Multipliers are estimates based on analysis of data for flu-related hospitalizations and at least one other level of disease severity (e.g., deaths, ICU-level hospitalizations, mild/moderate cases). If you have reliable data, it is possible to generate your own multiplier by determining the ratio between the number of flu-related hospitalizations and number of cases for the other disease severity level. Additional information is available here (Methods section). The strength of the default multipliers is that they are calculated based on multiple studies from around the world; however, generating custom multipliers using data specific to your country or region could provide more accurate estimates.