COVID-19 Positive Cases, Evidence on the Time Evolution of the Epidemic or An Indicator of Local Testing Capabilities? A Case Study in the United States

Abstract

The novel SARS-CoV-2 coronavirus, first identified in Wuhan (Hubei), China, in December 2019, has spread to more than 180 countries and caused over 1,700,000 cases of COVID-19 worldwide to date. In an effort to limit human-to-human contact and slow the transmission of COVID-19, the disease caused by this novel coronavirus, the United States have implemented a collection of shelter-in-place public health interventions. To monitor if these interventions are working and to determine when people may go back to (perhaps a new) business as usual requires reliable monitoring systems that provide an accurate real-time picture of the trajectory of the epidemic outbreak. Here, we present evidence that our current healthcare-based monitoring systems, aimed at detecting the new daily number of COVID-19-positive individuals across the US, may be better at tracking the local testing (detection) capabilities than at monitoring the time evolution of the outbreak. This suggests that other data sources are necessary to inform (real-time) critical decisions about when to stop (and perhaps when to restart) shelter-in-place mitigation strategies.

Note: Funding: MS is partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number R01GM130668. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflict of Interest: The authors declare no conflicts of interest.

Keywords: COVID-19, Disease surveillance, COVID-19 testing