Many people use maps of COVID-19 cases that show the virus is “not in my area” as an excuse for not social distancing. But public health officials report that confirmed COVID-19 numbers show only the tip of the iceberg and the actual number of infected individuals is much higher.
The United States has been struggling to ramp up comprehensive testing for the past month with some success, but that fight is ongoing. Currently, every state has a backlog of tests that many cannot complete fast enough to provide a diagnosis, The Atlantic reported last week. The backlog of testing in many states is in the thousands. As a result, states are turning away people requesting tests even when they are showing symptoms. For each confirmed case of coronavirus, according to a report recently published in Science magazine, there are likely another five to 10 cases that remain undetected. Moreover, the tests currently available have very high rates of false negatives, a public health expert has warned in The New York Times.
Maps of confirmed cases that fail to convey these realities are contributing to a false sense of security. People often skip written information and instead derive a simplified message from a map. Maps of confirmed cases are likely no exception. We believe that many in the general public believe such maps show the actual spread of the virus, when they do not. Absence of evidence is not evidence of absence.
As in other states, it is currently practice in Maine to diagnose COVID-19 based on symptoms instead of testing for lower-risk cases, leading to undercounting. The reporting of case numbers on the Maine Center for Disease Control and Prevention website includes this disclaimer: “This information represents the number of full-time Maine residents who have tested positive for COVID-19. This is likely an underrepresentation of the true number of cases in Maine since not all individuals are being tested. For individuals not considered to be at high risk, medical providers are currently advised to diagnose COVID-19 based on symptoms.”
It is our collective goal as mapping professionals, academics and advisers to provide maps and analysis to keep the public informed and to help us all flatten the curve.
Currently, there is no way without widespread and targeted testing to map the actual number of cases. So, the number of confirmed cases and deaths is the only quantitative information available for public health officials to report. The media and the public focus on these maps and numbers and ignore disclaimers stating that the virus is more widespread. Health officials and the media need to do a better job conveying this crucial information, while we continue to strive for more testing and more comprehensive data.
It goes without saying that we all appreciate the hard work of our health care and public health professionals. We should all show our support for them and protect vulnerable members of our community by being realistic about the risk and practicing social distancing.
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