California COVID cases top 10 million; the real total could be much higher

California this week crossed more than 10 million official COVID-19 cases. So does that mean nearly 3 out of 4 of the Golden State's 39 million residents actually have avoided the virus so far? No way, experts say. There likely have been 44.6 million COVID-19 cases in the Golden State since early 2020, according to estimates from the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. That's nearly 5 million more than the state's population. And the high end of the institute's modeling says California could have had up to 52 million infections.

But because many cases involed no symptoms and most were not confirmed with a PCR test, the bulk of cases go uncounted.

“Almost everybody will get infected,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley's School of Public Health. With the virus showing no sign of slowing down, causing two giant surges in the past year, the outlook for avoiding the virus altogether is bleak. “COVID will be with us for the foreseeable future.”

Last month, the institute estimated that 82% of Americans had been infected at least once as of July 11. That translates to more than 270 million people.

While those numbers are based on computer models, a recent study published in the Journal of the American Medical Association focused on real human blood samples.

It showed the percentage of adults in the U.S. with infection-induced immunity levels reached 25% by December 2021, suggesting 1 in 4 people had been infected with COVID-19 before our worstever surge this winter. That's about 80 million people. But the country as a whole had racked up only 55 million official cases at that point.

And the number of confirmed COVID-19 cases has doubled since then. The researchers looked at antibodies in blood bank donors, nucleocapsid antibodies in particular, which come from an infection rather than vaccinations. Antibodies wane over time, so those estimates are also an undercount.

Something else is now clouding up the numbers: Reinfections are on the rise, now accounting for more than 10% of recent cases. That means the number of total cases is growing faster than the number of people who have been infected.

There's no question the state's official tally is increasingly considered an undercount with so many positive at-home test results going unreported. Still, perhaps our more-relaxed attitude for catching the latest immunityevading, yet less-deadly variants of the virus are playing a part in how quickly the millions add up.

The last million cases tallied by the state's public health department took only two months, compared with the million before (from 8 million to 9 million cases) that took twice as long. We hit our first million cases in early November 2020, nine months after we first learned the virus was spreading among us.

The good news is that each case is coming with fewer risks now than a year or two ago. In 2020, there were 2.5 million cases and 33,000 deaths. But so far, in the first seven months of 2022 there have been 75% more cases, nearly 4.5 million, but only 15,000 deaths, less than half of the 2020 death toll.

Though official COVID-19 counts are still important, experts say, there is also a simpler gauge.

“As long as you keep hearing that your friends have COVID,” Swartzberg said, “you know that there is an awful lot of cases going on.”