COVID-19 - a hypothetical question and reporting of figures.

[fannyanney]

This one has been playing on my mind since yesterday...

So say, hypothetically, the UK goes in to shut down as they have in Wuhan. Or for the sake of this question, even just your town or village.

You're at home, possibly alone or possibly with your family members/friends. Whatever.

You start to show signs of COVID-19. They're fairly mild (similar to Steve the machine) and you don't feel as if you need any medical treatment. Your family/friends in your home will have already been exposed to the virus as you would have been contagious before your symptoms started. Let's say, for the purpose of this question, that they show signs too either at the same time as you, or shortly after. They also have mild symptoms and make a full recovery while still isolated from anyone outside the home.

Would you notify the govt/nhs/PHE that you thought you had COVID-19, or would you just manage it at home?

If you'd just manage it at home (as I think I would, if mild), and wouldn't notify anyone, (perhaps out of fear of being quarantined away from family, or because you don't see any danger of staying with whoever is in your house because they will have already been exposed), then this means that official figures would be wrong. Potentially very wrong, if many people behaved in a similar way.

So.. surely this would completely skew the figures for the virus. There could potentially be an awful lot of people with mild symptoms, that will never be accounted for?

Also, this could then possibly be happening in China now? People not self reporting, and thus figures being way out (even without China's tendency to under report cases)

I work in public health. Yes this is exactly how it usually works and why it’s hard to get a sense of what’s really happening. On one hand, this is good because it means the case fatality rate is probably less than officially reported (a smaller percentage who get sick actually die, for a while it looked like 5%, now more like 2%, though I saw some ‘leaked’ numbers the other day that looked more like 16%).

On the other hand, there can be people dying who get recorded as dying from other things, respiratory failure, old age, heart attack, or whatever because they were never diagnosed. So figures can be higher than reported.

There are ways of estimating total cases and they will get a good sense. But humans are like herding cats, so it will never be perfect.