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Spotlight on the dark figure: Exhibiting dynamics in the case detection ratio of COVID-19 infections in Germany

Schneble, M.; De Nicola, G.; Kauermann, G.; Berger, U.

2020-12-24 epidemiology
10.1101/2020.12.23.20248763 medRxiv
Show abstract

The case detection ratio of COVID-19 infections varies over time due to changing testing capacities, modified testing strategies and also, apparently, due to the dynamics in the number of infected itself. In this paper we investigate these dynamics by jointly looking at the reported number of detected COVID-19 infections with non-fatal and fatal outcomes in different age groups in Germany. We propose a statistical approach that allows us to spotlight the case detection ratio and quantify its changes over time. With this we can adjust the case counts reported at different time points so that they become comparable. Moreover we can explore the temporal development of the real number of infections, shedding light on the dark number. The results show that the case detection ratio has increased and, depending on the age group, is four to six times higher at the beginning of the second wave compared to what it was at the peak of the first wave. The true number of infection in Germany in October was considerably lower as during the peak of the first wave, where only a small fraction of COVID-19 infections were detected. Our modelling approach also allows quantifying the effects of different testing strategies on the case detection ratio. The analysis of the dynamics in the case detection rate and in the true infection figures enables a clearer picture of the course of the COVID-19 pandemic.

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