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The CDC's current estimate (Covid-19 Disease Burden report) of cumulative total infections is 4.3 x the number of cumulative confirmed cases. As we move into higher vaccination percentages, higher infection-generated natural protection percentages, and have a shifting demographic of new infections due to unbalanced vaccination acceptance, is that case to inflection multiplier changing when evaluated over a more recent period, such as during the current delta variant dominated surge?
According to the CDC’s publication on the methods of their calculations (https://academic.oup.com/cid/article/72/12/e1010/6000389), there are some limitations which may affect the estimates. For one, the availability and use of testing for Covid has changed over time. Also, the testing could be “spotty” and testing could be much higher in certain geographic regions compared to other regions or locations. Also, there is now the recognition of the wide spectrum of disease possible with an infection, it can be asymptomatic, mildly symptomatic, more severe, or result in hospitalization and death. Those with asymptomatic disease or mildly symptomatic disease do not seek medical care and thus do not get tested, so we don’t know how much this happens, especially in the wake of the Delta variant.
Our recommendation is to look for newer publications from CDC to inform us of whether it going higher or lower.
