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Given how sensitive these results are to performance of the assay, I don't think it's safe to conclude that infections are "50-85-fold more than the number of confirmed cases". 7/8
Again, important to have this work being done. I'd just urge caution in interpretation. I will note again that I've been using a 10-20X ratio of cases-to-infections, but will be great to have more data here (I'd be happy to be wrong). 8/8https://twitter.com/trvrb/status/1249414308355649536 …
See this thread for a corrected confidence interval to the seroprevalence estimate:https://twitter.com/jjcherian/status/1251279161534091266 …
And see here for a full posterior seroprevalence estimate that takes into account uncertainty in sensitivity and specificity of the assay:https://twitter.com/richardneher/status/1251484978854146053 …
Totally agree. I'd have to see a *lot* more data on the assay's validation, particularly in the field and with diverse populations (with potentially divergent immunological histories and germline Ig genotypes from the initial controls) to buy the cited false discovery rate.
Beyond these arguments, I also worry that this was a convenience sample and test-seeking behavior may affect generalizability of results (travel history, symptoms, etc).
I’ve been thinking 10x-20x sounds reasonable too but that seems to plummet mortality below what we saw on the Diamond Princess, which I’ve been seeing presented as a pretty good example since they were tested in entirety. Is there something I’m missing about Diamond Princess?
This is specifically what I was looking at. Although I guess US is currently running at 5% case fatality rate so 10x would be aligned with 0.5% lower bound?https://twitter.com/adamjkucharski/status/1243466394991239170?s=21 …
There were 30 deaths at the time which implies 5200*30 = 156k infections (using IFR=0.5%, 2x in 5 days, & 18.5 days from symptoms to death) which is 1.6%
Chelsea MA test suggests possibility of 16x more cases. Given non-random sample, perhaps 10x is a safe assumption for a hotspot. https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/?outputType=amp#click=https://t.co/p9NodslbMA …
except these results are being replicated all over the world. Most notably in Netherlands, Denmark, Finland, Germany
2-3% prevalence at Netherlands : 0.9 - 1.5% CFR
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