'Massive blindspot': Missing data in COVID pandemic leaves US vulnerable
While discussions about flattening the curve, passing the peak and plateauing have generated some optimism, public health professionals fear that a key factor in understanding the novel coronavirus pandemic has been forgotten: the missing data.
There are at least 671,000 confirmed cases of COVID-19 in the United States, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. However, experts have warned that the number is likely much higher because testing has been sparse.
"We, in the U.S., have a massive blindspot because of the lack of testing," Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor who worked on a website to help bridge the data gap, told ABC News. "We've not really had a deep understanding of the amount of illness that happened in the community."
"Without knowing, it creates a real barrier to us to be able to effectively model and project out the epidemic in the U.S. because we need to understand how much infection has taken place," Brownstein added.
Brownstein believes the number of cases in the U.S. is more likely in the millions. He said through the website he helped create, which allows the public to self-report any symptoms, some 400 people who responded (out of the 400,000 who used it) said they tested positive for COVID. But 4,000 displayed all the symptoms of the disease. The most severe cases may include fever, heavy dry cough, and serious breathing issues that can lead to hospitalization or even death. While 80% of cases are believed to have mild or no symptoms at all.
"The majority of people, at least 10x or more, who were displaying COVID symptoms said they were not tested," he said.
Antibody testing, which may identify those that have been exposed to the virus and recovered, also is not widespread, although there are efforts in several states. Antibody testing would give a truer sense as to how widespread the infection was in the U.S.
With all the missing information, Brownstein said it's hard to feel optimistic about the possibility of flattening the curve -- the concept of spreading out the cases that hit the hospital system over time so that resources aren't taxed, better care can be provided, and a second wave of cases is prevented in the future.
"When we don't have the true insight of testing, when testing is uneven and not comprehensive, it creates a fear on the part of public health that we may be relying on imperfect data to make decisions," Brownstein said.
He did note that if the number is in the millions, it offers a promising sign that the majority of people infected have not experienced severe cases.
Even that appears uncertain. Initial data coming out of China, where the pandemic appears to have started, was that 80% of cases were mild. But it's hard to know the true hospitalization rate or death rate without knowing the estimated total number of cases.
Dr. Angela Rasmussen, a virologist and associate research scientist at Columbia University's Center for Infection and Immunity, similarly said that the lack of data leaves the U.S. vulnerable when trying to understand the virus and make decisions going forward.
Unlike Brownstein, Rasmussen said it is too difficult to quantify the amount of data we're missing.
"I'll just say that we're missing a lot both in terms of people who are infected, as well as people who were previously infected," Rasmussen told ABC News.
