COVID-19 case tally may be tens of thousands higher because the state isn't counting rapid-result tests

Texas isn't including positive COVID-19 test results in its official tally if those positives come from rapid-result tests, meaning there could be tens of thousands more cases in the state than the official statistics report, according to the Houston Chronicle.

Thousands of Texans have taken the antigen tests that deliver results in 30 minutes or less. The tests are reportedly used in doctors offices, hospitals, and clinics. But state guidelines consider a positive result from an antigen test to be a "probable" COVID-19 case, rather than a confirmed case.

The Texas Department of State Health Services currently only reports confirmed cases to the public.

The rapid-result tests have been approved by the Food and Drug Administration under an emergency use authorization, but there are concerns about the tests' reliability — specially, the FDA warns of a risk that the tests are more likely than others to produce a false negative result. A person with COVID-19 could potentially be led to believe that they are not infected.

The result of DSHS's treatment of these tests could be hugely significant to the state's overall statistics. From the Chronicle:

And while there is no way to independently estimate the scope of the undercount, based on the 11 Texas counties that publish antigen tests results separately of their own accord, the state's tally is short by at least tens of thousands of cases — but likely far more, a Houston Chronicle analysis found.

And the undercount is about to get worse. The federal government is rolling out a program to use thousands of antigen tests in nursing homes across the country — including Texas.

As of Sunday, Texas had 442,014 recorded cases of COVID-19, and 7,016 fatalities.

It's possible that the state will begin counting probable COVID-19 cases in its numbers, according to DSHS spokesman Chris Van Deusen, and such a change could lead to a sudden, dramatic spike in the total number of cases. In May, according to the Chronicle, DSHS instructed county health departments to note probable cases and the type of test used, but did not want that data released to the public.

This issue has created confusion in Bexar County, where 3,500 cases were removed from the county's total by the state because they were probable, rather than confirmed. It also alters the national total — Texas doesn't report antigen test results even though the CDC calls for states to do so.