On testing for infections during epidemics, with application to Covid-19 in Ontario, Canada

During an epidemic, accurate estimation of the numbers of viral infections in different regions and groups is important for understanding transmission and guiding public health actions. This depends on effective testing strategies that identify a high proportion of infections (that is, provide high ascertainment rates). For the novel coronavirus SARS-CoV-2, ascertainment rates do not appear to be high in most jurisdictions, but quantitative analysis of testing has been limited. We provide statistical models for studying testing and ascertainment rates, and illustrate them on public data on testing and case counts in Ontario, Canada.