Reason: CDC Antibody Studies Confirm Huge Gap Between COVID-19 Infections and Known Cases

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Newly published antibody test results from half a dozen parts of the country confirm that COVID-19 infections in the United States far outnumber confirmed cases. The ratio of estimated infections to known cases in these studies, which the U.S. Centers for Disease Control and Prevention (CDC) reported on Friday, range from 6 to 1 in Connecticut as of early May to 24 to 1 in Missouri as of late April.

These results confirm something we already knew: The COVID-19 infection fatality rate—deaths as a share of all infections—is much lower than the crude case fatality rate—deaths as a share of known cases. That is bound to be true when testing is limited and a virus typically produces mild or no symptoms. At the same time, the CDC's antibody studies imply that efforts to control the epidemic through testing, isolation, quarantine, and contact tracing will not be very effective, since they reach only a small percentage of virus carriers.

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Since neither contact tracing nor a vaccine is likely to save high-risk Texans, the ultimate death toll will depend largely on precautions aimed at protecting them. Gov. Greg Abbott has responded to the new wave of infections, which he says is driven largely by young people who have been getting together for drinks in close proximity, by closing bars. But if young Texans are increasingly disinclined to follow social distancing rules, that step may not accomplish much. They can still get together in private, and their risk of exposure will in any case be higher as they return to work. Nor can those people, whose own risk of dying from COVID-19 is very low, necessarily be counted on to avoid contact with Texans who are much more vulnerable to the disease.

The onus for preventing contact between potential carriers and high-risk individuals seems to be shifting, fairly or not, from the first group to the second. Minimizing COVID-19 deaths will require adapting to that reality.

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