Mild COVID breakthrough cases likely underreported as infections rise

Coronavirus

CLEVELAND (WJW) – The number of vaccinated people testing positive for COVID-19 is on the rise and local doctors report more breakthrough cases across hospital systems.

However, only certain types of COVID breakthrough cases are reported at both the state and federal level, leaving patients with mild cases underreported.

“We estimate anywhere from two to 10 times as many positives that are being reported is the real situation,” said Dr. David Margolius, Division Director of Internal Medicine at MetroHealth.

The Ohio Department of Health and the Centers for Disease Control and Prevention report breakthrough cases in patients requiring hospital admission or cases that resulted in death.

The CDC made the change in May in order to “maximize the quality of data collected on cases of greatest clinical and public importance.”

“It’s still rare, but I get a dozen COVID positive cases a day in my basket and usually three or four of them have been vaccinated,” said Dr. Margolius.

The latest breakthrough case data from the Ohio Department of Health shows more than 1,000 fully vaccinated patients required a hospital stay since January compared to more than 27,700 unvaccinated patients.

Reported COVID deaths are also significantly lower when comparing vaccinated versus unvaccinated patients.

More than 8,100 unvaccinated patients died since January due to COVID compared to just over 140 vaccinated individuals.

“Breakthrough infections that lead to a mild illness with delta variant are probably about one in 100,” said Dr. Keith Armitage, an Infectious Disease Specialist and Medical Director of the UH Roe Green Center for Travel Medicine & Global Health. “For mild cases, the data is probably a little less clear. I do think that the CDC wants to track this and I think, overall, we’re getting a decent handle on it, but we may be missing some cases.”

Dr. Margolius said he is aware of occasional pregnant patients with breakthrough cases.

“If their symptoms are concerning enough, they are eligible for the monoclonal antibody treatment so someone who is pregnant who is positive can reach out to their health care system, their doctor, to ask about the monoclonal antibody treatment,” he said.

“I have not seen any breakthrough cases in pregnant women. I am not aware of any. We’ve had some sad, tragic cases of unvaccinated pregnant women who developed critical illness.”

Cuyahoga County Board of Health Commissioner Terry Allan reports 135 breakthrough cases and 15 deaths.

The Cleveland Department of Public Health did not respond to requests for data.

“COVID for vaccinated people becomes more and more like the common cold or something even weaker than the flu,” said Dr. Margolius. “If you’re unvaccinated, that’s where the deadly, scary virus is that has shut down the world for the past 18 months.”

Although a COVID vaccination is not a guaranteed way to prevent an infection, it is still very effective at significantly lowering chances of severe or life-threatening infection. Doctors continue to encourage the public to get vaccinated.

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