A new study suggests that the number of people who have contracted COVID-19 could be much higher than the official case counts. The Johns Hopkins Coronavirus Resource Center has reported more than 107 million people have come down with the virus globally. In the United States there have been over 27 million confirmed cases. Those numbers are startling, but they are likely an underestimate. The number of people who have caught COVID could be much higher.
How Many People Have Actually Caught COVID?
Researchers at the University of Texas Southwestern think that the number of people who have caught COVID could be up to three times higher than the Hopkins estimate (PLOS ONE, Feb. 8, 2021). A model they developed with the help of a machine-learning algorithm estimates that more than 71 million Americans had been infected as of early February.
Why is the estimate important?
The authors introduce their research this way:
“Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, daily counts of confirmed cases and deaths have been publicly reported in real-time to control the virus spread. However, substantial undocumented infections have obscured the true size of the currently infected population, which is arguably the most critical number for public health policy decisions. We developed a machine learning framework to estimate time courses of actual new COVID-19 cases and current infections in all 50 U.S. states and the 50 most infected countries from reported test results and deaths.”
Critical decisions about testing and treating the coronavirus are based on accurate numbers. Public health authorities need to know how many people have actually caught COVID and how many are infectious at any given time. That’s how they know whether restrictions are needed and which might be most effective.
The Number Crunchers:
To calculate the number of people who have caught COVID, the algorithm counts the number of deaths and estimates based on an infection fatality rate of 0.66%. To check the accuracy of the algorithm, the researchers used blood tests that show how many individuals in an area have been exposed to the coronavirus.
The calculations track closely to the percentage of people with positive antibodies. The algorithm estimates higher infection rates for other countries as well. In some cases, the number of actual cases is more than five times higher than the official count.
If you check the Johns Hopkins Coronavirus Resource Center for COVID cases in the United Kingdom you will see a little over 4 million. The algorithm estimates six times that number, or roughly 25 million people in the UK, caught COVID.
The Hopkins case count for Mexico is put at nearly 2 million cases. The algorithm puts that number at around 27 million, which is 15 times higher than the official tally.
Why Are Accurate Numbers Important?
Some people maintain that it doesn’t matter how many individuals have caught COVID. They insist that the virus is not that big a deal and that it’s just like the flu. The algorithm relies largely on reported deaths, because those numbers are based largely on official death certificates.
What About Phony Death Certificates?
Although some visitors to this website suggest that many doctors are intentionally misrepresenting cause of death, we think that is rare. Filling out a death certificate is an awesome responsibility. According to an article in StatPearls (April 30, 2020):
“The process of medical death certification is a challenging and daunting task for most healthcare practitioners and physicians who are tasked with this responsibility. In most instances, in the United States, when a death certificate must be completed, it is the responsibility of the physician to fill it out.
“It is considered a class 1 felony to willfully and knowingly falsify information on the death certificate.”
We doubt that very many physicians would take such a risk.
Cause of Death?
Many people who catch COVID die from complications of the disease. Some die from pneumonia. Others die from heart problems or blood clots that lead to strokes. What is the cause of death in such situations? Here is what the article cited above suggests:
“Hip fracture from falls, especially in elderly, frail patients, is very common. The presence of hip fracture can predispose patients to sepsis and a thromboembolic event that can ultimately cause death. If as a sequela of a hip fracture from a fall, a patient later develops pulmonary embolism from prolonged immobilization, the manner of death in this instance will be an accident.”
In the case described above, the doctor could write that cause of death was pulmonary embolism (blood clot in the lungs). But the underlying trigger was a hip fracture. Ditto for COVID-19. The ultimate cause of death might be stroke, heart attack or pneumonia, but the initiating event was COVID-19.
Still confused? Let me put it to you this way. If someone is shot in the chest, bleeds out and ultimately suffers cardiac arrest, what is the cause of death? You could try to say cardiac arrest. The underlying reason the person died, however, is clearly a gunshot.
Whatever the exact number, far too many people have caught COVID. We fear that we may ultimately come close to numbers reminiscent of the 1918 influenza pandemic.
The authors of the recent study summarize their findings:
“In conclusion, this study demonstrates that severe under-ascertainment has obscured the true severity of widespread COVID-19 all over the world. In the majority of the 50 countries, actual cumulative cases were estimated to be 5–20 times greater than the confirmed cases. Given that the confirmed cases only capture the tip of the iceberg in the middle of the pandemic, the estimated sizes of current infections in this study provide crucial information to determine the regional severity of COVID-19 that can be misguided by the confirmed cases.”
We are hopeful that vaccines and better treatments will gradually bring an end to the pandemic and the incredible suffering that it has caused. Until that day, though, we encourage people to remain cautious. We have experienced personal loss because of this virus. The pain and suffering are far too real. Here is a new article on one way to reduce your risk.