Dr. Michael Osterholm directs the Center for Infectious Diseases Research and Policy at the University of Minnesota. About a month ago, in an interview he said that COVID-19 is very complicated, and “The more we learn about it, the more we realize how little we know about it.” He emphasizes the crucial importance of quickly identifying individuals who have it, so they can be isolated.
But people pass this thing on to others before they even know they have it themselves, and sometimes they never know, because they never feel sick. Journalist Sara Chodosh wrote,
Some early models suggested up to 55 percent of the disease’s spread could be due to these hidden carriers, which make up an unusually high number of the virus’s total cases. A large testing mission in San Francisco found that around 50 percent of people with COVID-19 had no symptoms.
The Centers for Disease Control posited that 40% of transmission occurs before transmitter even feels bad. We were starting to hope we had a handle on the basic principles of contagion logistics. Then, a flareup of crossed signals emanated from the World Health Organization, which held that such transmission is rare, a statement that was then extensively unpacked, walked back, spun, and several other past-tense verbs based in public relations terminology.
One of the statements seemed to assert that the definition of “symptom” had been narrowed down to “droplets.” But some people shed virus like crazy, and never even spike a temperature. It was all very confusing.
A group of authors from the publishing platform Medium put together an explainer from which these sentences are excerpted:
It’s important to note that asymptomatic people who never exhibit signs of Covid-19 are different from pre-symptomatic people who initially don’t have symptoms but develop them later. It’s difficult, from a research standpoint, to tease these two groups apart.
The real conundrum is pre-symptomatic transmission… People appear to have the highest number of viral particles in their body, called the viral load, at the beginning of an infection right before they develop symptoms. Experts think people are most infectious when their viral load is highest…
This means a cough isn’t required to expel SARS-CoV-2 viral particles — just breathing or speaking could be enough, particularly when someone is shouting, singing, or breathing heavily from exercise.
Driving the point home, the authors emphasize again that there is “no simple way to distinguish between asymptomatic people and pre-symptomatic people when they are out in the world…” Pre-symptomatic people might be at large for as long as two weeks without anyone having a clue. Many businesses and institutions depend on hand-held thermometer guns, and perhaps they should not.
Some critics deprecate all this pursuit of what seems to some more of an etymological debate. But petty as it might appear, all this is of monumental importance. Words definitely need to be quibbled over. Everybody needs to know what everybody else is talking about. Before we send kids back to school we need to know what’s what, in no uncertain terms. We all need to be, as the saying goes, on the same page.
Which brings us back to the extremely uncomfortable reality revealed by Dr. Osterholm: “The more we learn about it, the more we realize how little we know about it.”
Your responses and feedback are welcome!
Source: “Transcript: Dr. Michael Osterholm speaks with Michael Morell on ‘Intelligence Matters’,” CBSNews.com, 05/13/20
Source: “The truth about asymptomatic COVID-19,” PopSci.com, 06/09/20
Source: “Coronavirus spread by asymptomatic people ‘appears to be rare,’ WHO official says,” CNN.com, 06/09/20
Source: “What the WHO Really Meant Regarding Asymptomatic Spread,” Medium.com, 06/09/20
Image by muffinn/CC BY 2.0