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What can we learn about SARS-CoV-2 prevalence from testing and hospital data?

Author

Listed:
  • Daniel W. Sacks
  • Nir Menachemi
  • Peter Embi
  • Coady Wing

Abstract

Measuring the prevalence of active SARS-CoV-2 infections in the general population is difficult because tests are conducted on a small and non-random segment of the population. However, people admitted to the hospital for non-COVID reasons are tested at very high rates, even though they do not appear to be at elevated risk of infection. This sub-population may provide valuable evidence on prevalence in the general population. We estimate upper and lower bounds on the prevalence of the virus in the general population and the population of non-COVID hospital patients under weak assumptions on who gets tested, using Indiana data on hospital inpatient records linked to SARS-CoV-2 virological tests. The non-COVID hospital population is tested fifty times as often as the general population, yielding much tighter bounds on prevalence. We provide and test conditions under which this non-COVID hospitalization bound is valid for the general population. The combination of clinical testing data and hospital records may contain much more information about the state of the epidemic than has been previously appreciated. The bounds we calculate for Indiana could be constructed at relatively low cost in many other states.

Suggested Citation

  • Daniel W. Sacks & Nir Menachemi & Peter Embi & Coady Wing, 2020. "What can we learn about SARS-CoV-2 prevalence from testing and hospital data?," Papers 2008.00298, arXiv.org, revised Mar 2021.
  • Handle: RePEc:arx:papers:2008.00298
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    References listed on IDEAS

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    1. Manski, Charles F. & Molinari, Francesca, 2021. "Estimating the COVID-19 infection rate: Anatomy of an inference problem," Journal of Econometrics, Elsevier, vol. 220(1), pages 181-192.
    2. Allcott, Hunt & Boxell, Levi & Conway, Jacob & Gentzkow, Matthew & Thaler, Michael & Yang, David, 2020. "Polarization and public health: Partisan differences in social distancing during the coronavirus pandemic," Journal of Public Economics, Elsevier, vol. 191(C).
    3. Karl M. Aspelund & Michael C. Droste & James H. Stock & Christopher D. Walker, 2020. "Identification and Estimation of Undetected COVID-19 Cases Using Testing Data from Iceland," NBER Working Papers 27528, National Bureau of Economic Research, Inc.
    4. Tomas Philipson, 1996. "Private Vaccination and Public Health: An Empirical Examination for U.S. Measles," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 611-630.
    5. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799, Elsevier.
    6. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of AIDS," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 549-573.
    7. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," NBER Working Papers 5428, National Bureau of Economic Research, Inc.
    8. Sumedha Gupta & Kosali I. Simon & Coady Wing, 2020. "Mandated and Voluntary Social Distancing During The COVID-19 Epidemic: A Review," NBER Working Papers 28139, National Bureau of Economic Research, Inc.
    9. Sumedha Gupta & Thuy D. Nguyen & Felipe Lozano Rojas & Shyam Raman & Byungkyu Lee & Ana Bento & Kosali I. Simon & Coady Wing, 2020. "Tracking Public and Private Responses to the COVID-19 Epidemic: Evidence from State and Local Government Actions," NBER Working Papers 27027, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Bollinger, Christopher R. & van Hasselt, Martijn, 2020. "Estimating the cumulative rate of SARS-CoV-2 infection," Economics Letters, Elsevier, vol. 197(C).

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