Yes, half of COVID-19 carriers show no symptoms (DIY asymptomatic carrier)

Study: Yes, half of coronavirus carriers have no symptoms

INTRO: What we’re learning from Iceland this week is as fascinating as it is crucial to fighting the coronavirus epidemic: That somewhere in the neighborhood of half of everyone testing positive for the coronavirus will show absolutely no symptoms.

The hard data, out of Iceland, straight from their (impressive) health ministry’s dedicated COVID-19 page:

– As of March 25, Iceland has administered 12,615 tests.
– Of those tests, Iceland has found 802 confirmed cases.
– While it might not sound like a lot, in a sparsely-populated nation of around 364,000 citizens, it’s an impressive number. They’ve nearly tested 3.4 percent of the entire country (compared to the United States, and according to the COVID-19 Project data tracker: we’ve tested 432,655 of our 327 million citizens, or just a tenth of one percent of our country’s population). Iceland currently claims to have tested more citizens per capita] than any other country in the world.

Needless to say, Iceland’s efforts are revealing fascinating and potentially lifesaving details about the virus. And via BuzzFeed News, it’s how they came to the striking conclusion about symptom rates, emphasis ours:

“Early results from deCode Genetics indicate that a low proportion of the general population has contracted the virus and that about half of those who tested positive are non-symptomatic,” said [Iceland’s chief epidemiologist Thorolfur] Guðnason. “The other half displays very moderate cold-like symptoms.”

Consider: Right now, in America, if you don’t have a fever, or aches, or any other cold or flu-like symptoms, nobody would tell you not to go to the store. Nobody would tell you not to leave your apartment. Unless you had been in contact with someone who tested positive, showed symptoms, or to an epicenter of the outbreak, nobody would advise you to self-quarantine. Because nobody would be advising you to quarantine, you could still be spreading the virus to other people — and of course, in any of those places, other people who should be quarantined could be spreading the virus to you.

This is the value of widespread testing. If we knew you had it, we would tell you: Isolate yourself, stay inside... (MORE)

Some COVID-19 patients still have coronavirus after symptoms disappear

RELEASE: In a new study, researchers found that half of the patients they treated for mild COVID-19 infection still had coronavirus for up to eight days after symptoms disappeared. The research letter was published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

In "Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus Infection," Lixin Xie, MD, Lokesh Sharma, PhD, and co-authors report on a study of 16 patients with COVID-19, who were treated and released from the Treatment Center of PLA General Hospital in Beijing between January 28 and Feb. 9, 2020. Patients studied had a median age of 35.5 years.

Researchers collected samples from throat swabs taken from all patients on alternate days and analyzed. Patients were discharged after their recovery and confirmation of negative viral status by at least two consecutive polymerase chain reaction (PCR) tests.

"The most significant finding from our study is that half of the patients kept shedding the virus even after resolution of their symptoms," said co-lead author Dr. Sharma, instructor of medicine, Section of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, Yale School of Medicine. "More severe infections may have even longer shedding times."

The primary symptoms in these patients included fever, cough, pain in the pharynx (pharyngalgia) and difficult or labored breathing (dyspnea). Patients were treated with a range of medications.

The time from infection to onset of symptoms (incubation period) was five days among all but one patient. The average duration of symptoms was eight days, while the length of time patients remained contagious after the end of their symptoms ranged from one to eight days. Two patients had diabetes and one had tuberculosis, neither of which affected the timing of the course of COVID-19 infection.

"If you had mild respiratory symptoms from COVID-19 and were staying at home so as not to infect people, extend your quarantine for another two weeks after recovery to ensure that you don't infect other people," recommended corresponding author Lixin Xie, MD, professor, College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing.

The authors had a special message for the medical community: "COVID-19 patients can be infectious even after their symptomatic recovery, so treat the asymptomatic/recently recovered patients as carefully as symptomatic patients."

The researchers emphasized that all of these patients had milder infections and recovered from the disease, and that the study looked at a small number of patients. They noted that it is unclear whether similar results would hold true for more vulnerable patients such as the elderly, those with suppressed immune systems and patients on immunosuppressive therapies.

"Further studies are needed to investigate if the real-time PCR-detected virus is capable of transmission in the later stages of COVID-19 infection," Dr. Xie added.

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