Coronavirus Chronicles — What Does Asymptomatic Mean?

As we have discussed, presymptomatic is a descriptor used in retrospect, for a subject who tested positive a while back, but showed signs of illness only after some time had elapsed.

In a nutshell, asymptomatic means the person tested positive for coronavirus more than two weeks ago, but shows no signs of sickness, and may never exhibit any. To be asymptomatic is to have what is called a “subclinical infection,” which typically means not having symptoms observable or detectable through physical examination or laboratory testing.

But in the case of this disease, the old definition is not accurate, because although nothing might be apparent to the naked eye, the person could test positive — if they can even get tested, and if the supplies and equipment and technicians are all in good working order.

In early April, the World Health Organization reported that there had been “no recorded case of asymptomatic transmission anywhere in the world,” an assessment that has since been seriously challenged. Another bit of news about these asymptomatic patients is, for some reason they seem able to shed virus way out of proportion to what might be reasonably expected.

A vast ignorance

It’s been half a year, and nobody really has a lock on how coronavirus spreads. It is estimated that close to half of the people who have it might be asymptomatic. Those are the family members and friends we know and love; the neighbors we don’t want to offend by masking and distancing; the healthy-looking people who shop at the health-food store.

But that is one of the most terrible aspects of this pandemic. We can’t believe the evidence of our own experience. We want, for instance, to gather with the people we have known and trusted and shared the glory of song with for years. But the legendary contagion-affirming events have included devotional group singing.

There was the now-famous March choir practice in Washington state, where everybody seemed okay, but 87% of the attendees got sick. There was the Fort Benning, Georgia, incident, where 142 asymptomatic, negative-testing soldiers started basic training, and then all 142 of them inexplicably turned up testing positive.

In Nashville, Tennesee, comedian D.L. Hughley collapsed onstage during a show. After being treated for exhaustion and dehydration, he told the world, “I also tested positive for COVID-19, which blew me away. I was what they call asymptomatic.” He cancelled further gigs and went into 14-day quarantine, a costly and disruptive proposition for a traveling performer.

A college football team, the LSU Tigers, started holding practices and then 30 of the 115 players had to be quarantined. Reportedly, none of them had anything worse than mild symptoms, and some had none, and nobody was hospitalized. The athletes shared their fate with patrons of the nightclubs in an area near campus known as “Tigerland.” Across the country, several other colleges have reported having athletes and athletic staff members test positive.

The big irony is that a lot of people who worry about catching COVID-19 have already had it. Now, the Centers for Disease Control suspects that the true number of cases could be 10 times as high as any researchers have yet been able to prove. It is possible that as many as 23 million Americans are carrying around coronavirus, and the very great majority are clueless.

CDC Director Robert Redfield told the press,

Researchers examining blood samples from across the country looking for antibodies lead to the health agency’s estimate. Scientists found that for each confirmed coronavirus case, there were 10 more people with antibodies…

This virus causes so much asymptomatic infection. The traditional approach of looking for symptomatic illness and diagnosing it obviously underestimates the total amount of infections.

It becomes increasingly clear that a large percentage of infected humans do not feel bad or show any signs, and knowing that people are asymptomatic is a lot easier than determining that they are not sick.

Another recent development is the phenomenon of “recrudescence.” In a supposedly recovered patient, the virus apparently can conceal itself in the body, undetectable by testing, and then hit that same person again.

Your responses and feedback are welcome!

Source: “High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice,” CDC.gov, 05/15/20
Source: “8 days after quarantine and testing negative, 142 Fort Benning soldiers test positive for COVID-19,” ConnectingVets.radio.com, 06/01/20
Source: “Comedian DL Hughley COVID-19 positive after fainting onstage,” SFGate.com, 06/21/20
Source: “LSU dealing with coronavirus outbreak to at least a quarter of its roster,” SFGate.com, 06/20/20
Source: “CDC estimates coronavirus cases 10 times higher than what’s being reported,” WSBTV.com, 06/25/20
Image by Jernej Furman/CC BY 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources