Estimating the Real Impact of the COVID-19 Pandemic in Kazakhstan: Factors Associated with Detection of the "True Infections".

The COVID-19 pandemic is ongoing worldwide, and various case and death numbers are being reported to track its spread. However, the number of actual cases is uncertain due to under-reporting. Using mortality data as a more reliable indicator, this study in Kazakhstan evaluated the extent of under-reporting and under-detection of COVID-19 cases from March 2020 to September 2022 using back-casting and capture-recapture methods. The results indicate that official case reporting in Kazakhstan significantly underestimates the number of infections by at least 50%. The study also suggests that improved testing capabilities may have led to a decrease in the percentage of unreported cases, however, early in the pandemic, Kazakhstan faced significant testing shortages. The study presents a mathematical model based on mortality data that highlights the severe under-reporting of COVID-19 cases in Kazakhstan and argues that understanding the true estimate of actual cases could aid in making informed decisions to end the pandemic.