The document summarizes several recent studies that found:
1) Transmission of COVID-19 can occur from asymptomatic individuals, suggesting case detection and isolation may require different strategies than for SARS.
2) Viral loads in asymptomatic COVID-19 patients were similar to levels in those with symptoms, indicating asymptomatic carriers could transmit the virus.
3) Asymptomatic cases were found in a family cluster of COVID-19 patients in China, requiring more detailed study of symptom progression and testing results.
4) The mechanism of transmission from asymptomatic carriers requires further study.
The document summarizes several recent studies that found:
1) Transmission of COVID-19 can occur from asymptomatic individuals, suggesting case detection and isolation may require different strategies than for SARS.
2) Viral loads in asymptomatic COVID-19 patients were similar to levels in those with symptoms, indicating asymptomatic carriers could transmit the virus.
3) Asymptomatic cases were found in a family cluster of COVID-19 patients in China, requiring more detailed study of symptom progression and testing results.
4) The mechanism of transmission from asymptomatic carriers requires further study.
The document summarizes several recent studies that found:
1) Transmission of COVID-19 can occur from asymptomatic individuals, suggesting case detection and isolation may require different strategies than for SARS.
2) Viral loads in asymptomatic COVID-19 patients were similar to levels in those with symptoms, indicating asymptomatic carriers could transmit the virus.
3) Asymptomatic cases were found in a family cluster of COVID-19 patients in China, requiring more detailed study of symptom progression and testing results.
4) The mechanism of transmission from asymptomatic carriers requires further study.
The document summarizes several recent studies that found:
1) Transmission of COVID-19 can occur from asymptomatic individuals, suggesting case detection and isolation may require different strategies than for SARS.
2) Viral loads in asymptomatic COVID-19 patients were similar to levels in those with symptoms, indicating asymptomatic carriers could transmit the virus.
3) Asymptomatic cases were found in a family cluster of COVID-19 patients in China, requiring more detailed study of symptom progression and testing results.
4) The mechanism of transmission from asymptomatic carriers requires further study.
•Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from
an Asymptomatic Contact in Germany. The New England journal of medicine. 2020;382(10):970-971. •Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. The New England journal of medicine. 2020;382(12):1177-1179. •Pan X, Chen D, Xia Y, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. The Lancet Infectious diseases. 2020. •Bai Y, Yao L, Wei T, et al. Presumed Asymptomatic Carrier Transmission of COVID- 19. Jama. 2020. •Kimball A HK, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020. MMWR Morbidity and mortality weekly report. 2020; ePub: 27 March 2020. •Wei WE LZ, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020. MMWR Morbidity and mortality weekly report. 2020;ePub: 1 April 2020. •Li R, Pei S, Chen B, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science (New York, NY). 2020.
(1) Transmission of 2019-nCoV Infection from an Asymptomatic Contact in
Germany Rothke https://www.nejm.org/doi/full/10.1056/NEJMc2001468 Despite these concerns, all four patients who were seen in Munich have had mild cases and were hospitalized primarily for public health purposes. Since hospital capacities are limited — in particular, given the concurrent peak of the influenza season in the northern hemisphere — research is needed to determine whether such patients can be treated with appropriate guidance and oversight outside the hospital. (2) SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients Lirong Zou https://www.nejm.org/doi/10.1056/NEJMc2001737 These findings are in concordance with reports that transmission may occur early in the course of infection5 and suggest that case detection and isolation may require strategies different from those required for the control of SARS-CoV. How SARS-CoV-2 viral load correlates with culturable virus needs to be determined.
(3) Asymptomatic Cases in a Family Cluster
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30114- 6/fulltext Pan X, Chen D. In the case of this family, since the time between presentation and identification of SARS-CoV-2 infection was short, more studies are needed to observe the symptoms and test results of infected individuals in greater detail.
(4) https://jamanetwork.com/journals/jama/fullarticle/2762028 Presumed Asymptomatic Carrier Transmission of COVID-19 (Yan Bai, et al)
The mechanism by which asymptomatic carriers could acquire and transmit the coronavirus that causes COVID-19 requires further study.
(5) Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
CONCLUSIONS In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19. (6) Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020 Wei
https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm presymptomatic or asymptomatic transmission modes have not been definitively documented for COVID-19
Substantial undocumented infection facilitates the rapid dissemination of novel
coronavirus (SARS-CoV-2 reporting inaccuracies and changing care-seeking behavior add another level of uncertainty to our estimations. Although the data and findings presented here indicate that travel restrictions and control measures have reduced SARS-CoV-2 transmission considerably, whether these controls are sufficient for reducing Re below 1 for the length of time needed to eliminate the disease locally and prevent a rebound outbreak once control measures are relaxed is unclear.
"Competing interests:J.S. and Columbia University disclose partial
ownership of SK Analytics. J.S. also reports receiving consulting fees from Merck and BNI. " NO EVIDENCE FOR SOCIAL DISTANCING https://www.cebm.net/covid-19/what-is-the-evidence-for-social-distancing-during-global-pandemics/
Although limited, the best available evidence appears to support social distancing measures as a means of reducing transmission and delaying spread. Staggered and cumulative implementation of these interventions may prove most effective. The timing and duration of such measures is critical.
EMERGING EVIDENCE IN COVID-19
Given its novelty, information on the effects of social distancing during the current COVID-19 pandemic is limited but emerging.
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