Study: Pandemic’s reach was more than official case counts
A new study that looks at the presence of coronavirus antibodies in nearly 62,000 life insurance applicants found that before the devastating holiday surge, the number of asymptomatic or undiagnosed coronavirus infections in the U.S. may have been twice as high as the official tally of cases overall.
The findings, published Tuesday in the journal JAMA Network Open, indicate that there were millions more asymptomatic and undiagnosed people than experts had realized — and suggests the pandemic could have been far more pervasive than it first appeared.
“The overall number of SARSCOV-2 infections in the U.S. may be substantially higher than estimates based on public health case reporting,” the study authors wrote.
When it infects human hosts, SARS-COV-2 can cause moderate to severe cases of COVID-19. In the U.S. alone, it has resulted in more than 535,000 deaths. But in many people, an infection can come and go while causing minimal or even no discernible symptoms.
That may be a good thing for those individuals, but it’s dangerous for communities, through which the virus can spread undetected. Indeed, a modeling study in January determined that asymptomatic individuals are responsible for more than half of coronavirus transmission.
But those who have beaten back a coronavirus infection should have antibodies to the virus in their blood — even if they didn’t know they were infected.
“Understanding … the actual prevalence of antibodies in the community would be helpful in understanding the likelihood of us continuing to have outbreaks,” said Dr. Sara Keller, an infectious disease physician at Johns Hopkins University School of Medicine who was not involved in either study.
Researchers have long suspected that the official coronavirus case totals were an undercount of the true number of cases.
To try to see whether that was indeed the case, two researchers from Clinical Reference Laboratory Inc. in Lenexa, Kan., tested blood samples provided by 61,910 life insurance applicants to look for the presence of antibodies to SARS-COV-2. They recorded each applicant’s age, sex, state of residence and antibody status; all other personal data were scrubbed.
All of the applicants reported that they were healthy when they provided the blood samples. But in 4,094 cases, the researchers found evidence of a past coronavirus infection in the form of antibodies.
Then the researchers used 2019 census data estimates to scale up the resulting antibody-positive rates for the entire country. They did a state-by-state analysis using the antibody results for life insurance applicants from each state.
Their results suggest that the proportion of people who had coronavirus antibodies varied greatly among the states. New York had the highest rate, at 14.4 percent, followed by Louisiana at 12 percent and Nevada at 10 percent. At the other end of the spectrum, the antibody prevalence rate was 0 percent in Alaska, 0.6 percent in Maine 1.4 percent in Oregon, 1.8 percent in Hawaii and 1.9 percent in New Mexico.
Overall, the team estimated that 15.9 million asymptomatic or undiagnosed SARS-COV-2 infections had taken place in the U.S. as of Sept. 30. At the time, the CDC reported a total of about 7.2 million cases.
“Our estimate implied more than twice the number of infections than cases reported to Centers for Disease Control and Prevention, suggesting a more widespread pandemic,” the study authors wrote.
Keller said she suspects the true number was “probably even higher” than that.
Re: “Focus on coaching,” Your Turn, Tuesday:
I agree: Gov. Greg Abbott makes decisions that could affect millions of Texans.
much more difficult than watching 10 to 15 highly skilled athletes run up and down a basketball court.
So, Gregg “Pop” Popovich, if you want to become a politician, throw your hat in the ring — otherwise stick to coaching the San Antonio Spurs.
Walter Banks, Universal City
In many ways, our son Caleb Thompson is a “typical” 20-yearold: He’d rather hang out with his friends than his parents, he loves and knows the words to Linmanuel Miranda’s “Hamilton” and “In the Heights,” and he has a mischievous smile that lights up the room.
However, in other ways, he is not “typical.” Born with a rare seizure disorder called Lennongastaut syndrome, this young man who has blessed us in more ways than we can count functions as a 4-year-old and will never be able to care for himself or live independently. Like so many other parents of profoundly intellectually disabled children, we are committed to caring for Caleb until we are physically no longer able to do so. Part of this commitment was securing legal guardianship for Caleb so we would be legally empowered to make his highly individualized health care, educational (he has been wonderfully served by North East ISD) and other decisions on his entry into adulthood.
To be sure, this is our story, but this story is neither about us nor Caleb. It is about the irrational and costly process that parents of profoundly and permanently intellectually disabled children must navigate to purchase their God-given parental rights from the state if they seek guardianship of their child, and our mission to change this process so parents of all means can continue to legally advocate for their children.
Briefly, this is the process we were required to navigate to obtain legal guardianship of our son:
File an application for guardianship with the probate court.
Subject ourselves to a court “investigation” that probed into every aspect of Caleb’s medical and our financial “sock drawers.”
The service of process on Caleb in our home (the court official inquired if Caleb would take the process, and we said, “Well, hand it to him and see.” The official could have given Caleb a $100 bill, and Caleb
wouldn’t have known the difference).
The appointment of an attorney ad litem to protect Caleb’s interests against his own parents and a required visit to our home (another trip through our medical and financial “sock drawers” against our will … can you say “forced state entry”?). When the attorney asked where Caleb was and we told him Caleb was on the school bus coming home, the attorney remarked, “I didn’t know they had school for kids like him.”
The procurement of a surety bond.
A probate court proceeding. For the privilege of going through this intrusive process, we paid north of $5,000 in court costs and attorney fees (we are blessed with the means to pay this, but so many others are not). But the guardianship is only good for one calendar year, and we must go through an annual review with legal fees of $450.
Thanks to state Rep. Steve Allison, House Bill 1675 has been filed and will be heard in the Texas House Judiciary and Civil Jurisprudence Committee, chaired by Rep. Jeff Leach, this week. HB 1675 waives the court investigation, appointment of an attorney ad litem, and modifies the review period to no more than once every five years, along with the associated costs for parents of documented profoundly intellectually disabled children who:
Have been primary caregivers for all or most of the “proposed minor ward’s” childhood. Seek the guardianship. Have “never been the subject of an allegation, complaint, or investigation concerning the abuse, neglect, or exploitation of ” their child.
Are not otherwise disqualified from serving as their child’s guardian.
We believe HB 1675 is a commonsense approach that will enable parents of all means to obtain guardianship of their profoundly intellectually disabled children and remain in the strongest position to continue to advocate for their children’s best interests.
We recognize that not all guardianships are the same, and we respect the state’s interest in finding the least restrictive means for disabled adults to advocate on their own behalf. For those parents of children who will never be intellectually independent, HB 1675 is the beginning of reforming the guardianship process. We thank Allison for advocating on behalf for future generations of parents and encourage you to contact your representative to voice your support for this bill.