A lot of people have been asking in recent weeks, “Just how many people are walking around, infected, without even knowing it? There could be thousands!”
I kept racking my brain with a way to figure that out. Then I came across a research paper or two that highlighted, within a small, fully-tested, population, numbers for infected, non-infected and infected-but-asymptomatic. And I pulled out a calculator and a scratch piece of paper and went to work.
Making Estimates from past research
I talked about research from the Cruise Ships that may be relevant to estimating the number of cases without testing everyone (since that isn’t a feasible option). Plus, this type of estimate would make a good “first guess” at the number of asymptomatic people (the people who don’t feel sick, but are still infected), too.
This type of estimating isn’t perfect. In fact, it is far from it. And it is just an estimate. But based on the past research, it is at least a start.
So, based on these real numbers at the end of the day on March 26th….
| Total Cases | Total Tested | Deaths | Percent-positive | Mortality Rate | |
| Mississippi | 485 | 2776 | 6 | 17.47% | 1.24% |
| Louisiana | 2035 | 15775 | 83 | 12.90% | 4.08% |
| Alabama | 531 | 4082 | 1 | 13.01% | 0.19% |
| Tennessee | 957 | 14909 | 3 | 6.42% | 0.31% |
| Arkansas | 349 | 1882 | 3 | 18.54% | 0.86% |
| Total | 4357 | 39424 | 96 | 11.05% | 2.20% |
The estimates for the total cases look like this….
| Estimated Symptomatic | Estimated Asymptomatic | Estimated total | |
| Mississippi | 740 | 162 | 902 |
| Louisiana | 3104 | 681 | 3785 |
| Alabama | 810 | 178 | 988 |
| Tennessee | 1460 | 320 | 1780 |
| Arkansas | 532 | 117 | 649 |
| Total | 6645 | 1459 | 8104 |
A reminder that the estimates are just that, estimates. The only real, true numbers are the ones that come from the State Departments of Health and the Center for Disease Control.
These estimated numbers should not be referenced in any official capacity as they are a good “first guess” based on past research and not hard, physical, actual numbers.
Answering your questions
This isn’t a big deal, Nick. There are only more positive cases because they are just testing more people, right?
You’re right that there are more positive cases because there are more tests. But, I would argue that more cases are bad regardless of the number of tests. People are concerned (I count as one of those people) because it reveals how widespread this virus is becoming. In the estimate above, you can see how the number of potential asymptomatic people increases with every positive case. That means the more people who test positive also means there are more people walking around who are sick and don’t realize it.
And because there is no indication how each next person will react to the virus (some get a cough, others die) people are worried about becoming ill.
The numbers on the chart that show the US surpassing other nations in cases are actual numbers and not a ratio of population, correct?
Yes. The numbers provided by the CDC, the WHO and all of the state departments of health are the number of people who are infected (or have been infected) with the virus.
Has the US actually test and confirmed more cases than other countries due to our medical facilities capabilities?
I don’t know. I do know that South Korea administered nearly 2,000,000 tests (at least that was the latest number I found). But I am unsure how many total tests the United States has given. I am also unsure about how many tests China or Italy have administered.
How do we know the United States has the most cases, the Chinese may not have been telling the truth
That is a valid concern. But we have to assume the numbers out of China are accurate because we have no hard evidence to suggest that the numbers are inaccurate.
People may say, ‘Nick, dude, just open your eyes’ but that isn’t how science works. We need to have evidence – a bit like the court system – in order to prove things. We can’t just go by our gut.
How do other countries count their numbers?
The nice thing about science and the medical community is that if it works in one place, people tend to adopt the same methods in another place. So, most countries count positive tests the same way as we do in America. And we got our way of doing things from other countries like China. At a minimum, I believe there is a nasal swab and a throat swab. Some places do a chest X-ray, too.
How many people are assumed to have Covid -19 because they have a fever and do not test positive for flu or strep? Wouldn’t the data need to be tested in the same way for comparison….apples to apples, sort of thing?
I have not seen reports of people being tagged as COVID-19 positive because they have a fever but do not test positive for flu or strep. If you have seen that somewhere, please shoot a link to me and I’ll be happy to check it out.
For a person to “test positive” for COVID-19, the virus needs to be found on the swabs taken from a patient.
What happened to that Imperial college study? Did they ever update it?
I saw a report recently that the author had backed off his claims. But those reports were pulled from multiple different interviews with multiple different sources. And it has yet to be changed in the scientific literature.
That makes it difficult to answer the question. But it doesn’t necessarily mean something bad. It means one of a few things. Either (a) nothing has actually changed, (b) something has changed but he isn’t writing about it, or (c) the scientific paper correcting the earlier work is due out in a month or two.
Because I don’t like citing other reports on these updates – I’d prefer to get information from official sources or scientific research papers – I can’t fully answer this question.
Is St. Dominic’s, a hospital in Jackson, running out of PPE?
Same answer applies here. There have been reports of concern that the hospital may eventually run out (that is a lot of qualifiers), but no hard evidence citing a lack of PPE. And until there is some more direct evidence, I hate to just go with what other people are reporting.
Why not just admit the President is right and start using the drugs he talked about?
Without dipping my toe too deeply into politics here, the President is not a doctor. Researchers, doctors, and probably most patients want to make sure things are done correctly before a treatment is administered. And, a bit like I said above, science has to be able to prove things through evidence. It is never about a gut feeling. And just because some drugs work well against one thing doesn’t mean they will work well against another one.
So, the researchers get in there and run trials to make certain that drugs work on a group of people first, before giving it to everyone. That is also how doctors and researchers figure out what side-effects may occur, if there are any longer-term issues, and if certain types of people react better to certain treatments.
It is about safety and accuracy.
How long before this is all over?
I don’t know. This is a bit like looking at car headlights at night to figure out how fast it is coming at you. There is no frame of reference to gauge things against and it is dependent on human nature (the driver could slam the gas pedal, for example). But so long as we continue to practice good social distancing and keep washing out hands, we can slow the spread.
