Seroprevalence (presence of antibodies) studies in 6 regions of the U.S. conducted by the CDC demonstrate that the percentage of the population that actual have been infected with the coronavirus far exceeds the number ascertained from COVID-19 positive tests.
This study found that to get the actual number of people infected by SARS-COV-2, the positive test data needs to be multiplied the following multiples:
So the range is 6X – 24X. As a reasonable average, let’s use 12X as our multiplier.
In the U.S., 3 million cases are currently identified by PCR tests, antibody tests, or “guessing”. Let’s ignore all of the false negative and false positive problems for a second and just assume that 3 million positive tests is semi accurate.
Multiplying this 3 million positive tests by the factor of 12X suggests that 36 million people have been infected with the coronavirus. That’s 11% of the U.S. population.
Even this calculation could be an underestimation due to the likelihood that the ELISA tests in the seroprevalence studies failed to detect antibodies in serum that were at concentrations below the lower limit of detection of the test, which is quite probable due to the variations amongst individuals in immune response and the differences in the amount of time elapsed from infection to the time blood was taken from the patient.
In my previous post, I estimate that the number of people may be slightly greater than 50 million people based on estimates from infection fatality rates and looking at the number of actual deaths (# of deaths is another controversial subject because of methodologies used in counting, but let’s assume it’s accurate for the sake of discussion).
If that number is accurate, that means we would need to apply a factor or 17X to test data rather than 12X.
This factor of 17X can be reconciled with 12X factor calculated by the seroprevalence data by simply assuming that 30% of the people who were infected with SARS-CoV-2 simply did not possess antibody titres that were above the lower limit of detection at the time of the seroprevalence test.
So, right now, I’m comfortable with stating that the actual multiplication factor for the US falls somewhere between 12X-17X. This would translate to somewhere between 11%-16% of the US population having been infected with SARS-CoV-2.
The CDC will be expanding this study to include 4 more regions of the US, so I’m anxious to see how those numbers compare.
Based on this, we can draw some conclusions. Either we don’t have enough tests to test everyone, OR most people are asymptomatic and aren’t compelled to get a test. I believe the reason is more weighted towards the latter due to the fact that studies have shown that anywhere from 17%- 80% of people who are infected never show symptoms (asymptomatic), or very mild symptoms. Published reports vary wildly on this number and hence the large range. (When considering the 12X-17X factor, I believe it’s extremely likely that it’s weighted more towards 80% asymptomatic, and perhaps even higher.)
This means that the number of total cases as measured by tests is completely pegged by the number of tests available and/or the number of people who decide to get a test because they show symptoms. Therefore, the actual number of measured cases being reported is a gross underestimation of the actual infections, either because of test-supply limitations or because of overwhelming presence of the asymptomatic population, or both.
This virus is certainly not a hoax as some contend (it’s a real virus that is killing people), but our situation is much better than what is being reported.
Read my prior post where I go through the math that shows that we are much closer to reaching herd immunity than most people realize. Complex mathematical models show that herd immunity for SARS-CoV-2 is more than likely in the 10-20% range, not the 70% number which is being reported everywhere. The 70% number is based on simplistic homogeneous models, which is a gross oversimplification of the heterogeneity displayed by this virus.
That means we’re much closer to naturally achieving herd immunity than most people realize. This will differ on a region by region basis, because the numbers presented above are averages across the U.S, so we will see regional pockets of increased rates of cases and deaths in the coming weeks, but the good news is that this problem will more than likely be resolved sooner rather than later, and we can get there naturally without a vaccine.
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