U.S. records 100 million Covid cases, but more than 200 million Americans have probably had it

The US recorded more than 100 million officially diagnosed and reported cases of Covid-19 this week, but the number of Americans who have actually had the virus since the start of the pandemic is likely more than double that.

Covid-19 has easily infected more than 200 million in the US alone since the start of the pandemic – some people more than once. The virus continues to evolve into more transmissible variants that evade immunity from vaccination and previous infection, making transmission incredibly difficult to control as we enter the fourth year of the pandemic.

The US officially had more than 100 million cases as of Tuesday, just under a third of the total population, according to data from the Centers for Disease Control and Prevention. The data is not perfect and is likely significantly lower than the actual number of infections, scientists say. Although it counts people who have tested positive more than once or caught Covid multiple times, it does not capture the number of Covid patients who were asymptomatic and never tested or tested at home and did not report it .

Dr. Tom Frieden, former director of the CDC under the Obama administration, estimates that the reported figures reflect less than half of the actual amount.

“There are at least 200 million infections in the U.S., so this is a small fraction of them,” Frieden said. “The question is really whether we will be better prepared for Covid and other health threats in the future, and the jury is still out on that,” he said.

Last spring, the CDC estimated that nearly 187 million people in the US had contracted Covid at least once by February 2022, more than double the number of officially reported cases at that time. The estimate is based on a survey of commercial laboratory data that found about 58 percent of Americans have antibodies as a result of a Covid infection. The study did not report reinfections or antibodies from vaccination.

The CDC subsequently recorded more than 21 million confirmed cases from March to December 21 of this year, although that is an underestimate because people using rapid tests at home are not included in the data.

More than 21 million additional confirmed cases on top of the CDC’s February estimate of about 187 million total infections gives a low 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, an epidemiologist and director of the Pandemic Center at Brown University’s School of Public health.

The US has made significant progress since the darkest days of the pandemic. Deaths have fallen by about 90% since the peak of the pandemic in January 2021, when more than 3,000 people succumbed to the virus each day before widespread vaccination. Daily hospital admissions 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. About 400 people still die a day from the virus and about 5,000 are admitted to hospital every day. The virus is still circulating at a level that would have been considered high earlier in the pandemic, with an average of nearly 70,000 confirmed cases reported per day, significantly down due to at-home testing.

More than one million people have died in the US from Covid since the start of the pandemic, more than any other country in the world.

“I think people have hardened themselves to it,” Frieden said of the victims of Covid. “Covid is a new bad thing in our environment and is likely to be here for the long term. We don’t know how this will evolve, if it will become less virulent, more virulent – there are years that get better and worse. “

White House chief medical adviser Dr. Anthony Fauci, who is stepping down this month, said the US could consider the pandemic over when hospitalizations and deaths from Covid drop to a level similar to the burden of the flu.

In the former, both viruses circulate simultaneously at high levels. From October to the first week of December, the flu killed 12,000 people, while Covid claimed more than 27,000 lives during that period.

“We’re still in the middle of it — it’s not over,” Fauci said on the “Healthcare Conversations” radio show in November. “Four hundred deaths a day is not an acceptable level. We want to make it much lower than that.”

Frieden said 95% of people who die from Covid are not up to date on their vaccines and 75% of people who would benefit from the antiviral Paxlovid do not get 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 will not only save lives, but reduce the disruption from Covid,” he said.

Dr. Ashish Jha, coordinator of the White House’s Covid task force, said that people who are up to date on their vaccines and treated when they have a breakthrough infection have almost no risk of dying from Covid at this stage of the pandemic. Jha called for older Americans in particular, who are more vulnerable to serious illness, to be beefed up to have more protection during the holidays.

“There are still too many older Americans who haven’t updated their immunity, who haven’t protected themselves,” Jha told reporters at the White House last week.

Michael Osterholm, a leading epidemiologist, said new variants of Covid will pose the biggest threat to US progress in 2023.

China eased its strict zero-covid policy, which had tried to crush outbreaks of the virus, in response to widespread social unrest in the fall. Infections are now rising in the country, raising concerns that Covid now has even more room to mutate.

The virus continued to mutate into increasingly transmissible versions of the omicron over the past year, at the same time that immunity from vaccination or previous infection waned.

“We want to believe that after three years of activity, all the immunity we must have acquired 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 waning immunity and variants – we can’t say that.”