Almost 16 million coronavirus cases have been reported in the United States, but the numbers of actual cases may be much higher. During an FDA panel hearing earlier this week “Dr. Aaron Hall of the division of viral diseases at the U.S. Centers for Disease Control and Prevention said both COVID-19 cases and deaths are still likely underreported.” That’s according to MLive.com.

There could be several factors for the underreporting. A big one is likely asymptomatic carriers who never tested. But then there is a segment of the population who know they have coronavirus but don’t get tested for various reasons. Perhaps a family member tested positive, so they know they have it as well but don’t want to wait in a long line to get tested, or perhaps someone is in denial and doesn’t want to confirm the diagnosis. For others, there are more calculated reasons for avoiding testing.

News & Guts spoke to two people this week who said they know they had COVID-19 but didn’t want to get tested. One was a college student who knew she had the virus based on symptoms like a loss of taste and smell. She said she didn’t report her case because she didn’t want to go home and potentially infect her family. Instead, she quarantined on campus. She told us if she took a COVID test she would have been forced to leave her living quarters and then she would have no place to stay isolated.

Another person we spoke with said he didn’t seek a COVID test when he had the virus because he worries that lingering symptoms may pop up years from now. His concern is that one day those symptoms may be considered pre-existing conditions by insurance companies. Since there is a worry that one-day insurance companies won’t cover pre-existing conditions, he wanted to play it safe and leave his case unreported.

A recent report from Clinical Infectious Diseases found that the actual number of cases may be up to eight times more than the current numbers reflect. Spectrum News 1 wrote about what the government researchers found:

The authors wrote the number of COVID-19 cases is underreported for a number of reasons. 

“Most unreported infections were asymptomatic or mildly ill people who recovered without seeking medical care or testing,” they wrote. “However, even persons with SARS-CoV-2 [also known as COVID-19] infection in medical settings may not be tested or nationally reported as confirmed cases.”

The” limited availability of tests,” and “false negatives” were also cited.

NPR says based on the model cited in the report actual cases “could be approaching 100 million now.” That would mean almost a third of the population has had coronavirus.