Fewer than half of American states are following federal recommendations to report “probable” coronavirus cases and deaths, where symptoms point to likely coronavirus infection but no test has been carried out. The news will spark fears that the impact of Covid-19 is being significantly under-reported. The Washington Post says that among states not disclosing “probable” cases and deaths are some of the most populous: California, Florida, North Carolina and New York. Disparities in counting are leading government officials and public health experts to suspect the virus’s true toll is above the official U.S. tally as of Sunday of about 1.9 million coronavirus cases and 109,000 deaths. Guidelines on reporting issued by the U.S. Centers for Disease Control and Prevention are voluntary, and since April the CDC has advised states to count both probable cases and deaths along with those confirmed by tests. However the Post says many states are not heeding the national guidelines on reporting probable cases and deaths.