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Related Experiment Video

Updated: Jun 30, 2026

Development of Multiplex Real-Time RT-qPCR Assays for the Detection of SARS-CoV-2, Influenza A/B, and MERS-CoV

Development of Multiplex Real-Time RT-qPCR Assays for the Detection of SARS-CoV-2, Influenza A/B, and MERS-CoV

Published on: November 10, 2023

How Many Veteran COVID-19 Cases Were There during the Pandemic?

Wathsala N Widanagamaachchi^1,2, Ariana R Callahan^1,2, Tina M Willson^1,2

¹Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.

Journal of Medical Virology

|June 29, 2026

Summary

This study reveals significantly more COVID-19 cases in U.S. Veterans than officially recorded. Undocumented infections were common, highlighting disparities in case ascertainment among demographic groups.

Keywords:

COVID‐19 United States bias incidence pandemics policy veterans

Related Experiment Videos

Last Updated: Jun 30, 2026

Development of Multiplex Real-Time RT-qPCR Assays for the Detection of SARS-CoV-2, Influenza A/B, and MERS-CoV

Development of Multiplex Real-Time RT-qPCR Assays for the Detection of SARS-CoV-2, Influenza A/B, and MERS-CoV

Published on: November 10, 2023

Area of Science:

Epidemiology
Public Health
Veterans Health

Background:

The COVID-19 pandemic has had a profound impact on public health globally.
Accurate estimation of disease incidence is crucial for effective public health response.
U.S. Veterans represent a unique population with specific healthcare utilization patterns.

Purpose of the Study:

To estimate the incidence of symptomatic COVID-19 cases, both documented and undocumented, among U.S. Veterans.
To analyze demographic variations in COVID-19 incidence and ascertainment bias.
To provide a more comprehensive understanding of COVID-19's true burden in the Veteran population.

Main Methods:

Utilized a mortality-based estimation approach extended to include excess all-cause deaths.
Analyzed a cohort of U.S. Veterans alive as of March 1, 2020.
Relaxed assumptions of constant infection fatality rate (IFR) over time and across age groups.
Conducted descriptive analyses to identify demographic ascertainment biases.

Main Results:

Estimated COVID-19 incidence among Veterans was substantially higher than documented cases in electronic health records.
Significant variations in ascertainment biases were observed across different demographic groups.
The study identified a considerable number of undocumented symptomatic COVID-19 cases.

Conclusions:

Actual COVID-19 case numbers among U.S. Veterans are likely much higher than official records indicate.
Documented COVID-19 rates may not be directly comparable across demographic groups or over time due to ascertainment biases.
Findings underscore the need for comprehensive surveillance and policy considerations that account for undocumented infections.