Random testing in Indiana shows COVID-19 is 6 times deadlier than flu

The random testing also shows that 2.8% of the state’s populations has been infected by the novel coronavirus.

Nir Menachemi

Jul 22, 2020

By Nir Menachemi

July 22, 2020

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Since day one of the coronavirus pandemic, the U.S.

has not had enough tests. Faced with this shortage, medical professionals used what tests they had on people with the worst symptoms or whose occupations put them at high risk for infection. People who were less sick or asymptomatic did not get tested. Because of this, many infected people in the U.S. have not been tested, and much of the information public health officials have about the spread and deadliness of the virus does not provide a complete picture.

Short of testing every person in the U.S., the best way to get accurate data on who and how many people have been infected with the coronavirus is

to test randomly.

I am a

professor of health policy and management at Indiana University, and random testing is exactly what we did in my state. From April 25 to May 1, our team randomly selected and tested thousands of Indiana residents, no matter if they’d been sick or not. From this testing we were able to get some of the first truly representative data on coronavirus infection rates at a state level.

We found that

2.8% of the state’s population had been infected with SARS–CoV–2. We also found that minority communities – especially Hispanic communities – have been hit much harder by the virus. With this representative data, we were also able to calculate out just how deadly the virus really is.

The process of random testing

The goal of our study was to learn how many Indiana residents, in total, were currently or had been previously been infected by the coronavirus. To do this, the people our team tested needed to be an accurate representation of Indiana’s population as a whole and we needed to use two tests on every person.

With the help of the Indiana State Department of Health, numerous state agencies and community leaders,

we set up 70 testing stations in cities and towns across Indiana. We then randomly selected people from a list created using state tax records and invited them to get tested, free of charge. Some groups showed up more readily than others and we adjusted the numbers to represent the demographics of the state accordingly.

Once a person showed up to our mobile testing sites, they were given both

a PCR swab test that looks for current infections and an antibody blood test that looks for evidence of past infection.

By testing randomly and looking for both current and past infections, we could extrapolate our results to the entire state of Indiana and get information about real infection rates of this virus.

The research team also worked with civic leaders from vulnerable communities to conduct open, nonrandom testing as well to see how the results of these two testing approaches would differ.

How widespread and how deadly

We tested more than 4,600 Indiana residents as part of the first wave of testing in the study. This included more than 3,600 randomly selected people and more than 900 volunteers who participated in open testing.

During the last week in April, we estimate that 1.7% of the population had active viral infections. An additional 1.1% had antibodies, showing evidence of previous infection. In total, we estimate that

2.8% of the population currently were or had previously been infected with the coronavirus with 95% confidence that the actual infection rate is between 2% and 3.7%.

Because our random sample was designed to be representative of the population of the state, we can assume with almost certainty that the entire state numbers are the same. That would mean that approximately 188,000 Indiana residents had been infected by late April. At that point, the official confirmed cases – not including deaths –

were about 17,000.

Focusing the tests on severe or high-risk people underestimated the true infection rate by a factor of 11.

Having a reliable estimate of the true number of people who have been infected also allowed us to calculate the infection fatality rate – the percentage of people infected with SARS-CoV-2 who die. In Indiana, we calculated the rate is 0.58%. For this calculation, we divided the number of COVID-19 deaths in Indiana – 1,099 at the time – into the total number of people that were determined to have been cumulatively infected at 2.8% of the population – 188,000.

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Early estimates suggested that

5% to 6% of cases in the U.S. were fatal, which is similar to the 6.3% that you would get by dividing confirmed cases in Indiana – 17,000 – by the deaths – 1,099. The infection–fatality rate of 0.58% is thankfully far lower, but is nearly six times higher than the seasonal flu which has a death rate of 0.1%.

This random testing also allowed us to make accurate estimates about what percent of infected people are asymptomatic. In our study, about 44% of those who tested positive for active viral infection reported no symptoms. While this was already

suspected by experts, our estimate is likely the most accurate to date.

Race, job and living situation matter

The general trends and information about the virus are incredibly important, but just as important are the ways in which human actions influenced what people are most affected.

We asked every person we tested about their race, ethnicity and whether they lived with someone who was previously diagnosed with COVID-19.

Our analysis of the random sample suggests that COVID-19 rates are much higher in minority communities, especially in Hispanic communities, where approximately 8% were currently or previously infected. While we do not definitively know why, it is possible that members of the Hispanic community in Indiana are

more likely to be essential workers, live in extended family structures that include relatives beyond the nuclear family or both.

We further found that people who lived with a person who was COVID-19 positive were approximately 12 times more likely to have the virus themselves than people living in a home with no infections. Living with extended family and being more exposed due to one’s job may make it easier for the virus to spread within some communities.

These findings, along with the relatively low 2.8% prevalence, suggest that social distancing slowed the spread of the virus in the larger population. However, the hardest-hit communities were those who, on average, are not able to practice social distancing as consistently as others.

What next?

Now that we have this information and have established a baseline, we will continue periodically testing a random sample of people in the state. Doing so will tell us how far the virus has infiltrated our population so that policy decisions can be tailored to the situation.

This is the first statewide random sample study in the U.S. and the numbers offer both points of hope and concern.

The good news is that social distancing worked. Efforts to slow the virus contained it to only 2.8% of the population and by slowing the spread of the virus in the community, Indiana bought some time to determine the best way forward. This provides more time for researchers to both determine the degree to which infection results in immunity and to accelerate the development of a vaccine.

But there is bad news as well. If only 2.8% of the population have been infected with SARS-CoV-2, 97.2% of the population have not been infected and could still get the virus. The risk for a large outbreak that could dwarf the initial wave is still very real.

The demographic distribution of infections, while disturbing, offers important information that can help public health officials direct testing, education and contact tracing resources that are language and culturally sensitive. The research team and the state health department are working with leaders from these communities to figure out how to best contain the spread of the virus in the areas most affected.

As businesses slowly reopen, we need to be vigilant with any and all safety precautions so that we do not lose the ground we gained by hunkering down. Hopefully numbers will go down, but regardless of what happens in the future, we now better know the foe we fight.

Nir Menachemi is a Professor of Health Policy and Management at IUPUI.

This article first appeared on The Conversation. You can find it here.

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Photo credit: Leigh Prather/Shutterstock.com – Dogs often react with great fear to July 4th celebrations. Border collies such as this dog are especially sensitive to loud noises.

Health, Well-being

Every dog has its day, but it’s not the Fourth of July

How to protect anxious pups from holiday booms.

Good Partner

6/25/2026
Christine Calder

The Fourth of July can be a miserable day for dogs. The fireworks make scaredy-cats out of many canines.

That’s because dogs, like humans, are hardwired to be afraid of sudden, loud noises. It is what keeps them safe. Some dogs, though, take that fear to the extreme with panting, howling, pacing, whining, hiding, trembling and even self-injury or escape. And, unlike humans, they don’t know that the fanfare on the Fourth is not a threat. Dogs hear the fireworks and process it as if their world is under siege.

How a dog responds to noises may be influenced by breed, with German shepherd dogs more likely to pace, while border collies or Australian cattle dogs are more likely to show their fear by hiding.

While we veterinarians don’t know exactly why some dogs are afraid of fireworks and others not, many dogs that react to one noise often react to others. Therefore, early intervention and treatment are essential in protecting the welfare of these terrified dogs. Here’s how you can protect your dog from fireworks.
- Take your pet to the vet. If your dog is afraid of fireworks, the first step is to have your veterinarian evaluate him or her, especially if your dog’s noise sensitivity is relatively new. One 2018 study found a link between pain and noise sensitivities in older dogs, indicating that muscle tension or sudden movements in response to a loud noise may aggravate a tender area on the body and thus create an association between the loud noise and pain, causing fear of that particular noise to develop or escalate.
- Create a “safe haven” in your home with a secure door or gate, preferably away from outside windows or doors. Close the blinds or curtains to reduce outside noises, and play some classical music to help reduce stress by creating a relaxing environment for your dog during the show. A white noise machine or box fan may also help reduce anxiety, along with a pheromone like Adaptil sprayed on bedding, a bandanna, a collar or from a diffuser plugged into the wall.
- Consider noise-canceling headphones such as Mutt Muffs to muffle the sounds and further reduce noise sensitivities.
- Find a food your pet will love. This could be cut pieces of boiled chicken or squeeze cheese. Sit with your pet and feed him with each boom. You can also use a long-lasting food-dispensing or puzzle toy to release food continuously during the show. This is to help your dog make a positive association with the noises for the future.
- Consider anxiety wraps, fabric wraps that exert a gentle pressure on your dog’s body. These may help to lower heart rate and other clinical signs of fear and anxiety, operating on the belief that they swaddle a scared animal and thus calm its fears. These work best, however, in conjunction with a complete behavior treatment plan including medication or behavior modification, or both.
- When it comes to comforting your dog, the jury is still out. It is difficult, however, to reinforce an emotional response with comfort. Therefore, it is OK to pet your dog when frightened by a noise event so long as the dog appears to be comforted and not more distressed by the attention.
This article originally appeared on The Conversation. You can read it here.
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Photo credit: Alex Cofaru/Shutterstock.com – A girl in a field of flowers.

Health, Well-being

Pollen is getting worse, but you can make things better with these tips from an allergist

Simple steps can ease spring allergy misery

Good Partner

6/25/2026
Kara Wada

Blooming flowers signal the beginning of spring, but for millions of people, they also signal the onset of the misery: allergy and asthma season. Itchy, watery eyes; sneezing, runny nose; cough and wheezing are triggered by an overreaction of the body to pollen.

Every spring, trees and grasses release billions of buoyant pollen granules into the air, using the wind to disperse across the countryside in an effort to reproduce. It’s all about survival; plants that release more pollen have the survival advantage.

As an adult and pediatric allergist-immunologist in the Midwest, the onset of spring signals my busy season treating hundreds of patients for their seasonal allergy and asthma symptoms. If you suffer through the season, know that you are not alone. Throughout history, pollen has taken the fun out of spring for many. In modern times, however, medical science has identified practices and treatments that help.

Older than the dinosaurs, as wide as the world

Fossilized specimens of pollen granules have been found predating dinosaurs and alongside Neanderthals.

And, sinus and asthma symptoms and treatments are documented throughout history and across the globe. People just didn’t know exactly how to treat the symptoms, or exactly what was causing them.

For example, over 5,000 years ago, the Chinese used the berries of the horse tail plant, ma huang (Ephedra distachya), to relieve congestion and decrease mucous production associated with “plant fever” – a condition affecting people during the fall.

In Egypt, the “Papyrus Ebers,” written around 1650 B.C., recommended over 20 treatments for cough or difficulty breathing, including honey, dates, juniper and beer.

Although Homer’s “Iliad” describes the loud noise of breathing in battle as “asthma,” Aretaeus of Cappadocia of the second century A.D. is credited with the first clinical description more consistent with modern understanding of this condition. He wrote of those who suffered that:

“They open the mouth since no house is sufficient for their respiration, they breathily standing, as if desiring to draw in all the air which they possibly can inhale… the neck swells with the inflation of the breath, the precordia (chest wall) retracted, the pulse becomes small and dense,” and if the symptoms persist, the patient “may produce suffocation after the form of epilepsy.”

Tobacco leaves were exported to Europe for experimentation in treating the symptoms of spring time coughing and sneezing. Jeep 2499/Shutterstock.com

By the time Columbus landed, indigenous populations in Central and South American were utilizing ipecacuanha, a root found in Brazil with expectorant and emetic properties and balsam, which is still used in some cold remedies today. Coca and tobacco leaves, used medicinally by the Incas, were later exported to Europe for additional experimentation for the treatment of rhinitis and asthma.

Aside from the “plant fever” described in China, the first written description of seasonal respiratory symptoms is credited to Rhazes, a Persian scholar, around 900 A.D. He described the nasal congestion that coincided with the blooming of roses, termed “rose fever.”

Symptoms noticed, but no cause identified

As scientific advancement was stifled during the Middle Ages, in large part due to the plague, it wasn’t until 900 years later, in 1819, that Dr. John Bostock published a description of his own seasonal allergies. But he didn’t know what was causing them.

Having suffered from “summer catarrh” since childhood, Bostock persisted in his study of the condition, despite an initial lackluster response from the medical community.

In the nine years between his first and second publications, he found only 28 additional cases consistent with his own seasonal allergy symptoms, which perhaps demonstrates the lower prevalence of the condition at the time. He noted that nobility and the privileged classes were more often afflicted by seasonal allergies. This was thought to be the consequence of wealth, culture and an indoor life.

Societal changes with their roots in the Industrial Revolution, including increased exposure to air pollution, less time spent outdoors, increased pollen counts and improved hygiene, all likely contributed to the increased prevalence of allergies that we continue to see today. They also helped form the hygiene hypothesis, which states that in part decreased exposure to particular bacteria and infections could be leading to the increase in allergic and autoimmune diseases.

The source of seasonal symptoms at the time was also thought to be caused by the smell of new hay. This led to the coining of the term “hay fever.”

Bostock instead suspected the recurring symptoms were triggered by the summer heat, since his symptoms improved when he spent the summer on the coast. It would later became common for nobility and aristocrats to spend allergy season in coastal or mountain resorts to avoid bothersome symptoms.

Identifying the true culprit

Through methodical study and self-experimentation, Dr. Charles Blackley identified that pollen was to blame for allergy symptoms. He collected, identified, and described various pollens and then determined their allergic properties by rubbing them into his eyes or scratching them on his skin. He then noted which ones resulted in redness and itching. This same technique is used in skin prick testing by allergists today.

Inspired by discoveries related to vaccination, Dr. Leonard Noon and John Freeman prepared doses of pollen extracts for injection in an effort to desensitize patients with allergic rhinitis in the early 1900s. This effective treatment, called allergy immunotherapy, also known as allergy shots, is still used today.

Antihistamines first became available in the 1940s, but they caused significant sedation. The formulations with fewer side effects that are used today have only been available since the 1980s.

Pollen counts likely to grow

Pollen on a street in Atlanta, March 31, 2019. Lynne Anderson, CC BY-SA

Though recognized by ancient civilizations, seasonal allergic rhinitis and allergic asthma have only increased in prevalence in recent history and are on the rise, now affecting 10 to 30 percent of the world’s population.

Fueled by warmer temperatures and increased carbon dioxide levels, pollen seasons are longer, and pollen counts are higher. Many experts believe this will worsen in the coming years due in large part to climate change.

To keep you and your loved ones safe from pollen, close windows and change out of clothes exposed to pollen as soon as you come indoors. Monkey Business Images/Shutterstock.com

What can you do? Often, those who are allergic need a multifaceted approach.
- Find out what allergens are causing your symptoms. Take note of when your symptoms start by making a note in a calendar or planner.
- Minimize exposure to allergens. Track pollen counts. When pollen counts are high, keep the windows closed at home and in the car. After spending time outdoors, shower and change clothing to prevent ongoing exposure to pollen.
- Take a pro-active approach to treating symptoms. Starting medications before symptoms develop can prevent symptoms from getting out of control. This can also decrease the amount of medication needed overall. Long acting non-sedating antihistamines are helpful for itching and sneezing. Nasal corticosteroid sprays are more helpful for stuffy noses.
- Consider a visit to see a board certified allergist/immunologist. She or he can help you determine which particular pollens maybe the source of your symptoms.
- Explore the role of immunotherapy with your doctor. Immunotherapy changes the immune response through administration of small regimented doses of allergens over time. This induces a state of tolerance, eventually helping people become less allergic over time.
While pollen season is coming, taking a multifaceted approach can provide much needed relief from the symptoms that have plagued humankind throughout the millennia.

This article originally appeared on The Conversation. You can read it here.
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Photo credit: Canva – 3D printing can help dental patients.

Care, Health

22-year-old gives out toothy smiles by providing free 3D-printed dentures to those in need

He could make dentures within a day.

Erik Barnes

6/25/2026

Much like anything else, the cost of dental care has risen as need grows. A report from the American Dental Association found that, in 2024, dental spending grew by $7 billion from 2023. A young engineer is making a difference, though. He has helped put a smile back on the faces of folks in need by providing free dentures made with 3D printers.

Connor Gibson isn’t a dentist or even an expert on 3D printers. He’s a Tennessee community college student who wants to help people. While studying engineering at Walters State Community College, Gibson volunteered with Remote Area Medical (RAM). RAM is a nonprofit that provides mobile clinics offering free medical, vision, and dental care through volunteers.

An issue that bites

A common issue the clinics found was that many people needed dentures. The cost of dentures can be very pricey, ranging from $452 dollars to over $6,500 depending on the patient’s needs and their insurance coverage. Another issue was availability. Even if a patient could afford dentures, it could take weeks or even months before they could be delivered.

But Gibson had an idea. He thought that if he could 3D print pairs of dentures, it would save money and time. After all, having a 3D printer on-site would allow the dentures to be made within hours rather than weeks. A patient could get a free set of dentures the same day as their visit.

Great idea…but how?

There was a setback: Gibson had no experience in dentistry or 3D printing at all. In spite of his inexperience, Gibson used his engineering and design skills to teach himself how to use a 3D printer. He also got dental experts to teach him how to make dentures the old fashioned way. This way, he was sure to accurately recreate every detail via 3D printing. After taking an impression, Gibson was then able to design specific dentures per patient.

“Honestly, if you told me three years ago this is what I would be doing, I would have called you crazy,” Gibson said to CNN. “I made it my mission and studied up like I was doing a test, studying up on videos and documents — anything I could find on how to make a denture using this specific software and how to 3D print it.”

After Gibson successfully completed a pair of 3D-printed dentures for the first time, he knew it was something special. Seeing the tears of joy on the patient’s face was enough to confirm he was doing the right thing.

“That first delivery was really a huge eureka moment,” Gibson said. “To see that raw, human emotion and just know that I played a change in this person’s life… it’s very humbling, and I’m beyond blessed.”

Gibson has since been helping RAM develop more denture mobile clinics that can quickly develop dentures for patients who drop in.

How to find low-cost dental care near you

If you or someone you know needs low-cost to free dental care, there are options. In addition to Medicare, Medicaid, and CHIP, you can find local and state programs online. You can also dial 2-1-1 for information.

Another option dental schools and dental hygiene schools that provide supervised, low-cost care from their students.

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