Seemingly “Healthy” People Might Be Driving New Coronavirus Infections
On Monday afternoon, actor Idris Elba tweeted that he has coronavirus: "This morning I tested positive for Covid 19. I feel ok, I have no symptoms so far but have been isolated since I found out about my possible exposure to the virus. Stay home people and be pragmatic."
The fact that Elba wasn't showing any symptoms should worry people in the U.S., where testing has lagged far behind other countries dealing with the outbreak. Initially hospitals could only test people once they were showing symptoms and if they had recently been to a country with substantial outbreak or been in contact with someone known to have the virus—a condition hard to meet on its own since, again, there was such little testing. As a result, the Centers for Disease Control (CDC) doesn't have anywhere near a full figure for how many Americans are likely infected. An estimated 41,000 Americans have been tested so far, a stark comparison with South Korea, where up 20,000 people are being tested each day. Only 125 out of every million people in the U.S. have been tested, well behind many other countries.
New evidence suggests relying on visible symptoms is more dangerous than previously thought. A study published in the magazine Science on Monday found that some "86 percent of all infections were undocumented" prior to late January. On top of that, "these undocumented infections often experience mild, limited or no symptoms and hence go unrecognized, and, depending on their contagiousness and numbers, can expose a far greater portion of the population to virus than would otherwise occur." Symptoms include fever, dry cough, and shortness of breath, but the research from Science suggests that someone who has already contracted coronavirus can show few symptoms, if any, and still be infectious. By the time someone with COVID-19 begins to show symptoms, there's no telling how many other people they may have infected if they haven't been social distancing.
That's counter to what we've been hearing from some public officials so far. Bruce Aylward, MD, part of the World Health Organization team that visited China's facilities in February, told The New York Times, "There’s this big panic in the West over asymptomatic cases." He added, "There is no evidence that we’re seeing only the tip of a grand iceberg, with nine-tenths of it made up of hidden zombies shedding virus. What we’re seeing is a pyramid: most of it is aboveground." Still, other public-health experts have recommended an abundance of caution. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, “I don’t think there’s any question that someone who is without symptoms and carrying the virus can transmit the virus to somebody else.” And speaking to The Atlantic, Carolyn Cannuscio, the director of research at the Center for Public Health Initiatives at the University of Pennsylvania, said, "The measures that have worked to get transmission under control or at least to bend the curve, in China and South Korea, have been extreme measures to increase social distancing." In other words, merely washing your hands and avoiding people with a cough isn't enough at all.
Unfortunately, with presidential campaigns under way, some candidates are undermining that abundance of caution. Former vice president Joe Biden tweeted on Sunday, "If you are feeling healthy, not showing symptoms, and not at risk of being exposed to COVID-19: please vote on Tuesday."
It's not clear what the "not at risk of being exposed to COVID-19" qualifier means, since there's no known demographic that isn't at risk of contracting the disease. And evidence now suggests that "feeling healthy" and "not showing symptoms" aren't indications that a person doesn't have the disease or isn't infectious. Being asymptomatic is not evidence that someone isn't infected: A study in Annals of Internal Medicine, published a week ago, finds that an individual can go 14 days between infection and showing symptoms, and some carriers may even remain completely asymptomatic. The Annals of Internal Medicine report doesn't address potential spread from asymptomatic infections, but estimates that at least 101 out of every 10,000 cases may develop symptoms even after the CDC's recommended 14-day self-isolation period. So "not showing symptoms" is not enough for us to assume that someone isn't a carrier and can't spread the disease to other people at a polling location.
In Ohio, one of several states scheduled to hold primaries on Tuesday, Republican governor Mike DeWine ordered voting be moved to early June, with an extension in place for absentee and mail-in ballots. (Over the course of less than 24 hours, Ohio's primaries were delayed, reinstated by a judge, then delayed again after a health emergency was announced.) Primaries are continuing as scheduled on Tuesday in Arizona, Illinois, and Florida. In Florida alone, more than 20 percent of the population is 65 years old or over, one of the demographics most at risk from COVID-19.
What is so deadly about the novel coronavirus is that it spreads rapidly without layman detection—until it's too late.
Originally Appeared on GQ
