The number of coronavirus-related cases and deaths in the Brazilian state of Sao Paulo is likely to be under-reported, a state health official said Thursday.

Some of the cases have likely been registered as severe acute respiratory syndrome (SARS) due to the state’s low Covid-19 testing capacity, said Paulo Menezes, coordinator of the state’s health ministry.

The state of Sao Paulo registered 5,717 new cases and 285 related deaths in the previous 24 hours – bringing the total in Brazil’s most populous state to 129,200 cases and 5,717 deaths.

But the actual death toll is likely higher, Menezes said.

“When we look at the curve, we see a significant increase of hospitalizations by SARS since February. It’s possible that we have SARS cases from Covid-19 that are not diagnosed by lab tests, but this is something that happens all over the world, it’s not just something observed here,” he said.

Menezes added that the state of Sao Paulo – which has a population of more than 45 million and is the epicenter of Brazil’s outbreak – currently performs about 8,000 Covid-19 tests daily. In April, that average was about 1,000 tests per day.

The state government forecasts that it will reach the daily testing capacity of European countries like Spain and Italy within three months.