Estimating COVID-19 Virus Prevalence from Records of Testing Rate and Test Positivity

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Abstract

Introduction

PCR testing for COVID-19 is not done at random but selectively on suspected cases. This paper presents a method to estimate a “genuine Virus Prevalence” by quantifying and removing the bias related to selective testing.

Methods

Data used are from nine (9) neighbouring countries in Western Europe that record similar epidemic trends despite differences in Testing Rate. Regression analysis is used to establish a relationship of declining Test Positivity with increased Testing Rate. By extrapolating this trend to an “infinitely complete” Testing Rate, an unbiased Test Positivity or “genuine Virus Prevalence” is computed. Via pairing of “genuine Virus Prevalence” with Excess-Deaths, a “genuine Infection Fatality Rate (IFR) is also derived.

Results

Peak levels of “genuine Virus Prevalence” were around 0.5 to 2% during the 1 st epidemic “wave” (week 10 to week 20) and are approaching similar levels in the ongoing 2 nd “wave” (week 34 onward). “Genuine Virus Prevalence” estimates are close to reported Seroprevalence in the studied countries with a correlation coefficient of 0.58. “Genuine” IFR is found comparable to closed-community model IFR. Finally, results of community mass-testing in Slovakia are within the estimated range of “genuine Virus Prevalence”.

Conclusions

Estimates of “genuine Virus Prevalence” benchmark favourably to other indications of virus prevalence suggesting the estimation method is robust and potentially deployable beyond this initial dataset of countries. “Genuine Virus Prevalence” curves suggest that during the 1 st epidemic “wave”, curve flattening and waning happened at very modest levels of infection spread, either naturally or facilitated by government measures.

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