Confirmed cases come from people who have been tested by PCR.
Due to the lack of tests and costs, most people with COVID-19 will never be tested.
As a result, we may actually have many more people with COVID-19 than is shown in the health department statistics.
This ambiguity overwhelms all others and will not be fixed by simply increasing the availability of tests.
Instead, we just ask people directly without depending on testing.
Epidemiology is the science of estimating actual cases from some other data.
Historically, cases were counted using clinical symptoms and signs.
With the advent of genetic testing,
we have focused on confirmed cases and abandoned the traditional measures of doctors' judgements.
But with the lack of widespread genetic testing,
we should not use confirmed cases as the only method of tracking the spread of disease.
Alternatively, we can return to the historical ways of epidemiology and count clinical cases.