Evaluating undercounts in epidemics: response to Maruotti et al. 2022

Abstract

Maruotti et al. 2022 used a mark-recapture approach to estimate bounds on the true number of monkeypox infections in various countries. These approaches are fundamentally flawed; it is impossible to estimate undercounting based solely on a single stream of reported cases. Simulations based on a Richards curve for cumulative incidence show that, for reasonable epidemic parameters, the proposed methods estimate bounds on the ascertainment ratio of $\approx 0.2-0.5$ roughly independently of the true ascertainment ratio. These methods should not be used.