Official counts of COVID-19 cases understate the number of people affected by coronavirus

Reviewed by James Ives, M.Psych. (Editor)Jul 28 2020

In mid-April, as the COVID-19 epidemic roared through the nation, 2,017,105 jobholders were absent from work because they were ill.

The April figure was the highest number since at least 1976, and more than double the rate from mid-April 2019, according to a new study from researchers at Harvard Medical School and CUNY's Hunter College.

The findings suggest that the official counts of COVID-19 cases greatly understate the number of people sickened by the virus.

The surge in sickness-related work absences was largest for immigrant workers, a group that includes many essential workers at high risk of coronavirus exposure; immigrant jobholders' absence rate rose almost five-fold from 12 months earlier, when their absenteeism rate had been 37% lower than that of native-born jobholders.

Workers 55 and older, and those with less education also had larger than average year-over-year increases in sickness-related absences. The research appears Monday, June 27 in the Journal of the American Medical Association (JAMA): Internal Medicine.

Researchers analyzed the Census Bureau's monthly Current Population Survey which tracks U.S. employment. Because the survey asked only about work absence during a single week in mid-April, the figures likely understate the number of jobholders who were out sick during the course of the month.

The share of workers who were out sick was virtually identical in the first two months of 2019 and 2020. As in most years, work absences began dropping in the early spring of 2019, falling to 0.58% of the workforce by April.

In contrast, in 2020 the number who were out sick began rising in March as COVID-19 illnesses began spreading, and soared in April, when 1.51% of all job holders were out sick, nearly triple the percentage from a year earlier.

"I've seen firsthand COVID-19's impact on the critically ill patients in our ICU, and we've known that many more were also ill at home," noted lead author Dr. Adam Gaffney, a pulmonary and critical care specialist at Harvard Medical School and the Cambridge Health Alliance, a safety-net hospital system at an epicenter of the pandemic in eastern Massachusetts.

"But our study indicates that the pandemic has sickened many more people than we had realized, especially vulnerable employees like immigrants."

Millions of immigrants and people of color have put themselves in harm's way to keep vital services running during the COVID-19 crisis,"

Dr. Steffie Woolhandler, Primary Care Doctor and Distinguished Professor, Lecturer  Department of Public Health, CUNY's Hunter College, Harvard Medical School

Woolhandler is also a lecturer in Medicine at Harvard.

"Many are uninsured and have no income if they miss work. The least we can do to protect them is to assure paid sick leave and universal health care, benefits that workers in every other wealthy nation already enjoy."