33% Asymptomatic

[mu_hilltopper]

https://www.axios.com/china-coronavirus-cases-asymptomatic-378654f1-82b9-404c-80d7-bb84e326ad27.html

data suggests that one-third of coronavirus cases in the country were asymptomatic "silent carriers,"

33% is a big big number.    Even 10% has major ramifications.


Any doctors out there explain .. Does the asymptomatic body even fight the virus?  Could an asymptomatic patient spew the virus for months or years?

(Long story short, my wife got strep throat 6x in 5 months.  Turns out my sons were asymptomatic strep carriers.  Once we put the kids through antibiotics, my wife never got it again.    If that applies to COVID, we're screwed.)

[jficke13]

https://www.axios.com/china-coronavirus-cases-asymptomatic-378654f1-82b9-404c-80d7-bb84e326ad27.html

data suggests that one-third of coronavirus cases in the country were asymptomatic "silent carriers,"

33% is a big big number.    Even 10% has major ramifications.


Any doctors out there explain .. Does the asymptomatic body even fight the virus?  Could an asymptomatic patient spew the virus for months or years?

(Long story short, my wife got strep throat 6x in 5 months.  Turns out my sons were asymptomatic strep carriers.  Once we put the kids through antibiotics, my wife never got it again.    If that applies to COVID, we're screwed.)

Not a doctor, but I'd be sort of encouraged by a 1/3 asymptomatic rate. Yes, it makes containment an issue, but everyone with a brain is self-isolating as much as is feasible at this point already. My gut reaction is that 33% of the population being asymptomatic means that there's a good number of people developing immunity and bolstering the populace that we need to establish herd immunity without straining the healthcare system.

[jesmu84]

https://www.axios.com/china-coronavirus-cases-asymptomatic-378654f1-82b9-404c-80d7-bb84e326ad27.html

data suggests that one-third of coronavirus cases in the country were asymptomatic "silent carriers,"

33% is a big big number.    Even 10% has major ramifications.


Any doctors out there explain .. Does the asymptomatic body even fight the virus?  Could an asymptomatic patient spew the virus for months or years?

(Long story short, my wife got strep throat 6x in 5 months.  Turns out my sons were asymptomatic strep carriers.  Once we put the kids through antibiotics, my wife never got it again.    If that applies to COVID, we're screwed.)

Strep is bacteria though. So, you don't develop immunity to it, whether you're an asymptomatic carrier or not. Even the asymptomatic Covid carriers will develop natural immunity and once they are no longer "active" it shouldn't be an issue any more so than a symptomatic carrier.

Just tell yourself asymptomatic and symptomatic are the exact same processes with regards to infection/spread/immunity. Just that one doesn't have symptoms.

[Frenns Liquor Depot]

This is why we need the blood test referenced in the other thread.  At the end of the initial wave we need the ability to ‘clear’ people. 

Wide scale testing of those not clear. 

[forgetful]

https://www.axios.com/china-coronavirus-cases-asymptomatic-378654f1-82b9-404c-80d7-bb84e326ad27.html

data suggests that one-third of coronavirus cases in the country were asymptomatic "silent carriers,"

33% is a big big number.    Even 10% has major ramifications.


Any doctors out there explain .. Does the asymptomatic body even fight the virus?  Could an asymptomatic patient spew the virus for months or years?

(Long story short, my wife got strep throat 6x in 5 months.  Turns out my sons were asymptomatic strep carriers.  Once we put the kids through antibiotics, my wife never got it again.    If that applies to COVID, we're screwed.)

I think based on what we know about other coronaviruses, that many experts would have assumed an asymptomatic rate of between 10-40%. Which is why you need widespread testing.

The problem is, we can't even test all the people showing up to hospitals, not to mention those that are symptomatic.

[Johnny B]

This means 33 during the entire time they are infected no symptoms?

[Hards Alumni]

This means 33 during the entire time they are infected no symptoms?

Yes, which is why its pretty bad news.

[Coleman]

Yes, which is why its pretty bad news.

It is bad news vis a vis containment (which is already out of the bag), but isn't this good news with regards to death rate? It means that while more may get it, far fewer will die? Right?

[Hards Alumni]

It is bad news vis a vis containment (which is already out of the bag), but isn't this good news with regards to death rate? It means that while more may get it, far fewer will die? Right?

Depends on how you think about it.  If we lock everyone down for two weeks, it is a good thing.  If we continue on with this half and half, or no lockdown its awful.  People who think they're fine go to work, the grocery store, and meet with family members... who may not be asymptomatic.  Who could get sick and die.

The main problem with asymptomatic people is that they spread unknowingly.  And currently, we aren't testing everyone, so those folks are out there infecting people at an alarming rate. 

[WarriorDad]

Depends on how you think about it.  If we lock everyone down for two weeks, it is a good thing.  If we continue on with this half and half, or no lockdown its awful.  People who think they're fine go to work, the grocery store, and meet with family members... who may not be asymptomatic.  Who could get sick and die.

The main problem with asymptomatic people is that they spread unknowingly.  And currently, we aren't testing everyone, so those folks are out there infecting people at an alarming rate.

Dr. Fauci implied in his interview he did not think it a good idea to lock everything down.

[The Hippie Satan of Hyperbole]

He said that he didn't think it was good to go into a national lock down.  His reasoning is that they only really work for about two weeks before people start ignoring it.  And therefore it makes more sense for regional areas to go on lockdown when it is most needed. 

IMO that makes sense....IF....it is also reinforced with longer term efforts to keep crowds from gathering.  Florida and Mississippi keeping their beaches open for instance, was a disaster. 

[BM1090]

Dr. Fauci implied in his interview he did not think it a good idea to lock everything down.

I mean, not really. He said nobody should go outside for "several more weeks" and he's continued to say we need to be more aggressive.

[Frenns Liquor Depot]

I posted this in the other thread, but it probably belongs here.

https://www.washingtonpost.com/world/asia_pacific/china-wuhan-coronavirus-zero-cases/2020/03/25/19bdbbc2-6d15-11ea-a156-0048b62cdb51_story.html


I cant figure out why China doesn't care about asymptomatic cases, unless maybe they don't spread?  Something just doesn't add up with the high number of asymptomatic, china's disregard for it, but their apparent return to manufacturing and seemingly getting control back in Wuhan.

[Hards Alumni]

I posted this in the other thread, but it probably belongs here.

https://www.washingtonpost.com/world/asia_pacific/china-wuhan-coronavirus-zero-cases/2020/03/25/19bdbbc2-6d15-11ea-a156-0048b62cdb51_story.html


I cant figure out why China doesn't care about asymptomatic cases, unless maybe they don't spread?  Something just doesn't add up with the high number of asymptomatic, china's disregard for it, but their apparent return to manufacturing and seemingly getting control back in Wuhan.

Or... China lies.

[Frenns Liquor Depot]

Or... China lies.

They definitely lie.  But they cannot fake what is going on in the manufacturing centers.  So somehow there arent people dropping left and right in a way that wouldnt allow the manufacturing centers to return to normal. 

There is just something that doesnt add up in all of that.

[forgetful]

Or... China lies.

If you look at how aggressive their suppression tactics were, I don't think they are lying. They damn near kept everyone under lock and key, and had digital tracking of where everyone was and who they contacted during very limited excursions.

No one else is taking that aggressive of a stance, not even close.

[rocket surgeon]

The 33% assymptomatic carriers- we should test test test and those who show positivity to the antibodies formed should be encouraged to donate their plasma to cure those who are symptomatic. All the while a vaccine is being worked on

[jesmu84]

The 33% assymptomatic carriers- we should test test test and those who show positivity to the antibodies formed should be encouraged to donate their plasma to cure those who are symptomatic. All the while a vaccine is being worked on

We don't have enough tests.

Can you link to data supporting plasma as a cure?

[rocket surgeon]

We don't have enough tests.

Can you link to data supporting plasma as a cure?

Not yet but I did find this article regarding the increased dialogue/ discussions about faster implementation of this therapy.

My point is, if one is very ill and/ or ill to the point of death, are we really worried about “side effects” or adverse reactions? 


https://www.genengnews.com/news/coronavirus-takeda-pursues-plasma-derived-treatment-alnylam-and-vir-eye-sirna-therapy/

I will continue to look for more data.  There is a lot of anecdotal data that I believe has to be taken seriously.  Especially in the cases I sighted above

[rocket surgeon]

Here is a very real anecdotal story, but real story about hydroxychlorquine

Dude returns from being on a cruise.  5 days later starts to feel ill.  4 days after falling ill, feels the need to see his doctor. When he arrives, his pulse ox # is 92, by the time they get him to ER, his pulse ox is 84.  They immediately put him on hydroxychlorquine.  2 days post hydroxy(present time) he is showing signs of improvement.  It remains  to be seen if it continues to help him, but my guess is he would be dead by now sans the hydroxy  is this the time to NOT use this drug?

[Jockey]

If you look at how aggressive their suppression tactics were, I don't think they are lying. They damn near kept everyone under lock and key, and had digital tracking of where everyone was and who they contacted during very limited excursions.

No one else is taking that aggressive of a stance, not even close.

So they were lying... but now they're not lying?

Russia is also lying about COVID. At what point should we say they are no longer lying?

[Hards Alumni]

Here is a very real anecdotal story, but real story about hydroxychlorquine

Dude returns from being on a cruise.  5 days later starts to feel ill.  4 days after falling ill, feels the need to see his doctor. When he arrives, his pulse ox # is 92, by the time they get him to ER, his pulse ox is 84.  They immediately put him on hydroxychlorquine.  2 days post hydroxy(present time) he is showing signs of improvement.  It remains  to be seen if it continues to help him, but my guess is he would be dead by now sans the hydroxy  is this the time to NOT use this drug?

Let's just say I wouldn't bet my life on that stuff, but if I was out of options, I would take it.

[forgetful]

So they were lying... but now they're not lying?

Russia is also lying about COVID. At what point should we say they are no longer lying?

I think this "they were lying, they are lying" stuff is wrong.

They didn't come public with the severity early, partially because they had no idea what it was like, and didn't want to create unnecessary unrest...I think that is wrong, always err on the side of caution. Right now, by all accounts of people I know in China, they are telling the truth, no new cases.

If they were lying, then we were lying worse. We lied about it "being contained," we refused to test, hiding the number of infected. We are not reporting all the people that have died, where we are not testing those dying from unexplained double pneumonia (China changing their what constitutes a case and a death is what shot their numbers up; we are still hiding our real numbers of dead).

Why did they do this, and why are we. Both the same two reasons, lack of tests initially, and trying not to create widespread panic. They didn't have tests, because no one even knew what this was at that point. We don't have tests, because we epically dropped the ball and failed our nation.

[Jockey]

I think this "they were lying, they are lying" stuff is wrong.

They didn't come public with the severity early, partially because they had no idea what it was like, and didn't want to create unnecessary unrest...I think that is wrong, always err on the side of caution. Right now, by all accounts of people I know in China, they are telling the truth, no new cases.

If they were lying, then we were lying worse. We lied about it "being contained," we refused to test, hiding the number of infected. We are not reporting all the people that have died, where we are not testing those dying from unexplained double pneumonia (China changing their what constitutes a case and a death is what shot their numbers up; we are still hiding our real numbers of dead).

Why did they do this, and why are we. Both the same two reasons, lack of tests initially, and trying not to create widespread panic. They didn't have tests, because no one even knew what this was at that point. We don't have tests, because we epically dropped the ball and failed our nation.

First off, they knew what is was like. That is why they arrested the doctor who tried to publicize the disease.

Second, "we" did not lie about the disease. The administration did. I did not say it was contained, I did not say we would be down to zero patients in a day or two. I did not say there was going to be a miracle. So, no, "we" did not lie.

Third, I don't care "why" our government lied. The results is that more people are dying than if the were truthful. Delaying widespread panic for a few weeks is not an excuse to lie.

[forgetful]

First off, they knew what is was like. That is why they arrested the doctor who tried to publicize the disease.

Second, "we" did not lie about the disease. The administration did. I did not say it was contained, I did not say we would be down to zero patients in a day or two. I did not say there was going to be a miracle. So, no, "we" did not lie.

Third, I don't care "why" our government lied. The results is that more people are dying than if the were truthful. Delaying widespread panic for a few weeks is not an excuse to lie.

At the point that they arrested the doctor, they barely knew anything. They didn't even know there was a new virus yet. No one had any samples. What they did regarding the doctor was terribly wrong, but the reason I'm not going to the "they lied" is I am aware of how hard it would be to verify that there was a new illness, determine what it was, and then find cases. I'm actually quite impressed how quickly the world was able to identify this and have tests on hand.

That honestly gave the world a chance to stop this. China failed to figure out many other aspects. They failed to shut down travel. The rest of the world also failed. We have failed miserably, we covered up cases, we are still covering up cases and deaths.

And I use we, as the colloquial "the United States," not involving you or I. You and I agree on who bares the blame here. But that doesn't change the fact that a lot of people are dying and will die. Each and every one of us, and our loved ones are at risk, regardless of age.

[Jockey]

And I use we, as the colloquial "the United States," not involving you or I. You and I agree on who bares the blame here. But that doesn't change the fact that a lot of people are dying and will die. Each and every one of us, and our loved ones are at risk, regardless of age.

I realized that, Forgetful and the point of my post wasn't to argue with you. I generally agree with the points you have been making.

As a matter of fact, the only thing I can think of off of the top of my head that we disagree on is China. They are a murderous government who will lie when they want to lie. They don't need a reason. We should never overlook that just because we need them as business partners.

I don't want to make inferences or put words in your mouth. I'm sure you have misgivings about China as well. I just think those misgivings need to be stronger.

[forgetful]

I realized that, Forgetful and the point of my post wasn't to argue with you. I generally agree with the points you have been making.

As a matter of fact, the only thing I can think of off of the top of my head that we disagree on is China. They are a murderous government who will lie when they want to lie. They don't need a reason. We should never overlook that just because we need them as business partners.

I don't want to make inferences or put words in your mouth. I'm sure you have misgivings about China as well. I just think those misgivings need to be stronger.

Oh I think China lies about nearly everything. They are a brutal murderous regime.

But knowing a little about this arena, and recognizing how hard it is to figure this out in the beginning, I think what most are calling lying now, is really just failure to know what they were dealing with, and panicking about the situation. I don't think there was really any intent (not that they wouldn't have used intent if they wanted/were able to).

This was a terrible situation. An almost perfect virus to hide and spread. Most nations would have done far worse in identifying this quickly and stamping it out. We had a month long head start on this, and look where we are.

[MU Fan in Connecticut]

So they were lying... but now they're not lying?

Russia is also lying about COVID. At what point should we say they are no longer lying?

My wife and mother-in-law were just telling me about this and said every in Poland knows he's lying and shared some old Polish saying about Russia that roughly translates to "The evil is always there."

[Coleman]

https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html

Testing in Iceland: 50% asymptomatic

[forgetful]

https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html

Testing in Iceland: 50% asymptomatic

With only 1% being positive, I wonder how many of those are false positives. Or positives due to non-infectious trace contaminants. Similar to what was seen in the dog from Hong Kong.

[mu_hilltopper]

Any doctors out there can explain .. if someone is asymptomatic .. do they fight the virus?   

Would they be carriers for the same amount of time, less, or more?

[The Hippie Satan of Hyperbole]

Any doctors out there can explain .. if someone is asymptomatic .. do they fight the virus?   

Would they be carriers for the same amount of time, less, or more?

They are about half as likely to transmit the disease as those who have symptoms.

https://www.bloomberg.com/opinion/articles/2020-03-30/asymptomatic-coronavirus-carriers-how-contagious-are-they

[Frenns Liquor Depot]

Does it concern anyone else that Scoop has been on this since since March 22 with a dedicated thread and much earlier in the massive COVID thread, while apparently this is new news to people running the country?

https://thehill.com/homenews/state-watch/490758-georgia-governor-says-he-didnt-know-asymptomatic-people-could-spread

[Jockey]

Does it concern anyone else that Scoop has been on this since since March 22 with a dedicated thread and much earlier in the massive COVID thread, while apparently this is new news to people running the country?

https://thehill.com/homenews/state-watch/490758-georgia-governor-says-he-didnt-know-asymptomatic-people-could-spread

I would say “willful ignorance, but really he is just a liar.

[jesmu84]

Does it concern anyone else that Scoop has been on this since since March 22 with a dedicated thread and much earlier in the massive COVID thread, while apparently this is new news to people running the country?

https://thehill.com/homenews/state-watch/490758-georgia-governor-says-he-didnt-know-asymptomatic-people-could-spread

If he didn't know someone asymptomatic could spread, that would be understandable. Maybe he's not in medicine or have understanding in that field. But it also means he isn't willing to ask or listen to experts.

[mu_hilltopper]

Who has two thumbs and is qualified to be governor? 

[forgetful]

We seem to know very little about the pathogenesis of this disease. It hits some extremely hard (regardless of age or underlying conditions), and others almost not at all. Doctor's are very confused as to what is driving this disparity. I wonder if it could be moderately simple.

Mode of entry, and viral load.

There is evidence that those whose first symptoms are GI related, have more mild cases, whereas those that have respiratory symptoms first, are more likely to be very ill.

It is likely that those with GI symptoms first are infected via an oral/fecal-ish route (this is what they believed was going on in cruise-ship-patients, where death rates are low). The initial infection and subsequent immune response is then in the GI tract, where before it can spread to the lungs, a moderate immune response has been initiated.

In contrast those infected via inhalation of aerosols (worse) or droplets (still bad) will have initial infections in the lungs. Leading to replication and spread in lung tissue before the immune response begins. Leading to potentially catastrophic damage.

On top of this, how much load is present in the initial infection will impact how much spread there is before the immune response. So mild exposure=mild symptoms, high exposure=severe symptoms (maybe why first responders are hit hard).

If this could be confirmed, could we use a limited micro dose of live virus given orally as a potential vaccine?

[jesmu84]

We seem to know very little about the pathogenesis of this disease. It hits some extremely hard (regardless of age or underlying conditions), and others almost not at all. Doctor's are very confused as to what is driving this disparity. I wonder if it could be moderately simple.

Mode of entry, and viral load.

There is evidence that those whose first symptoms are GI related, have more mild cases, whereas those that have respiratory symptoms first, are more likely to be very ill.

It is likely that those with GI symptoms first are infected via an oral/fecal-ish route (this is what they believed was going on in cruise-ship-patients, where death rates are low). The initial infection and subsequent immune response is then in the GI tract, where before it can spread to the lungs, a moderate immune response has been initiated.

In contrast those infected via inhalation of aerosols (worse) or droplets (still bad) will have initial infections in the lungs. Leading to replication and spread in lung tissue before the immune response begins. Leading to potentially catastrophic damage.

On top of this, how much load is present in the initial infection will impact how much spread there is before the immune response. So mild exposure=mild symptoms, high exposure=severe symptoms (maybe why first responders are hit hard).

If this could be confirmed, could we use a limited micro dose of live virus given orally as a potential vaccine?

Of course this brings up another point:

Screening currently asks about fever, cough, shortness of breath, close contact with a positive patient.

But shouldn't they also be asking about GI dysfunction?

[Frenns Liquor Depot]

If this could be confirmed, could we use a limited micro dose of live virus given orally as a potential vaccine?

Who needs to confirm it, lets just go and see what happens!

[Coleman]

We seem to know very little about the pathogenesis of this disease. It hits some extremely hard (regardless of age or underlying conditions), and others almost not at all. Doctor's are very confused as to what is driving this disparity. I wonder if it could be moderately simple.

Mode of entry, and viral load.

There is evidence that those whose first symptoms are GI related, have more mild cases, whereas those that have respiratory symptoms first, are more likely to be very ill.

It is likely that those with GI symptoms first are infected via an oral/fecal-ish route (this is what they believed was going on in cruise-ship-patients, where death rates are low). The initial infection and subsequent immune response is then in the GI tract, where before it can spread to the lungs, a moderate immune response has been initiated.

In contrast those infected via inhalation of aerosols (worse) or droplets (still bad) will have initial infections in the lungs. Leading to replication and spread in lung tissue before the immune response begins. Leading to potentially catastrophic damage.

On top of this, how much load is present in the initial infection will impact how much spread there is before the immune response. So mild exposure=mild symptoms, high exposure=severe symptoms (maybe why first responders are hit hard).

If this could be confirmed, could we use a limited micro dose of live virus given orally as a potential vaccine?

I think you're right on both counts, especially viral load. This is why otherwise healthy doctors in their 30s are getting really sick and/or dying.

A micro dose of live virus could work but it is fraught with ethical and practical implications. How much is enough to trigger necessary antibodies to prevent further infections? How much is too much, which would trigger potentially severe illness and/or death? We don't know yet. And the answers likely vary from person to person. Purposely infecting someone, even if with good intentions, likely flies in the face of the hippocratic oath to do no harm.

A vaccine is a much better option.

[forgetful]

I think you're right on both counts, especially viral load. This is why otherwise healthy doctors in their 30s are getting really sick and/or dying.

A micro dose of live virus could work but it is fraught with ethical and practical implications. How much is enough to trigger necessary antibodies to prevent further infections? How much is too much, which would trigger potentially severe illness and/or death? We don't know yet. And the answers likely vary from person to person. Purposely infecting someone, even if with good intentions, likely flies in the face of the hippocratic oath to do no harm.

A vaccine is a much better option.

Agree on the vaccine being better, and the ethical issues. That's why this is so complicated. I'm actually going to be putting a host of discussions regarding ethics around COVID-19, in one of my courses right now.

[Hards Alumni]

Interesting discussion, guys.