Want the current COVID-19 number in U.S.? Multiply by 90

Today, the official total number of confirmed COVID-19 cases in the U.S. is 13,677. I believe the actual number of infections is closer to 1.25 million, and here is why.

I work as an urgent care physician at the Palo Alto Medical Foundation Urgent Care in Palo Alto, CA, where I help run our outdoor drive-thru clinic for patients experiencing respiratory symptoms.

  • A typical turnaround time for COVID-19 testing today in Northern California in commercial labs (5 days)
  • Day 5: Symptoms begin
  • Day 7: Jack presents to clinic, COVID-19 test is performed and sent to laboratory
  • Day 12: Test result returns positive and the local health department is notified

DELAY BETWEEN INFECTION AND CASE REPORTING

Let’s start with total confirmed cases in the United States so far.

Total confirmed cases adjusted for delay on March 8 and beyond were projected by multiplying the previous day’s number by 1.32.

FOR EVERY CONFIRMED CASE, THERE ARE MANY MORE UNCONFIRMED CASES OUT THERE

Data from South Korea suggest that for every symptomatic case, there are many more asymptomatic cases (especially young people) that are walking around with mild or no symptoms. Another study estimates that in Wuhan, China, prior to the travel restriction, 86% of all cases were undocumented, which roughly translates into: only 1 out of 7 infections were confirmed by testing.

BUT WHAT ABOUT SOCIAL DISTANCING AND FLATTENING THE CURVE?

I know what some of you may be thinking.

Internist | Medical Director at Prealize Health | Soros Fellow | Yale MD | Harvard MBA | Views are my own

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