This surge's COVID cases are severely undercounted, epidemiologists say. But does it matter?

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(NEXSTAR) – You may turn to the latest official COVID-19 case count to get a sense of just how bad things are in your state or county. But that number is almost certainly inaccurate, epidemiologists say.

Since the beginning of the pandemic, cases have always been underreported. First there weren’t enough tests available. Then there’s the fact that many people with asymptomatic or mild cases never take a test. Now, with the prevalence of at-home testing, many are catching the virus and not reporting it.

“With the home testing, we’ve lost our ability to track based on reported cases,” said Dr. George Rutherford, an epidemiologist at the University of California, San Francisco.

Epidemiologists agree there’s an undercounting going on. But just how underreported are cases? We’re left to do some guesswork there, too.

Rutherford pointed to a study of leftover hospital blood that suggested official COVID case counts may be missing as many as half of real cases.

Epidemiologist and Harvard Medical professor John Brownstein told Bloomberg he thought the COVID case count “could be three times bigger” than what the Centers for Disease Control and Prevention is reporting.

Another study out of New York found the true case count could be as much as 31 times higher than what’s reported. (The study is not yet peer reviewed.)

Even in 2020, before home testing for the virus, we were undercounting COVID-19 cases, studies of people’s antibodies in the U.S., Germany and the Netherlands found.

“But, you know, on the other hand, it doesn’t matter,” said Rutherford. “Because we know that the hospitalizations, while they’re going up, are relatively low and the ICUs are relatively not full. There were three patients at San Francisco General the other day.”

While we’ve lost the ability to accurately track the number of new cases, hospitals are still tracking COVID-19 admissions. The CDC reports a seven-day average of around 4,300 new COVID admissions, up 1% week-over-week. Meanwhile, COVID-related deaths were down 10% week-over-week, the CDC reported.

“This is the third largest surge we’ve had without a doubt, but it’s also the mildest, as well,” Rutherford said. He attributed the lower hospitalization rates to vaccinations and booster shots, combined with natural immunity and a variant that’s less severe.

While tracking the exact number of COVID-19 cases per day might not matter, the virus is still hugely important, Rutherford emphasized.

“Remember, you don’t want to get this. This is not something that’s a casual nothing deal because of the risk of long COVID. And that’s a real risk.”

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