If 48 of 5000 (i.e., 1%) random asymptotic people tested positive in Iceland -- a relatively geographically isolated place -- you can bet that at least 1% Americans are infected, and I think we can almost guarantee the percentage is higher.
In any case, even if we go with 1%, then we have about 3.3 million cases in the US, of which we have only detected an incredibly small fraction. If 1% of CA is infected, they have 395,000 cases.
With more testing, of course we'll identify more of those people.
I also think the reported deaths through about last week are vastly underestimated due to the dearth of testing, even of those hospitalized. People hospitalized with COVID-19-like symptoms in states with incredibly limited access to testing (a vast majority of them) have been treated as if they were positive without testing. If they died, they didn't count as a COVID-19 death because the diagnosis wasn't confirmed. In some cases, diagnosis is confirmed later and "old" cases get reported as "new."
We must watch the numbers, but understand how, in the absence of widespread testing, you can't take the reports at face value.
While the number of cases is vastly underestimated, there are cases where reported deaths on a given day are inflated. For example, "new deaths" skyrocketing in NY. As they confirm previous deaths as being COVID-19-related they are counted as "new." This is an increase in the COUNT in the previous 24 hours -- not necessarily a statement that xxx number of COVID-19 positive patients died in the last 24 hours.
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On edit:
If you have any doubt about how fouled up CA's testing, tracking, and reporting is, this quote from an article in The Guardian should provide some insight:
California’s patchwork response to testing has also left it struggling to keep pace with the virus, and the state is now looking to establish a coordinated approach. At least 22 state laboratories, seven hospitals and two private outfits are conducting tests in California, but it remains hazy how testing at those sites is being tracked.
“We are cobbling together various approaches,” Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California’s Keck School of Medicine, told the LA Times. “The whole thing is badly discombobulated ... I think 100% that the system is broken.”
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