CDC Says Coronavirus Cases May Be 10 Times Higher Than Reported; List of Those At Risk For Severe Strain of Disease Expanded

Coronavirus Published On June 25, 2020 06:28 PM
Ernice Gilbert | June 25, 2020 06:28:12 PM

A National Guard on-the-go testing team administers coronavirus tests in Houston on Thursday. By THE NEW YORK TIMES

The Centers for Disease Control and Prevention on Thursday said the number of coronavirus cases in the U.S. may be 10 times higher than the 2.3 million confirmed cases reported in the country.

“Our best estimate right now is that for every case that’s reported, there actually are 10 other infections," CDC Director Robert Redfield said during a call with reporters on Thursday.

According to Mr. Redfield, the larger estimate was based on blood samples collected around the U.S. in search of antibodies to the disease. He said for every confirmed case, 10 more people had antibodies.

This means in the U.S. Virgin Islands, where 80 confirmed cases have been reported, there may have actually been 800 cases, and on the U.S. mainland, where 2.3 million cases have been confirmed, the CDC said more than 20 million people may have been infected. However, it was not clear what results the V.I. Department of Health may be seeing from data collected through testing for antibodies. Calls placed to D.O.H. Commissioner Justa Encarnacion were not immediately returned.

The CDC director also estimated that 92 to 95 percent of the U.S. population was still at risk of being infected by Covid-19.

Mr. Redfield, who said the virus is taking a different shape relative to who is being infected, warned of a twofold blow to the U.S. during the fall, when both influenza and Covid-19 will be circulating. Currently, however, the virus is infecting more younger people and there are fewer hospitalizations. 

“We’re not talking about a second wave right now, we’re still in the first wave,” Mr. Redfield said. “That first wave is taking different shapes.”

Also on Thursday, the CDC updated and expanded its list of individuals who are at risk of getting severely ill with Covid-19. 

Older adults and people with underlying medical conditions remain at increased risk for severe illness, but now the CDC has further defined age and condition-related risks.

As more information becomes available, it is clear that a substantial number of Americans are at increased risk of severe illness – highlighting the importance of continuing to follow preventive measures, the CDC said.

“Understanding who is most at risk for severe illness helps people make the best decisions for themselves, their families, and their communities,” stated Mr. Redfield. “While we are all at risk for COVID-19, we need to be aware of who is susceptible to severe complications so that we take appropriate measures to protect their health and well-being.”

COVID-19 risk related to age

CDC has removed the specific age threshold from the older adult classification. CDC now warns that among adults, risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness.

Recent data, including an Morbidity and Mortality Weekly Report published last week, has shown that the older people are, the higher their risk of severe illness from COVID-19. Age is an independent risk factor for severe illness, but risk in older adults is also in part related to the increased likelihood that older adults also have underlying medical conditions, the CDC said.

COVID-19 risk related to underlying medical conditions

CDC also updated the list of underlying medical conditions that increase risk of severe illness after reviewing published reports, pre-print studies, and various other data sources. CDC experts then determined if there was clear, mixed, or limited evidence that the condition increased a person’s risk for severe illness, regardless of age.

There was consistent evidence (from multiple small studies or a strong association from a large study) that specific conditions increase a person’s risk of severe COVID-19 illness:

  • Chronic kidney disease
  • COPD (chronic obstructive pulmonary disease)
  • Obesity (BMI of 30 or higher)
  • Immunocompromised state (weakened immune system) from solid organ transplant
  • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Sickle cell disease
  • Type 2 diabetes


These changes increase the number of people who fall into higher risk groups, the CDDC said. An estimated 60 percent of American adults have at least one chronic medical condition. Obesity is one of the most common underlying conditions that increases one’s risk for severe illness – with about 40 percent of U.S. adults having obesity. The more underlying medical conditions people have, the higher their risk, the CDC said.

The CDC also clarified the list of other conditions that might increase a person’s risk of severe illness, including additions such as asthma, high blood pressure, neurologic conditions such as dementia, cerebrovascular disease such as stroke, and pregnancy.  An MMWR published today further adds to the growing body of research on risk by comparing data on pregnant and nonpregnant women with laboratory-confirmed SARS-CoV-2 infection. Pregnant women were significantly more likely to be hospitalized, admitted to the intensive care unit, and receive mechanical ventilation than nonpregnant women; however, pregnant women were not at greater risk for death from COVID-19.

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