Infectious Disease

Mannequin estimates 53M COVID-19 instances had occurred within the US by September

December 11, 2020

3 min read

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Reed does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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In a new model study, researchers estimated that by September 30, the United States could have had nearly 53 million SARS-CoV-2 infections – including 2.4 million associated hospitalizations.

The analysis published in Clinical Infectious Diseases offers a more complete picture of the impact of the pandemic, which saw approximately 6.9 million laboratory-confirmed cases reported nationwide over the same period. The estimate took into account undetected and unreported infections and could be useful in informing containment efforts and resource allocation, researchers said.

Carrie Reed Pullquote

Carrie Reed, PhD, AC DC The epidemiologist and colleagues used the model to adjust the reported number of confirmed COVID-19 cases for factors that could lead to under-detection of SARS-CoV-2 infection, including test sensitivity – a similar method used to increase incidence The 2009 influenza was estimated to be a (H1N1) pandemic. The researchers found that of the estimated 52.9 million COVID-19 cases recorded in their model, 44.8 million were symptomatic.

Healio spoke to Reed about the study’s impact on future COVID-19 surveillance efforts.

Q: What is the impact of this study on public health surveillance? What do these results mean for clinicians?

A: While case reports provide valuable data to inform the local public health response to the pandemic at the local level, the reported cases do not capture all cases of COVID-19 in the country. These estimates provide a more comprehensive assessment of the full impact of COVID-19 as of September 2020. Estimating undetected and unreported cases can help provide direct and accurate evidence of the impact of the COVID-19 pandemic on the healthcare system and society at large, hospital resources, support When planning – including vaccination schedules – forecast the future burden of COVID-19 cases and assess the potential impact of interventions.

Q: What improvements can be made to the current reporting? and Monitoring Practices For COVID-19?

A: The high number of infections in the United States has impacted the ability to generate detailed case reports of all infections, including patient demographics and hospital status. In cases where there was no hospital stay, for example, we assumed the proportion of reported cases that were hospitalized, of those with complete data. However, it is unclear whether this assumption could have overestimated or underestimated hospital stays. Implementing a random sampling approach to get complete data on a smaller subset of the reported cases can improve our ability to draw conclusions about the overall reported cases, the risk of major diseases, and the most affected populations.

Q: Were there any results from this study that surprised you? Which dates and why??

A: Many respiratory viruses cause similar symptoms that are difficult to distinguish without laboratory testing. Test rates for SARS-CoV-2 have improved over time, but there are still people who are in both inpatient and outpatient settings with potential COVID-like diagnoses (e.g., pneumonia, shortness of breath, coughing sickness, and Shortness of breath) of health care. that are not tested and diagnosed as COVID-19 cases. In addition, only about a third of people who said they had a COVID-19-like illness in online surveys said they had used testing services or medical care. All of this underscores the potential for underreporting and the importance of data to monitor search behavior in healthcare and clinical testing practices for patients with different clinical syndromes and in a variety of health and geographic settings to better understand how many more diseases can occur undetected.

Q: What were the limitations of this study and how can they be considered for future analysis?

A: These estimates of COVID-19 infection, symptomatic illness, and hospital stays have several limitations. In the early stages of the COVID-19 pandemic, as is generally the case with the emergence of a novel virus such as SARS-CoV-2, data on testing, detection and case reporting are required to assess the actual burden of a disease was incomplete or not available. In some severely affected areas of the United States, in particular, the size of the COVID-19 outbreak quickly exceeded the ability of health systems to produce detailed reports on cases that included information such as the patient’s age and whether or not they were hospitalized Not . This led to case reports to the CDC that lacked important patient information. The CDC needed to estimate the age and hospital status of patients with missing data from cases with known information about age and hospital status.

To obtain information on how to estimate the burden of disease for COVID-19, we relied on our experience with estimating the burden of disease for influenza. The CDC has been monitoring influenza testing practices in hospitalized patients since 2010 to provide estimates of the annual burden of influenza disease in the United States. Nearly a decade of collecting and analyzing influenza data has shown that tests for respiratory disease in different parts of the country vary according to care preferences, age groups, and varying degrees of disease severity. The data currently available on COVID-19 testing practices are limited to these variables. As more complete data on these variables become available, the COVID-19 exposure estimates will be updated on the CDC COVID-19 website.

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