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Asymptomatic infection

COVID-19: What proportion are asymptomatic? https://blogs.bmj.com/bmj/2020/05/04/... Between 5% and 80% of people testing positive for SARS-CoV-2 may be asymptomatic Symptom-based screening will miss cases, perhaps a lot of them Some asymptomatic cases will become symptomatic over the next week (i.e. pre-symptomatic) Children and young adults can be asymptomatic There is not a single reliable study to determine the number of asymptotics Population based antibody testing required Diamond Princess https://www.ncbi.nlm.nih.gov/research... 3,711 people tested 634 tested positive 18% Vo’Euganeo, (50Km west of Venice) https://www.bmj.com/content/368/bmj.m... All 3,000 people in village tested 50 – 75% asymptomatic Asymptomatics infectious represented ‘a formidable source’ of contagion 328 adults in Shanghai https://www.clinicalmicrobiologyandin... 328 adults were diagnosed with COVID-19 in Shanghai Among them, 13 patients were asymptomatic at time of diagnosis No subjective symptoms 2 weeks before admission All of the 13 (4%) them were close contacts of the confirmed cases Japanese nationals evacuated from Wuhan https://www.ijidonline.com/article/S1... 565 citizens had been evacuated 30.8% (7.7– 53.8%). 30 days after evacuation Asymptomatic and Pre-symptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington https://www.ncbi.nlm.nih.gov/research... CDC 76 residents categorized as asymptomatic or symptomatic at the time of testing and for previous 14 days 23 (30%) residents, antigen positive and symptomatic 13 (57%) were asymptomatic 10 of these 13 previously asymptomatic residents developed symptoms within 7 days Therefore 3 (4%) out of 76 truly asymptomatic RT-PCR) values indicated large quantities of viral RNA in asymptomatic, pre-symptomatic, and symptomatic residents Symptom based screening on a particular day could fail to detect half of positive cases Iceland https://www.nejm.org/doi/full/10.1056... Population screening, 57% symptomatic, 43% asymptomatic CDC, Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) https://www.cdc.gov/coronavirus/2019-... 13% of positive children asymptomatic Risk of transmission is thought to be greatest when patients are symptomatic since viral shedding is greatest at the time of symptom onset and declines over the course of several days to weeks. WHO 81% of infections show mild symptoms 14% exhibit severe symptoms 5% fall critically ill Asymptomatic coronavirus infection: MERS-CoV and SARS-CoV-2 (COVID-19) https://www.sciencedirect.com/science... The extent of asymptomatic MERS-CoV (2012) cases is about 9.8% How much is covid-19 spreading via asymptomatic versus symptomatic infections? (4th May) https://www.cebm.net/covid-19/covid-1... Mathematical models SEIIR Susceptible Exposed Infected, symptomatic Infected, asymptomatic Recovered Therefore, need widespread antibody testing and contact tracing as soon as possible.