The US recorded more than 100 million officially diagnosed and reported Covid-19 cases this week, but the number of Americans who have actually had the virus since the pandemic began is likely to have more than doubled.
Covid-19 has easily infected more than 200 million people in the US alone since the pandemic began – some people more than once. The virus continues to evolve into more transmissible variants that elude immunity from vaccination and previous infections, making controlling transmission incredibly difficult in the fourth year of the pandemic.
The United States officially recorded more than 100 million cases as of Tuesday, almost a third of the total population, according to the Centers for Disease Control and Prevention. The data isn’t perfect and likely vastly undercounts the true number of infections, scientists say. While it counts people who have tested positive more than once or been infected multiple times with Covid, it does not count the number of Covid patients who were asymptomatic and never tested or tested at home and did not report it.
Dr. Tom Frieden, former CDC director under the Obama administration, estimates that the reported data reflects less than half the actual total.
“There have been at least 200 million infections in the US, so this is a small fraction of that,” Frieden said. “The question really is whether we are better prepared for Covid and other health threats in the future and the jury is out on that,” he said.
The CDC estimated last spring that nearly 187 million people in the United States had contracted Covid at least once as of February 2022, more than double the officially reported cases at the time. The estimate was based on a survey of commercial lab data that found about 58% of Americans had antibodies as a result of Covid infection. The survey did not take into account reinfections or antibodies from vaccinations.
The CDC subsequently recorded more than 21 million confirmed cases from March through December. 21 of this year, although this is an underestimate because people who use rapid tests at home are not included in the data.
The more than 21 million additional confirmed cases, on top of the CDC’s February estimate of about 187 million total infections, gives a lower estimate of more than 208 million infections since the pandemic began.
“It’s really hard to stop this virus, and that’s one of the reasons we’ve shifted the focus to hospitalizations and deaths rather than just counting cases,” said Jennifer Nuzzo, epidemiologist and director of the Pandemic Center at the Brown University School of Public Health.
The US has made significant strides since the darkest days of the pandemic. Deaths have fallen by about 90% since the pandemic peaked in January 2021, when more than 3,000 people succumbed to the virus every day before widespread vaccination. Daily hospitalizations are down 77% from a peak of more than 21,000 in January 2022 during the massive Omicron surge.
Despite these advances, deaths and hospitalizations remain stubbornly high given the widespread availability of vaccines and treatments. Around 400 people still die from the virus every day and around 5,000 are hospitalized every day. The virus is still circulating at levels that would have been considered high earlier in the pandemic, with an average of nearly 70,000 confirmed cases per day, a clear undernumber due to at-home testing.
More than a million people have died from Covid in the US since the pandemic began, more than in any other country in the world.
“I think people have gotten used to it,” Frieden said of Covid’s toll. “Covid is a new bad thing around us and it’s likely to be here for the long term. We don’t know how this will develop, whether it will become less virulent, more virulent – we have years that get better and worse. “
White House medical adviser Dr. Anthony Fauci, who is stepping down this month, said the US could consider the pandemic over if Covid hospitalizations and deaths fall to similar levels as the flu burden.
For one thing, the two viruses circulate at high levels at the same time. From October to the first week of December, the flu killed 12,000 people, while Covid killed more than 27,000 during that period.
“We’re still in the middle of it — it’s not over yet,” Fauci told the Conversations on Health Care radio show in November. “400 deaths a day is not an acceptable level. We want to get it much lower.”
Frieden said 95% of people who die from Covid are not up to date on their vaccinations and 75% of people who would benefit from the antiviral Paxlovid are not getting it.
“We should celebrate these great tools that we have, but we’re not doing a good job of getting them into people and that would not only save lives but also reduce the impact of Covid,” he said.
DR Ashish Jha, the coordinator of the White House Covid task force, said people who are up to date on their vaccines and are treated if they have a breakthrough infection are at almost no risk at this point in the pandemic to die from Covid. Jha has particularly urged older Americans, who are more susceptible to serious illness, to get empowered so they have more protection during the holidays.
“There are still too many older Americans who haven’t updated their immunity and haven’t protected themselves,” Jha told reporters at the White House last week.
Michael Osterholm, a leading epidemiologist, said new Covid variants would pose the greatest threat to US progress in 2023.
In response to widespread social unrest in the fall, China eased its strict zero-Covid policy, which has been used to try to quell outbreaks of the virus. Infections in the country are now rising sharply, raising concerns that Covid now has even more room for mutation.
The virus has continued to mutate into increasingly transmissible versions of Omicron over the past year, while immunity from vaccination or previous infections has waned.
“We want to believe that after three years of activity, all the immunity we should have acquired either through vaccination or previous infection should protect us,” said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But with the immunity going down and the variants – we can’t say that.”