Present Covid-19 cases is only a fraction of what they were on top of the omicron wave.
But many people in the country may notice what appears to be a stream of cases in their social circles.
Health experts say that this anecdotal evidence may not be just coincidence, as the United States may be in a “hidden” wave – a much larger than reported data suggests.
“There’s a lot of COVID out there. I see it in my social circles, in my children’s schools, and in hospital staff infection rates,” Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told ABC News. in a wave. “
Although it is clear that infection rates have risen steadily in recent weeks to the highest reported level since mid-February, researchers acknowledge that it is difficult to know how high COVID-19 cases and even hospitalization rates actually are. given the probable “significant” undercount of infections.
This is due in part to changes in data collection and reporting and the prevalence of home testing. Some government officials report that health departments and health facilities have also completed traditional tracking of COVID-19 patients, which epidemiologists say makes it harder to know how many patients are entering hospitals in need of care.
Last month, former FDA commissioner Dr. Scott Gottlieb that officials probably only picked up “one in seven or one in eight” infections.
And President Joe Biden’s new coronavirus response coordinator, Dr. Ashish Jha, acknowledged that there are “a lot of infections” last week, probably the result of highly infectious omicron subvariants that are spreading across the country.
“We know that the number of infections is actually significantly higher than that. It is difficult to know exactly how many, but we know that many people are diagnosed using home tests,” Jha explained.
More than 100,000 Americans officially test positive every day
The nation’s reported daily average of cases, which officials say consists mainly of PCR tests, now stands at more than 100,000 new cases reported per day, according to data from the Centers for Disease Control and Prevention (CDC).
In recent weeks, almost every state in the country has reported an increase in COVID-19 infections and the number of virus-positive people hospitalized.
The Northeast remains the country’s most notable known COVID-19 hotspot, though increases in some cities, such as Boston, appear to show initial signs of slowing down.
Nationally, according to CDC societal levels, more than 45% of Americans live in an area with a medium or high COVID-19 risk.
The high level of society suggests that there is a “high potential for strain on the health care system” and a “high level of serious illness”, and therefore the CDC recommends that people wear a mask in public indoor environments, including schools.
The number of admissions has been increasing in recent weeks, but not at a rate as significant as infections.
However, during the spring and winter, hospitalization data have also become less available, prompting some experts to suggest that patient totals may also be underestimated.
Earlier this year, the Department of Health and Human Services finalized the requirement for hospitals to report several important COVID-19 measurements, including a daily total of the number of COVID-19 deaths, the number of emergency department overflows and ventilated patients, and information on critical staff shortages.
In addition, some states have stopped direct reporting of statistics, including hospital bed use and availability, COVID-19-specific hospital measurements, and ventilator use.
However, Doron said a possible significant increase in infections without an overwhelming number of hospitalized COVID-19 patients could be a promising sign.
“If cases are really much higher than what we see, it means that the ratio of hospitalizations to deaths and deaths to cases is even lower than what we see, and we are already seeing a ‘decoupling’ between cases and hospitalizations and deaths. said Doron, which could indicate that the virus is moving closer to a form that Americans can live with.
Still, Doron added, “at the population level, however, COVID poses a greater risk because there are so many cases and hospitals are already so filled with both COVID and non-COVID patients.”
A shift away from traditional testing
In recent months, coast-to-coast states have moved to closed public test sites with an abundance of rapid COVID-19 tests now available at pharmacies and through the federal government.
“While home testing has created wider population access to infection status and hopefully better access to treatment, it has also created a major blind spot in our public health surveillance,” John Brownstein, Ph.D., an epidemiologist at Boston Children’s Hospital and an ABC News contributor, said. . “The recent BA.2 increase was masked by the shift in test behavior and likely delayed decisions on public health interventions.”
The shift away from traditional COVID-19 testing has left some health professionals concerned about continuing problems with access to appropriate health care and preventive health tools, such as testing and antiviral treatments, to protect vulnerable communities.
According to ABC News’ analysis last summer of pharmacy locations across the country, there are 150 counties where there is no pharmacy, and nearly 4.8 million people live in a county where there is only one pharmacy for every 10,000 residents or more.
“What worries me even more is what can happen in communities and among families with fewer resources. Public test sites are closed, home tests are expensive in the pharmacy, and it requires literacy and technology to navigate the system to order free tests or get tests refunded by insurance, Doron says.
Broader insight into infection through home testing and wastewater sampling will be crucial in the future to fully understand the scale of increases and protect all Americans, Brownstein said.
Viruses do not disappear in low-transmission counties
This winter, after the omicron rise, the CDC released a new risk level map, which shifted away from focusing on the transmission level in a community, and rather shifted attention to hospital capacity and hospitalization levels.
The rollout of the new card, which aims to help people and local officials assess when to implement potential mitigation measures, caused controversy among some Americans, Doron explained. While some people argued that the shift in metrics was long overdue and a sign of the times, others said the move was premature.
“Some people were happy because they felt we were past the time period where we had to reintroduce restrictions and mandates every time cases increased, given widespread population immunity to vaccination and infection,” Doron said. “It made other people angry because a transition to a medium or high risk status now requires increases in hospital admissions, which are lagging indicators, in other words, there may be many cases before hospitals become full and some people may choose to take extra precautions before. “
Brownstein noted that given the shift away from transmission speeds, some Americans may not be fully aware of the continuing dangers of the virus, as a green county is not necessarily a sign that the virus is simply disappearing.
“While the CDC map reflects reduced risk of serious complications from COVID infection, it unfortunately hides places with high societal transmission,” Brownstein said. “This masking of risk can give a false sense of security, especially for those at high risk of hospitalization and death.”