In epidemiology it is standard to estimate how many cases you are identifying, versus the number implicitly in the community. We have had serious problems with political denial there is ANY community spread or ANY asymptomatic spreaders. As an example, we just had
our governor authorize the return of people without symptoms to handle food in restaurants. (If you have trouble with that link, you might be able to read
this one.)
For much of this pandemic I've been using a multiplier of 5, and assuming there was a great deal of community spread.
When this mess is over, and all kinds of things are known for certain, we will have a much better idea of various important numbers. What I'm telling you is that predictions made with a substantial multiplier have done better than many other models in making predictions. This is still true, even though the multiplier that works best has come down. Control of epidemics requires taking action based on incomplete data about transmission.
Waiting for the kind of reliable data you describe amounts to a default decision to let the pandemic burn itself out, at whatever cost that implies.
I'm not making detailed distinctions between asymptomatic, presymptomatic and oligosymptomatic, which your examples touch on. I'm talking about people who genuinely think they do not have any infection, and who exhibit no clinical symptoms their doctors recognize. That example of "glassy lung" would be a definite sign, not a symptom, but it would turn up on an X-ray. If the doctor and patient both fail to think anything is wrong there will not be such an X-ray.
After those initial chaotic months, the multiplier I used came down, but that was the same time when various authorities learned about manipulating numbers to fit some political narrative. The problem at present is that chaotic disorganization has been replaced with organized misinformation. Those responsible have not realized the problem with distorting data so that all the numbers fit together. Here in Florida we have
local communities that are hard hit running their own community dashboards using data from local hospitals. We have the state firing those who created the original state dashboard. We have the White House intervening to cut the CDC out of the loop of collecting data for the entire nation, turning this over to political appointees at HHS. I could go on, but the result would simply be more distrust of the numbers. I'm having to act like an amateur intelligence analyst trying to figure out what is really going on in a hostile nation.
I've been in that situation before, but that is a different story.
(If you think Florida is unique, you should see the disparity between different counties in Texas. Some say they have had only a handful of cases, and don't expect more. Another county (Karnes) is currently running
306 cases per day per 100,000, many times what the state as a whole is doing. That infection rate is terrible.
Here's an explanation of what it means. If I lived there, I would stay in my bunker until water ran out.)
My simple prediction is that we will find that Florida does not have the pandemic under control, nor does the nation. The bottom line will be a surge in deaths, weeks or months after infection. We are still running well over 100 deaths reported per day, (182 yesterday,) in this state alone. With 20% of this state's population counted as elderly, it will take a long time to exhaust the number of susceptible people at risk of dying.
For the nation, there are predictions of 300,000 dead by the end of this year. My private estimates look higher. I keep hoping something will change.
That study in Korea was done in a way that probably would not work in the U.S. When a rash of cases appeared in members of one church, the KCDC stepped in and isolated everyone who might have been exposed. They also chose a group to use for tests described in the paper. Nobody fought lawsuits all the way to their supreme court.
As for the phrase "since pretty much everyone knows by now that the virus is serious", (assuming you mean everyone sane,) you must not keep up with
U.S. news and lack regular interactions with people who are still deep in denial, like some neighbors. When I went to get groceries last night I saw one person wearing both a face mask and a transparent shield. I also saw people who only put some kind of cloth over their face so they could get in the store, which now has someone outside to stop them if they don't.
We've just been through a bitter local dispute over reopening schools. There is no money allocated for personal protective equipment or extensive testing. Teachers are told to implement CDC guidelines, "if feasible". All you need to do is count class sizes and room sizes to see that recommended spacing is not feasible even if students should become compliant angels. My teacher friend has filed retirement paperwork. This makes sense to me, because while she indicated she preferred to teach via the Internet, she was given no guarantees. If she was ordered to teach face-to-face, and refused, she could be dismissed for cause.
I don't understand those, including teachers, who argued vociferously for face-to-face classes without adequate protection, support and testing.
Some aspects of our national debate sound to me a lot like Livia's
pep talk to her gladiators in "I, Claudius", where she accuses them of using tricks that are ruining the games in an effort to stay alive. (Unfortunately, that clip misses her opening statement, "You're all scum, and you know it.")
