Medscape asked top experts to consider the most pressing scientific questions about COVID-19. Check back often for more information COVID-19 Data Dive, And Medscape Coronavirus Resource Center For a complete cover.
Dr. William P. Hanage
Good to see World Health Organization returns comment that asymptomatic infections are rare.. Understanding that COVID-19 can now be transmitted by asymptomatic individuals is paramount to public health.
Classic paper A study published in 2004 demonstrated that the amount of pre-onset infection directly determines the ease with which a symptom-monitoring system can control the disease. A disease like the original SARS or EbolaInfection is closely associated with the disease and can be effectively stopped by self-isolation or distance from the symptomatic person.
Compare it with a virus like HIV This can go undetected for years while the patient remains infectious without treatment or testing. By symptom Immunosuppression A virus has occurred and the virus is already infected.
Or influenza.. Although a completely different virus, the challenge in controlling influenza is that an infected individual can become infected without noticing that they are infected.
Work like Preprint From Corey Peak, ScDInfectious disease epidemiologists have shown a link to pandemics. While tracking contacts can be overwhelmed by large-scale outbreaks, “when resources are prioritized for scalable interventions such as social distance… Active surveillance or high-risk contacts. Individual quarantine can contribute synergistically to mitigation efforts.” If there is a large amount of pre-onset infection, isolating high-risk contacts can have great benefits by preventing others from getting infected before they are known to be ill.
There is also the fact that COVID-19 has many different symptoms besides a dry cough and fever. It can be difficult to determine if someone is really asymptomatic rather than “abnormally symptomatic”.
That’s why I think “unknowingly spread” is a better way to tell the public about this issue. Even in the absence of symptoms and complete absence of infection, this is arguably the leading cause of pandemic spread.
This primarily explains why controlling pandemics is so difficult, and why interventions that work regardless of whether a person has symptoms are effective. Please note that more will be sent in the future.
Dr. William P. Hanage Bill Hanage Harvard T. H. Chan is an Associate Professor at the Center for Infectious Diseases Dynamics at the Department of Epidemiology in the School of Public Health. He specializes in the evolution of pathogens. Follow him twitter..
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