True number of U.S. COVID-19 cases likely over 100 mln by end of 2020: study

Tourists visit the National Mall in Washington, D.C., the United States, on Aug. 18, 2021. (Xinhua/Liu Jie)

"Many cases went undetected due to limited testing early in the year and a large number of infections that produced mild or no symptoms," U.S. health expert Francis Collins said.

WASHINGTON, Sept. 8 (Xinhua) -- The true number of U.S. COVID-19 cases by the end of 2020 was likely more than 100 million, said a new study by researchers at Columbia University.

"At the end of last year, you may recall hearing news reports that the number of COVID-19 cases in the United States had topped 20 million. While that number came as truly sobering news, it also likely was an underestimate," wrote National Institutes of Health Director Francis Collins in a blog post on Tuesday about the study published by science journal Nature.

In the study, researchers at Columbia University estimated the percentage of people who had been infected with SARS-CoV-2 in communities across the country through December 2020.

They started with existing national data on the number of coronavirus cases both detected and undetected in 3,142 U.S. counties and major metropolitan areas. They then factored in data from the Centers for Disease Control and Prevention (CDC) on the number of people who tested positive for antibodies against SARS-CoV-2. These CDC data are useful for picking up on past infections, including those that went undetected.

From these data, the researchers calculated that only about 11 percent of all COVID-19 cases were confirmed by a positive test result in March 2020. By the end of the year, with testing improvements and heightened public awareness of COVID-19, the ascertainment rate, or the number of infections that were known versus unknown, rose to about 25 percent on average.

"Many cases went undetected due to limited testing early in the year and a large number of infections that produced mild or no symptoms," Collins said.

Collins said the revised number, which is nearly a third of the U.S. population of 328 million, illustrates "just how rapidly this novel coronavirus spread through the country last year."

The United States surpassed 20 million confirmed COVID-19 cases on New Year's Day, according to data from the Johns Hopkins University (JHU).

As of Wednesday afternoon, the country's caseload was over 40,412,000 with a death toll of 652,175, according to a tally by JHU.