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About one-third of Oklahomans have been infected with COVID-19, Dr. Jennifer Clark said Wednesday, basing her assessment on the antibody testing data in the state's weekly epidemiology and surveillance report.

Clark said the state's latest epidemiology report showed that 32.6% of people whose blood was tested Jan. 1-7 were positive for the virus' antibodies.

"As a sample of the population, this is a very rough way to measure prevalence of COVID in Oklahoma," Clark said. "This really shows the gap in the 'real' number of cases relative to what is being seen with testing and reporting."

The federal Centers for Disease Control and Prevention says serology — or antibody — testing estimates how many people in a population have had COVID-19. Antibodies typically form at a high enough level to be detected one to three weeks after infection.

Clark provided her weekly COVID-19 data presentation Wednesday during Project ECHO, an OSU Center for Health Sciences program to offer medical education and care management to rural and underserved areas.

"It looks like we've got roughly — based on antibodies — 32% of our population (has antibodies) right now," Clark said.

Perhaps her largest concern, she said, is that viral testing — different from antibody surveillance — has been depressed since mid-December. So the state and local health departments aren't capturing more of the active infections to get people appropriately isolated or quarantined to slow the spread.

The daily case rates and active infections are lower than the actual disease circulation in the state; hence the antibody data are used as an indicator.

The week of Dec. 10, 134,000 tests were performed. Since then, the weekly numbers of tests have been much lower, between 54,200 and 95,200.

"We need to be markedly higher," Clark said.

The state and other public health and medical professionals have acknowledged that case numbers and testing have been depressed by the holidays.

Clark said Oklahoma is on pace this month to outstrip December metrics "by quite a bit." She expects January to be at least close to double December's numbers.

She said epidemiologists aren't sure when the current surge will peak, but some are anticipating it in late January or early February.

"It will be dependent upon how many people get sick, along with those that are immunized," Clark said. "The combination of those things will diminish the population at risk, and transmission will go down.

"But it's unclear when that inflection point is going to occur."

Hospitalization data reporting isn't affected by the holidays and serves as a solid anchor point to evaluate the state's situation.

Oklahoma hit a record for new COVID-19 hospital admissions on four consecutive days, with the seven-day average peaking Tuesday at 199 per day. That's nearly 1,400 new hospitalizations in one seven-day period.

Until 1,856 statewide COVID-19 hospitalizations were reported Tuesday, the number had remained above 1,900 since Dec. 28.

But there is a bright spot, Clark noted: There hasn't been an uptick in influenza yet, which isn't typical by this point in the flu season.

Since Sept. 1, there had been 122 flu hospitalizations and no deaths reported statewide through Tuesday.

COVID-19 in the same time frame: 14,131 hospitalizations and 2,004 deaths.

"Obviously, when you compare (the flu) to COVID-19, it gets a little uncomfortable to look at those numbers, needless to say," Clark said.

She said children are a primary source of flu transmission, which is mitigated by the state's two largest public school systems not holding in-person classes, in addition to public health measures.

The wearing of face masks is likely among the largest reasons for the flu's minimal presence, she added.

"If there's anything that shows that what we're doing is making a difference, it's with flu," Clark said.

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