Hey Docs! What percentage of people are infected but not tested?

4,080 Views | 23 Replies | Last: 4 yr ago by tysker
BusterAg
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Also, what percentage of people show telltale symptoms and test negative?

This seems to be the place where there the data is most confusing. No one knows how many people are sick on their couch with this disease but don't fall into the confirmed case stat.

Seems like those working with patients should have at least anecdotal information on this, but I might be wrong.
agforlife97
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This data is starting to be collected but no one really knows. Some random testing of people coming to the hospital for non-covid things suggests it could be 10% or higher. It's crucial that this data be collected so more intelligent policy decisions can be made.
Mordred
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BusterAg said:

Also, what percentage of people show telltale symptoms and test negative?
No one knows the answers to your other questions, but this can be somewhat inferred:

In Texas, latest numbers I could find show 13.7k tests were administered with a 7% positive test. Texas is 44th in the country in testing per capita.

NY has administered 103k tests with a 30% positive test result.

Lousiana is at 16% positive rate.

https://www.vox.com/2020/3/26/21193848/coronavirus-us-cases-deaths-tests-by-state

I couldn't find numbers for the whole country, but I didn't try that hard. Nobody knows how many of those getting tests were exhibiting symptoms, or if it was doctors/nurses getting tested proactively, but you can probably assume the majority are for people with symptoms or a confirmed exposure.
Thomas Ford 91
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At this point, we have no sure way of knowing. All methods require reliable numbers that are testing-based. The lack of early testing makes this very difficult now.

But, 10% of the population would approximately match up with the total deaths, if it doubles every 6 days, kills .02%, and the average time from infection to death is 17-20 days.
VKint
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There are still a lot of tests with pending results. I am waiting for one from 8 days ago. Don't forgot that false negatives could be as high as 30%.
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Harrison Wells
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VKint said:

There are still a lot of tests with pending results. I am waiting for one from 8 days ago. Don't forgot that false negatives could be as high as 30%.

Well that's disappointing
Dad
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When you factor in asymptomatic cases that were never tested, mild cases that were never tested, false negatives, the growth rate of cases, and the delay in getting results I think at least 400,000 people either have it now or have recovered in this country.
One-Eyed Fat Man
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How high is the sky?
Marcus Aurelius
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Vast majority.....
Kool
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VKint said:

There are still a lot of tests with pending results. I am waiting for one from 8 days ago. Don't forgot that false negatives could be as high as 30%.
Unfortunately, I think that you are absolutely correct. If we could get a finger ***** blood test for antibodies that would be great. I may sound like a broken record, but I am concerned that a lot of the false negatives represent poor collection or transport technique. A true nasopharyngeal swab is NOT a lot of fun to do, nor that easy to do.
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Keegan99
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Anecdotally, every friend / acquaintance or friend-of-friend that has it (all effectively clinically diagnosed) has not been tested. Without exception.

We're missing a massive number of non-hospitalized cases.
Pasquale Liucci
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Wouldn't this bode well for the CFR of the disease?
culdeus
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Lester Freamon said:

Wouldn't this bode well for the CFR of the disease?
CFR is normally tabulated well after the virus has stopped circulating. That typically includes some level of antibody testing to confirm non-symptomatic cases. The fact that the media is promoting a more or less real time CFR is a little reckless.
tysker
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VKint said:

There are still a lot of tests with pending results. I am waiting for one from 8 days ago. Don't forgot that false negatives could be as high as 30%.
Not to sound ****ty, but frankly, then what's the point? We won't be able to glean any real information from the data with false negatives anywhere near those levels. Heck, self-diagnose would probably give similar results.
Pasquale Liucci
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This is more or less my point. The hype is way overblown. Not to say this disease isn't an absolute b**** (it is), but if the case count is significantly higher than what is currently advertised, modeling is seriously overshooting how bad this will get.
Marcus Aurelius
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Lester Freamon said:

Wouldn't this bode well for the CFR of the disease?


I think so. I suspect that if one divided the COVID deaths by the confirmed pos plus the suspected cases the CFR would be much lower than 1.4%.
Builder93
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1.4% sounds low but with it being so contagious, don't you think without SIP measures, this would get out of control?
Kool
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Edit wrong thread, sorry
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Not a Bot
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And the biggest problem with the testing being so unreliable is that hospitals, in an effort to conserve PPE, are taking suspected patients off isolation if they test negative. We are retesting two patients today who have been off isolation but have all the telltale signs. If they test positive we will have a ton of our staff on quarantine including me.
Aggie71013
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What I dont understand is we seem to be assuming that everyone with symptoms that aren't being tested are indeed positive. In Houston less than 10% of those tested are confirmed positive. Even if you factor in a 30% false negative, most people being tested do not have it. Shouldn't this be extrapolated to those that have symptoms but aren't being tested?
TXAggie2011
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Given the amount of negative tests among those who have reasons to be tested, even factoring in false negatives, given some of the varying on the ground experiences, it's hard for me to think that there really has been super widespread infections in many places. I don't know, I hope most of the US and world has already gotten this thing without realizing it but I have some doubt.
BiochemAg97
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tysker said:

VKint said:

There are still a lot of tests with pending results. I am waiting for one from 8 days ago. Don't forgot that false negatives could be as high as 30%.
Not to sound ****ty, but frankly, then what's the point? We won't be able to glean any real information from the data with false negatives anywhere near those levels. Heck, self-diagnose would probably give similar results.
You realize that is the low end for false negatives for the rapid flu test? The rapid flu test brochure states even says the false negative can be as high as 90% in some circumstances. Yet all kinds of people use the results of the rapid flu test.

Also, given most areas of the country are coming in with 10% positive results and 90% negative results, assuming a 30% false negative only gets you to 14% positive cases.
BiochemAg97
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I haven't figured out where the 30% false negative came from and if it actually applies to the current test,

The early China tests were considered to be subpar. The CDC test was considered to not work 1/3 of the time. The current RT-PCR tests were designed to be better. Is the 30% false negative the number for the old tests that some media people are running with, or is there some actual evidence the 30% false negative rate applies to the current test?
Pumpkinhead
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Builder93 said:

1.4% sounds low but with it being so contagious, don't you think without SIP measures, this would get out of control?


Exactly. A lot more people having this than tested means maybe it is even more contagious than '2 to 3 times more then flu' as estimated by CDC because of so many asymptomatic carriers. Which means it would be infecting tens of millions of people in a matter of weeks, and thus even a smaller percentage of people getting seriously ill or dying In such a short time overwhelms healthcare capacity , as you see in Italy, Spain, New York, etc.
tysker
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I had no idea it was that high!
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