26 ms·

Coronavirus clue? Most cases aboard U.S. aircraft carrier are symptom-free

373 points by mancerayder 7y ago

GANG718 7y ago
This is because they're testing the entire population as opposed to simply those who end up hospitalized and those around them. We need population testing to get an actual idea of how many people in an area have it. There's likely way more cases nationwide than being reported. In NYC, most asymptomatic/low symptom cases of coronavirus aren't going to be tested until antibody testing later on.
- JoeAltmaier 7y ago
  Yes. Many institutions test only if preparing to admit. Anybody else is told to go home and recover in isolation.
  - glofish 7y ago
    if the US has 33K deaths and the death rate is 0.6% then the US must have at least 5 million cases. If the death rate is lower (most likely around 0.3%) then it means 10 million infections. Also a good news actually.
    - cm2187 7y ago
      Agree, though still a long way from herd immunity, which I understand starts at 50%-ish.
      - btilly 7y ago
        Herd immunity varies by disease. A lot. For each disease we estimate a number called R0, which is how many people the average person will transmit it to if no precautions are taken. Herd immunity sets in when only 1/R0 people have not managed to get it. With the flu, R0 is about 1.3. Meaning that herd immunity to a particular strain starts slowing the spread after about 1/4 of us are immune. (It can continue spreading for some time after that point.) I calculated that from the fact that 1 - 1/1.3 = 0.23076923076923076... R0 for COVID-19 is likely around 5.6 +- 0.9 per https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.If https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v... we take the middle of that range, over 82% of us have to get it before herd immunity starts to work in our favor.
        dmoy 7y ago
        This is also why people refusing the MMR vaccine is really, really hurtful to vulnerable populations. Measles R0 is like 15 or something - it's crazy infectious. So one kid in a daycare or class of 20 with parents who don't believe in vaccines is enough to push you under herd immunity. Bake in the fact that MMR vaccine is only ~97% good against measles, and you end up with a bunch of dead kids. We got lucky last time around in Seattle area, in that it only cost us $1m and 0 deaths to get it under control.
        networkimprov 7y ago
        Herd immunity is derived from R0 and "susceptibility" percentage. The value for the latter also varies with disease and strain. If you look at the Italian data, their % positive level never crossed ~30%, and overall averaged <20%. That might indicate that susceptibility for this agent is well below 50%. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...
        btilly 7y ago
        If you look at the Italian data, their % positive level never crossed ~30%, and overall averaged <20%. That might indicate that susceptibility for this agent is well below 50%. The more likely explanation is that social distancing was implemented early enough, and tests were given to people who might or might not have had it. There is no reason to believe that we burned through most of the vulnerable people in the population.
        Mvandenbergh 7y ago
        Could you post a working version of that link? Most R0 estimates I have seen are between 2.5 and 3.5. 5.6 seems really high to me. It is worth considering that even if the % immune is lower than the herd immunity level, it still slows the outbreak and reduces Re. That gives us a much slower ramp up and gives other measures like less restrictive social distancing, contact tracing, etc. a chance to work. Even if all those together only get Re down to between 1 and 2, we still benefit since it means we might only need another 1 or 2 lockdown periods before we get an effective vaccine.
    - pesfandiar 7y ago
      Those death rates in US are optimistic in my opinion. What if the actual rate is higher because of worse health in impoverished demographics, or the simple fact people might avoid healthcare because of its prohibitive costs?
      - glofish 7y ago
        these death rates come from published research if anything the death rates over across all age groups are even lower - this is a very common observation as initially most non-symptomatic are missed. there is a very strong age dependence with this disease, and probably many other risk factors - predisposition to pneumonia etc.
        pesfandiar 7y ago
        If I understand correctly, research about the death rate is based on people who were tested positive (any source that's based on the general population?). This, depending on the region, could mean people with severe symptoms or non-randomly-selected test takers only. This adds much uncertainty to the estimated overall infection numbers.
      - three_seagrass 7y ago
        Lots of people in NYC are getting dragged out of their homes in body bags that will never get tested. https://www.yahoo.com/news/teams-retrieving-280-bodies-day-170100636.html https://www.yahoo.com/news/teams-retrieving-280-bodies-day-1...
        radioactivist 7y ago
        They are now including many of the suspected (but untested) cases in their reported numbers now. It increased the total from New York by a significant amount, see [1]. The increase is roughly in line with similar estimates from excess mortality [2], so I would guess they are catching most of the deaths with the new reporting scheme. [1] https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-confirmed-probable-daily-04142020.pdf https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d... [2] https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
    - IAmEveryone 7y ago
      That’s 3% of population. Meaning it would 25x times as many deaths to get to “herd immunity”. That’s 750,000 deaths. Good news?
      - glofish 7y ago
        not sure what you are getting at, having 10x more infections yet the situation is still manageable is actually pretty good news
- jobigoud 7y ago
  > This is because they're testing the entire population Not really, they are testing a population of only young, healthy and fit individuals with an obesity rate and other conditions absolutely not in line with the general population.
glofish 7y ago
I find this to be good even excellent news. It is quite possible the virus is not nearly as dangerous and lethal as people fear. If the young have nothing to worry about the prospects are pretty good. The best way to reach herd immunity is to have lots of immune people around you.
- jbotz 7y ago
  Since about a week ago data has been coming in from antibody testing in Europe... and the results are that IFR (infection fatality rate) is clearly less than 0.5% (0.37% in one city in germany[1]) and the number of actually infected people at least 15 times to 30 times higher than the confirmed number of cases. [1] https://www.n-tv.de/wissen/Heinsberg-Studie-entraetselt-Coronavirus-article21704605.html https://www.n-tv.de/wissen/Heinsberg-Studie-entraetselt-Coro...
  - endymi0n 7y ago
    Note though that the study, its methods and especially its politically charged presentation by repeat social media offenders are still disputed [1] [1] https://www1.wdr.de/nachrichten/offene-fragen-heinsberg-studie-corona-100.html https://www1.wdr.de/nachrichten/offene-fragen-heinsberg-stud...
    - Barrin92 7y ago
      Today there's been a new result from antibody tests in the netherlands done on blood dononrs which showed about 3% infection rate. Extrapolated to the population that would imply 500k infections, 20x higher than the official stats. The Heinsberg study isn't the only source pointing to this. Almost a month ago the NYT also ran a story on randomly tested Iranian airplane passengers which suggested that as of that time there may already have been 500k-5mil infections in the country. https://www.straitstimes.com/world/europe/dutch-study-suggests-3-per-cent-of-population-may-have-coronavirus-antibodies https://www.straitstimes.com/world/europe/dutch-study-sugges...
      - 7y ago
blakesterz 7y ago
>> The majority of the positive cases so far are among sailors who are asymptomatic, officials say. I don't know much about this kind of thing, but isn't the most important word in that sentence "sailors"? I would think people living on an aircraft carrier are, on average, way different in many major ways than the average American. So it seems like making any kinds of assumptions based on this wouldn't be super reliable.
- richardw 7y ago
  It probably means this is your best possible case outside of an Olympic village.
  - edmundsauto 7y ago
    If it's true that men are more susceptible to infection/complications/death, the only way the population could be better would be if the ship were staffed entirely by women. That would be an interesting scenario for military leadership to plan.
- londons_explore 7y ago
  I'd take issue at the use of the word 'sailor', when it's been an awfully long time since the navy used sails to get into battle...
  - delecti 7y ago
    Sailor - noun: a person whose job it is to work as a member of the crew of a commercial or naval ship or boat, especially one who is below the rank of officer. Language evolves. Computers used to be people, my cellular telephone rarely conveys my voice, my laptop seldom touches my lap, I virtually never write anything at my desk. https://en.wikipedia.org/wiki/Computer_(job_description) https://en.wikipedia.org/wiki/Computer_(job_description) https://en.wiktionary.org/wiki/telephone#Etymology https://en.wiktionary.org/wiki/telephone#Etymology https://en.wikipedia.org/wiki/Desk#Etymology https://en.wikipedia.org/wiki/Desk#Etymology
  - 7y ago
Leary 7y ago
Sailors are very young. You can't assume that the proportion of people who are asymptomatic to be the same for every age group. The 60% asymptomatic percentage is also a lot lower than some of the assumptions flowing around the internet (~90%).
- elihu 7y ago
  Yep. From the article: > Still, the case of the Theodore Roosevelt offers a case study for researchers about how the virus spreads asymptomatically in a confined environment among mostly younger adults. ...but they don't mention what the average age is. Presumably someone has the data to produce an interesting scatterplot of age versus symptom severity.
  - jki275 7y ago
    Average age is probably early 20s. Huge number of first term Sailors between 18 and 22.
m0zg 7y ago
Young people in the best shapes of their lives tolerate C19 well. I thought it was common knowledge.
manifestsilence 7y ago
So people who are fit enough to pass active duty basic training tend not to have symptoms. Solution: put everyone through basic training?
- Loughla 7y ago
  Solution: put everyone through basic training. Corequisite Solution: make everyone be 18-34 years old.
  - youareostriches 7y ago
    Carrousel! https://scifi.stackexchange.com/questions/22080/what-did-the-crowd-think-it-took-to-win-renewal-in-carrousel https://scifi.stackexchange.com/questions/22080/what-did-the...
- sethammons 7y ago
  The same for people who want to be taller: get them into the NBA as data shows basketball players tend to be tall.
- trhway 7y ago
  >Solution: put everyone through basic training? i'm afraid the fatality rate caused by basic training, i.e. elderly and severe diabetes/hypertension/etc., may happen to be pretty close to the covid. Btw, i think the aircraft carrier commander is an outstanding and exceptional guy - he put the lives of his sailors above his career.
- nradov 7y ago
  I know you're joking, but putting everyone on a daily fitness regimen would likely save lives. (Obviously not something we can mandate.)
  - drusepth 7y ago
    A friend and I were having a tangentially related conversation about net-healthy processes that could theoretically be mandated during a pandemic and their effects on the populace at large. Putting everyone on a daily fitness regimen would almost certainly save lives, even outside of our current pandemic. Likewise, if things got bad enough that grocery stores had to close and the national guard / army / gov were called in to deliver daily rations to households, I wonder what kind of effect that'd have on the country's obesity problem long-term, also. Ignoring the completely dystopic dictatorship and near-apocalyptic context that'd be required for such a scenario, of course.
eximius 7y ago
This is mixed news. While this indicates the death rate may be lower and the infection rate higher among the general population, the demographic of individuals in the US military are going to be of significantly higher health than the general population. So, it doesn't necessarily ease the risk for demographics already identified as 'at-risk'. If anything, their risk might be understated given the higher infection rate.
- scarface74 7y ago
  Especially once you consider all of the pre-existing conditions that make you ineligible to be in the military.
  - cryoshon 7y ago
    this is a really good point. AFAIK, 100% of the canonical pre-existing conditions which are highly dangerous with COVID are disqualifiers for joining the military. this cohort will give us a much better picture of how the virus impacts a totally healthy and young population. as with countless other pieces of evidence, it should also help to put the "it's just a flu bro" falsehood to bed.
    - jjtheblunt 7y ago
      Does the mortality rate across entire population (not particular subpopulations) exceed that of the flu?
      - TheCoelacanth 7y ago
        Almost certainly. The US had 27k deaths in the past two weeks. That's more than some entire years of flu related deaths. Give it another few weeks and it will be more than any recent year.
      - ashtonkem 7y ago
        Yes. Current understanding of the mortality rate is that it’s roughly 10x more lethal than the flu across all age demographics. This means you might only have a 0.2% of dying as a 20 year old, but you only had a 0.02% chance of dying of the flu. The caveat is that mortality rate is intimately tied with the availability of certain types of care; if you need a vent and the hospital is full, you die even if otherwise you would’ve lived. Thus case mortality rate will change dramatically once the hospitals fill up.
andrewla 7y ago
There's always the chance that the test itself is not particularly good and just has a high false positive rate. Although it is difficult for a PCR test to produce a match if there is no genetic material present, it may amplify trace signals, depending on the cutoffs chosen.
- JackFr 7y ago
  This seems to me the most obvious implication. That when you only test symptomatic people, the test might be accurate, but in testing everyone the false positive rate is much higher.
- ImaCake 7y ago
  I looked into this a few weeks ago. The PCR test has an incredibly low false positive rate, below 1%. It is low enough that it is feasible to test a 100,000 people and expect basically zero false positives. The false negative rate is somewhere around 30%. So the real danger with PCR is that you will miss cases. The opposite is true for the antibody tests. The false negative rate is around 10% and the false positive rate is also around 10%. So in 100,000 tests, you would expect to miss about 1,000 true positives. But, and this is critical, you would also mistakenly get 1,000 false positives - even if only 1/100,000 people are actually infected! Next time you see someone claiming 50% asymptomatics. First thing to ask is whether they used PCR. Or if they used an assay with a terrible false positive rate.
  - danieltillett 7y ago
    If not done well PCR has an incredibly high false positive rate. If you contaminate your set up area (or equipment) with past PCR amplification material you will get a very high rate of PCR positivity. Of course if you do things correctly this shouldn’t happen, but if the average pathology lab technician is as skilled as my ex-students and colleagues (and myself) then I would be not be so keen to rule out false positives. Yes there is a major issue with false negatives, especially when the swab was not performed or stored correctly. RNA is not very stable and it is very easy to destroy all the viral RNA if you are not careful.
alkonaut 7y ago
Were they testing for the virus or for antibodies? If it was testing for the virus tests only show positive for a few days then testing everyone on board will miss those who already had it, correct?
- greedo 7y ago
  According to the Captain's email, sailors were tested, and results known the next day. I don't know what equipment they had onboard the Roosevelt, but the quick turnaround might indicate the type of test. These tests were also performed around Mar29.
  - alkonaut 7y ago
    Sounds like RT-PCR tests. Serological tests probably aren’t available in that scale yet (unsure). Regardless, it’s going to be extremely interesting now that countries start doing random serological tests. I read today about a group of Swedish athletes who visited a competition in Wuhan in October and some developed severe respiratory issues afterwards that couldn’t be diagnosed. Edit: 5 were tested and 1 was positive which was interpreted as being a later infection. So no October infection.
scythe 7y ago
Do we know if these cases are truly asymptomatic or just presymptomatic as was observed on the Diamond Princess? 48% asymptomatic initially: https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-... 18% asymptomatic retrospectively: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/ Also, 58% of asymptomatic COVID-19 infections still show damage to the lungs on CT: https://appliedradiology.com/articles/study-investigates-diamond-princess-cruise-ship-covid-19-findings https://appliedradiology.com/articles/study-investigates-dia...
- danieltillett 7y ago
  Do you know any studies of the outcome of the 32 Diamond Princess patients that were the ICU at the time the boat was emptied? I have been looking and I can’t find any data on what was the final clinical outcome of all patients on the Diamond Princess?
  - iso947 7y ago
    Wiki said there have been 14 deaths so far, most recently just 3 days ago.
    - danieltillett 7y ago
      It seems they are only tracking the Japanese deaths. It doesn’t seem like anyone is tracking the seriously ill who were transported home, or those that became ill once they got home. Even on these incomplete number the true death rate is 2%.
  - scythe 7y ago
    I know this is a rather unorthodox source, but 538 reports a death rate of 1.2%. https://fivethirtyeight.com/features/a-comic-strip-tour-of-the-wild-world-of-pandemic-modeling/ https://fivethirtyeight.com/features/a-comic-strip-tour-of-t...
btilly 7y ago
This figure does not surprise me. It is in line with Iceland finding that 50% of people they tested were asymptomatic. However as https://www.propublica.org/article/what-we-need-to-understand-about-asymptomatic-carriers-if-were-going-to-beat-coronavirus https://www.propublica.org/article/what-we-need-to-understan... notes, in other samples about 75% of people who were asymptomatic at the time of the test went on to develop symptoms. So the fact that these sailors are currently asymptomatic does not mean that they will remain so. See https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/ https://www.cebm.net/covid-19/covid-19-what-proportion-are-a... for more on how different data points are all over the place.
- lbeltrame 7y ago
  Are there any data on the severity of the symptoms? From what I've gathered, but without any hard data, in non-severe cases (i.e. not needing hospitalization) they can vary from a slight sore throat, dry cough and mild fever, to the same with a high fever and general sense of exhaustion.
  - lazyasciiart 7y ago
    Non-severe covers bronchitis, pneumonia, etc. My friend (who tested positive but was not hospitalized) described it as "chest pain, difficulty breathing, if I do something silly like walk 10 feet to the kitchen I get lightheaded and hold on to the wall" - for about ten days.
    - acdha 7y ago
      The question I had was whether there’s a connection between delay and severity: if you’re one of those asymptomatic cases for a week or two, how does that change the likelihood of ending up on the worse end of the spectrum?
    - ajross 7y ago
      What has gone wrong with this site? Why is this comment grayed out form downvotes? It's a straightforward testimony of real experience, and it doesn't even vary significantly form the consensus set of symptoms. I see this all the time, on a site that used to be a really good spot for rational discussion.
Mikeb85 7y ago
All the data points to the fact that coronavirus is more widespread and less deadly than most outlets are reporting (after all, increase the denominator, the % goes down). The countries with the lowest death rates are also the countries that did the most comprehensive testing. Ditto for this aircraft carrier. Of course governments and outlets are fearmongering lest they be accused of not doing enough, but this thing is way overblown and I fear we'll be living with the consequences for an entire generation.
- deleted 7y ago
  [deleted]
- coherentpony 7y ago
  Are you of the opinion that this is simply just a slightly worse flu? > All the data points to the fact that coronavirus is more widespread and less deadly than most outlets are reporting You couldn't be more wrong. There are nurses and doctors working on the front lines dealing with patients, and they're completely and utterly overloaded. Lack of resources. Lack of help from local and federal governments. They're the ones telling us this is way more deadly than it seems.
  - Mikeb85 7y ago
    > Are you of the opinion that this is simply just a slightly worse flu? I mean I'm about 95% sure I already had it. Had literally every single symptom but the local health authority (Alberta, Canada) wouldn't test me. My SO had it worse but again, they wouldn't test her. Felt like a worse flu + more coughing and shortness of breath. Worse fever. My symptoms were bad for about 3 days, then felt like a cold for about a week, then a cough stuck around another week or two after. My SO had bad symptoms for about a week, was moderately sick for another week and a bit, but her symptoms disappeared pretty quickly afterwards. In either case, because we didn't require hospitalisation, AHS wouldn't test us. Anyhow, there's a massive body of evidence that there's many times more people infected than confirmed cases. Are you disputing that? Do you actually think there is no one infected other than confirmed cases? Our health authority, until a few days ago, wouldn't test anyone that wasn't a severe case or an at-risk group... You could literally have every single symptom and they'd simply tell you to stay home. Now they've only expanded testing because there's way less hospitalisations than their models predicted... Edit > There are nurses and doctors working on the front lines dealing with patients, and they're completely and utterly overloaded. Lack of resources. Lack of help from local and federal governments. Maybe that's a failing of your health care system? In Canada hospitalisation rates are way less than predicted. Our province also gave away a bunch of PPE because it doesn't appear as though they'll get used. Edit 2 - described more symptoms
ivoras 7y ago
Adding to that, Netherlands' study of antibodies in blood donors' samples shows about 10x difference between the number of reported / tested cases and actual cases in the general population (i.e. a lot more people got it and were not sick): https://www.nytimes.com/reuters/2020/04/16/world/europe/16reuters-health-coronavirus-netherlands-study.html https://www.nytimes.com/reuters/2020/04/16/world/europe/16re...?
- feral 7y ago
  The Netherlands has 3.3k deaths vs 29k confirmed cases, which would give a CFR of ~10% I.e. the Netherlands aren't testing much. A 10x reduction there brings it back to the CFR range we see in countries with bigger testing programs. I'm not a specialist but have been following this for a while, and have yet to see evidence the IFR for this isnt around 0.5-1% (assuming decent healthcare). That's what we saw in the Diamond Princess data, and a bunch of other places.
  - Gibbon1 7y ago
    My current bet is younger healthy people are more likely to be asymptomatic. And older people much less so. Theodore Roosevelt with likely a young population, most are asymptomatic. Diamond Princess much older population most are symptomatic.
    - alexbanks 7y ago
      This is a thing I've been thinking about a lot. We're quick to say "We're not testing enough", but also quick to throw statistics around "disproving" the amount of asymptomatic cases. I am on the side of "It's probably orders of magnitude widespread than most countries think", and the number of totally asymptomatic cases is actually far far higher. You can't test only the old and the already sick and then accurately assess likelihood to develop symptoms. Your sample is totally wrong.
      - feral 7y ago
        Humanity's understanding of this disease is much more sophisticated than the two comments above this would imply. Researchers are not stupidly looking at Diamond Princess and getting confused because the population is old. Rather it's a powerful dataset because it enables us to quantify the asymptomatic people of all ages, because people were tested fairly exhaustively before being allowed leave, regardless of symptoms, and because we've had enough time for many of the cases to play out. The diamond princess data revealed a large number of asymptomatic cases in China, the absence of which were skewing the detected cases in China much older. Anyway, you don't need to think anything complicated about correcting for ages, etc You can just look at the data from the Netherlands where they conclude they have 3% population infection, by looking at the random serological testing, and then look at the number of confirmed deaths they have, and do the very simple math. It's very hard to do that and then say we're missing say 10x higher numbers of asymptomatic cases all over the place. This blog post I wrote a while back is Ireland specific but has figures on CFR and IFR I think are still valid, and references to the academic articles I got them from: https://medium.com/@fergal.reid/predicting-the-impact-of-coronovirus-on-ireland-bff1b6d00d6a https://medium.com/@fergal.reid/predicting-the-impact-of-cor...
icedchai 7y ago
Nothing new here. People were talking about asymptomatic spread by younger people for months. Why is Esper surprised?
deleted 7y ago
[deleted]
mrfusion 7y ago
Could past infections from other corona viruses be Protecting people? I’d like to see research on that.
- vardump 7y ago
  Like https://en.wikipedia.org/wiki/Human_coronavirus_NL63 https://en.wikipedia.org/wiki/Human_coronavirus_NL63. "Human coronavirus NL63 (HCoV-NL63) is a species of coronavirus that was identified in late 2004 in a seven-month-old child with bronchiolitis in the Netherlands.[1] The virus is an enveloped, positive-sense, single-stranded RNA virus which enters its host cell by the ACE2 receptor." To add, I also wonder whether those with contacts to disease super spreaders (aka toddlers in kindergarten) have better immunity against covid-19, just by being previously infected by other coronaviruses. Possibly some currently unknown ones as well.
paypalcust83 7y ago
There are multiple, dynamic risk-factors being discovered, treatment options, and different genomes of this species of virus circulating. 1) Being overweight is a major risk-factor for requiring critical care, and most US military folks aren't weight-enabled. 2) Being older is another risk factor. Also, most US military folks aren't well-aged either, typically in their 20's-30's. 3) Having type A blood group is a potential risk factor. Type O blood group is a potential protection factor. 4) Being male was a risk-factor for the L-strain. It's possible the military folks caught an S-strain that has less gender specificity, but it also may have nothing to do with it. 5) SARS-CoV-2 as a species maybe drifting genetically towards more communicability but less virulence. H1N1, HIV and others have also shown this pattern. 6) COVID-19 may not be best helped with non/invasive high-pressure ventilation that causes extreme barotrauma. In fact, it may not even be the same as previous instances of ARDS. 7) It's possible they were exposed to a variant of one of the newer genomes of S-strain that goes up to 78% "asymptomatic" community spread. 8) "Asymptomatic" means subclinical in terms of manifested, obvious symptoms. There is still the real possibility of internal organ damage regardless. Only a vaccine will be able to end this threat.
- empath75 7y ago
  > 5) SARS-CoV-2 as a species maybe drifting genetically towards more communicability but less virulence. H1N1, HIV and others have also shown this pattern. This is not true for either of those diseases.
manfredo 7y ago
Random testing in Germany has also revealed higher than expected rates of people with antibodies. Their IFR (infected fatality rate) was 2% overall based on non-random testing. Random testing has yielded an IFR or 0.37%. This does not increase the risk. These tests only test people who had coronavirus. The larger this portion, the more herd immunity there is in the population. It implies that there were a larger than expected number of people who had the virus, at some point in time. But that's a lagging indicator.
- jaynetics 7y ago
  The lower rate was calculated based on only 7 or 8 fatalities. Also the people in Gangelt, where that test was carried out, are significantly younger than the average German. Their share of people over 75 is 17% below the national average.
  - arcticbull 7y ago
    That isn't what I saw when I looked up their demographics, it looked roughly in line, skewing older even. [1] They had 12.8% over 75 as compared to for instance, 9% in Frankfurt [2]. Also in a population of 10,000-ish the number of fatalities would have to be by definition closer to 40. [1] https://www.citypopulation.de/en/germany/census/nordrhein_westfalen/05370008__gangelt/ https://www.citypopulation.de/en/germany/census/nordrhein_we... [2] https://www.citypopulation.de/en/germany/hessen/frankfurt_am_main/06412000__frankfurt_am_main/ https://www.citypopulation.de/en/germany/hessen/frankfurt_am...
    - jaynetics 7y ago
      Well, you divided the much lower 2011 population by the size of an age group in 2018, and compared that with a random city? For the German average, see https://cdn.britannica.com/34/184234-050-91AEB8AF/age-breakdown-bar-graph-Germany.jpg https://cdn.britannica.com/34/184234-050-91AEB8AF/age-breakd...
- system2 7y ago
  If 0.37% is true, why are the hospitals in this shape?
JPKab 7y ago
Might also be important to note that sailors on an aircraft carrier are primarily college-aged.
- tropo 7y ago
  Also 0% with asthma, obesity, diabetes, etc.
  - rootusrootus 7y ago
    Not true. For various reasons, the military grants medical waivers and allows some people with asthma and other afflictions to remain enlisted.
    - dguaraglia 7y ago
      Yeah, but that number is going to be way lower than the average population.
    - jki275 7y ago
      Asthma, no. Diabetes, no. There is not a single person on that ship with either, they’re both disqualifying from shipboard service. There are probably some people who are overweight to a varying degree, but again people who get overweight and don’t get back within standards get removed from the Navy.
- rootusrootus 7y ago
  ~50% of enlisted sailors are 25 or younger, with each successive age bracket getting smaller. For officers it is more like ~13% and it's evenly distributed by age bracket.
JetBen 7y ago
This was a bioweapon launched against us by the evil Chinese Communist party. We just watched China murder over 145,000 people. We must punish their horrible regime severely!
twomoretime 7y ago
Now hopefully we can get a better estimate of the range of the latent period. That these cases are asymptomatic does not mean they won't show symptoms at some later date. It also does not mean they are invulnerable to reinfection, and if this virus indeed has Antibody Dependent Enhancement like SARS, this could create an extremely dangerous setup for a second wave with a significantly higher, order of magnitude, death rate. All of the bits and pieces are floating around in papers, hopefully they won't be confirmed like everything else that started as errant literature.
dboreham 7y ago
People reading here may be interested in recent UK statistical office data, analyzed here: https://youtu.be/F39kVKSCP40 https://youtu.be/F39kVKSCP40 This is data that examines among other things the overall death rate irrespective of reported cause.
syntaxing 7y ago
Is it possible that more people are asymptomatic because the sample population is more athletic? I would imagine there's a certain physique that's maintained and required for the military.
gdubs 7y ago
Stanford’s study should give us more info soon. They recently screened a decent sized group in Santa Clara County to get a sense of how widespread it is, using their newly developed finger-prick test which looks for both antigens and antibodies (whether you have it / had it and recovered). Currently the test is being prioritized for frontline healthcare workers while they work on scaling up: https://www.stanforddaily.com/2020/04/04/stanford-researchers-test-3200-people-for-covid-19-antibodies/ https://www.stanforddaily.com/2020/04/04/stanford-researcher...
- zephyrnh 7y ago
  It's been 12 days since they tested everyone. My understanding is that the results for serological tests are available right away, so I was expecting them to publish results within a few days. Any idea why they haven't yet?
  - usaar333 7y ago
    Perhaps they can't get statistical significance. You'd ballpark a 0.5% infection rate in the Bay Area going by deaths and current best guesses for IFR. Your false positive rate might exceed that. These tests are better done in highly infected areas like NYC.
    - oldgradstudent 7y ago
      > current best guesses for IFR The entire point of the study is that we don't have good estimates of the IFR.
      - usaar333 7y ago
        We have randomized PCR studies and ships where everyone got tested. Yes, there is error there (false negatives), but there's an upper bound to how much there can be.
  - xorfish 7y ago
    They would need to collect data again now to get a better result. Otherwise the data is the same as on the day the test was made.
jyounker 7y ago
We can't tell anything from the article. * We don't know how many people were tested. * We don't know how many people tested positive. * We don't know the false positive rate for the test.
- badfrog 7y ago
  > We don't know how many people were tested. > We don't know how many people tested positive. Both of those are in the article.
asdf21 7y ago
I'm calling it now, I bet many people (>20%) have had it, whether they realize it or not. To be honest, I think it was all over the Bay Area in late December, Early January (when I'm pretty sure I had it) and Feb.
- adjkant 7y ago
  Given that Wuhan did not even report its first case publicly until the 31st, this seems highly unlikely. Even if you believe China was 15-30 days behind in reporting (pushing it) and that somehow a near patient zero traveler from there ended up in the bay, having it spread to "all over the bay" levels by late December would be incredibly contagious. No timeline supports your claim here. https://www.who.int/news-room/detail/08-04-2020-who-timeline---covid-19 https://www.who.int/news-room/detail/08-04-2020-who-timeline...
- JshWright 7y ago
  How do you explain the hospitalization rate not climbing until a couple months later?
  - phkahler 7y ago
    There are 2 strains?
    - JshWright 7y ago
      That would be a very obvious thing to detect (and we have not seen evidence of that).
      - serf 7y ago
        evidence of what? two separate strains? this paper mentions two strains[0], 'L' and 'S' type, was it refuted? [0]: https://academic.oup.com/nsr/article/doi/10.1093/nsr/nwaa036/5775463 https://academic.oup.com/nsr/article/doi/10.1093/nsr/nwaa036...
        7y ago
aazaa 7y ago
Nowhere does the article mention which kind of test was run. Was it qPCR or serological? The latter tests whether you have had an infection. The former tests whether you currently have one. The distinction between presymptomatic and asymptomatic is tricky as well, but is less of an issue with a serological test than a qPCR.
ngcc_hk 7y ago
Is this related to the three strain theory?
deleted 7y ago
[deleted]
surge 7y ago
This was what was coming out when it was blowing through China, this was what the big concern back February. This isn't news. A good deal of people will never notice they have it which is why the spread of this thing is so difficult to contain. I guess maybe people doubted it really was that hard to stop or were not paying attention before, but its why its is absolutely critical everyone isolate even without symptoms.
nednar 7y ago
It's the first time I see news about the aircraft carrier. Could someone summarize why the captain got fired for testing his whole crew in an environment where a lot of people have to live very closely together? My first assumption is that it was a really good decision.
- WrtCdEvrydy 7y ago
  He sent an email to his commander and his commander's commander about how the situation was deteriorating... which were then leaked to the press and was promptly relieved of command by Acting Navy Secretary Thomas Modly who later on resigned. Most people think it was a good call but it also may have compromised the safety of the carrier because now it's known they may be operating under less than perfect condition.
  - khuey 7y ago
    The Washington Post managed to get the original letter: https://twitter.com/DanLamothe/status/1250840016806445056 https://twitter.com/DanLamothe/status/1250840016806445056 It's pretty clear he was canned by a political appointee for political reasons.
    - philwelch 7y ago
      Yes and no. He was relieved because he went around the chain of command, which is a universal career-ending move in the military even if you do it for all the right reasons—which he did. Also, although he was relieved of command, he wasn’t “fired” or “canned” or discharged from the Navy. He will undoubtedly go into an early retirement with a full pension at his current rank of Captain. That doesn’t change the fundamental unfairness of how he’s been treated, but he’s going to be fine. And I think he knew and accepted the consequences of his actions.
      - michaelt 7y ago
        Do you mean e-mailing your commander's commander is a universal career-ending move in the navy? Or was he discharged on evidence or assumption he leaked to the press himself?
dcaisen 7y ago
Is there any info on the sensitivity/specificity of this test and/or on how they confirm that positive results aren't false positives?
vrtx0 7y ago
IMHO, this article is intentionally misleading. The incubation period is currently estimated to be 2-14 days (mean is 5.6 days per CDC, similar per WHO). The article doesn’t mention any dates or time frames, but does mention: ”Roughly 60 percent of the over 600 sailors who tested positive so far have not shown symptoms of COVID-19” — note how “so far” is ambiguous in that sentence. It also states, “The Navy’s testing of the entire 4,800-member crew of the aircraft carrier - which is about 94% complete...”, which seems to indicate nowhere near enough time has elapsed to draw any sort of conclusion. This paper [1] found that testing of all pregnancy patients in a hospital yielded 34% asymptomatic cases. That number drops to 8% “shortly after discharge”, and could be lower than 8% (Again, no timeframe is stated). [1] https://www.sciencedirect.com/science/article/pii/S2589933320300483 https://www.sciencedirect.com/science/article/pii/S258993332...
- nostromo 7y ago
  Just as one data point, the captain of the ship raised alarms about the virus spreading late last month. So it’s not exactly a recent outbreak. Of course, without testing from that period it’s impossible to know.
  - fragmede 7y ago
    The general public may have had little to no access to testing back then, but the military certainly did. They may choose not to release numbers from back then, but the limited testing capacity existed is, IMO, quite justifiably used on people in the military. There’s plenty to criticize about the country’s response but lack of testing in the military isn’t one Of them, at least not relative to the broader (lack of) availability of testing to the wider public .
  - xorfish 7y ago
    If the virus spreads exponentially, you would expect most cases to be presymptomatic at any given time.
    - Traster 7y ago
thesz 7y ago
Let me cite full abstract of the research on CT scans of symptom-free COVID-19 patients [1] Purpose To evaluate the chest CT findings in an environmentally homogeneous cohort from the cruise ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19). Materials and Methods This retrospective study comprised 104 cases (mean age, 62 years ± 16, range 25-93) with COVID-19 confirmed with RT-PCR. CT images were reviewed and the CT severity score was calculated for each lobes and the entire lung. CT findings were compared between asymptomatic and symptomatic cases. Results Of 104 cases, 76 (73%) were asymptomatic, 41 (54%) of which had lung opacities on CT. Other 28 (27%) cases were symptomatic, 22 (79%) of which had abnormal CT findings. Symptomatic cases showed lung opacities and airway abnormalities on CT more frequently than asymptomatic cases [lung opacity; 22 (79%) vs 41 (54%), airway abnormalities; 14 (50%) vs 15 (20%)]. Asymptomatic cases showed more GGO over consolidation (83%), while symptomatic cases more frequently showed consolidation over GGO (41%). The CT severity score was higher in symptomatic cases than asymptomatic cases, particularly in the lower lobes [symptomatic vs asymptomatic cases; right lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-4); left lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-3); total score: 7 ± 5 (1-17) vs 4 ± 2 (1-11)]. Conclusion This study documented a high incidence of subclinical CT changes in cases with COVID-19. Compared to symptomatic cases, asymptomatic cases showed more GGO over consolidation and milder extension of disease on CT. [1] https://pubs.rsna.org/doi/full/10.1148/ryct.2020200110?fbclid=IwAR10SZ4I0ORtt5eu9wz55JaMJLfeRhg-mgfNsABwnbksoSClINKVXvHA7OU& https://pubs.rsna.org/doi/full/10.1148/ryct.2020200110?fbcli... One with asymptomatic illness very probably (3/4) will get lungs damage.
- kavalg 7y ago
  When you say damage, do you mean permanent damage? Or maybe it is still not clear?
  - officialjunk 7y ago
    permanent https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w...
    - 7y ago
misja111 7y ago
This is not news. The same was already reported one month ago in the Italian village of Vo, where the entire population was tested for Corona. Summary is here: https://www.bmj.com/content/368/bmj.m1165 https://www.bmj.com/content/368/bmj.m1165 "In an open letter to the authorities in the Tuscany region,1 Romagnani wrote that the great majority of people infected with covid-19—50-75%—were asymptomatic, but represented “a formidable source” of contagion." In the same report was another interesting paragraph as well: He noted that Romagnani’s findings appeared to contradict a WHO report based on covid-19 in China.2 This suggested that “the proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.” edit: really, downvoted? Because of the mentioning of China?
buboard 7y ago
There's another air craft carrier in france where 1/3 of soldiers got it. That said, soldiers everywhere are young and healthy , and usually vaccinated extra
LatteLazy 7y ago
While this is interesting... * Sailors are not in any way representative of the general population. * Sailors in the US Navy are notoriously overworked and there is a strong culture of working when sick. So we're they actually asymptomatic or did they report for work shivering and sweating and semi delerious?
Bombthecat 7y ago
Super healthy trained people can fight the virus easier? Who would have thought...
rezeroed 7y ago
Clue to what? Are we still pretending this isn't an old people, unhealthy people sickness?

373 points by mancerayder 7y ago

This is because they're testing the entire population as opposed to simply those who end up hospitalized and those around them. We need population testing to get an actual idea of how many people in an area have it. There's likely way more cases nationwide than being reported. In NYC, most asymptomatic/low symptom cases of coronavirus aren't going to be tested until antibody testing later on.

JoeAltmaier 7y ago
Yes. Many institutions test only if preparing to admit. Anybody else is told to go home and recover in isolation.
- glofish 7y ago
  if the US has 33K deaths and the death rate is 0.6% then the US must have at least 5 million cases. If the death rate is lower (most likely around 0.3%) then it means 10 million infections. Also a good news actually.
  - cm2187 7y ago
    Agree, though still a long way from herd immunity, which I understand starts at 50%-ish.
    - btilly 7y ago
      Herd immunity varies by disease. A lot. For each disease we estimate a number called R0, which is how many people the average person will transmit it to if no precautions are taken. Herd immunity sets in when only 1/R0 people have not managed to get it. With the flu, R0 is about 1.3. Meaning that herd immunity to a particular strain starts slowing the spread after about 1/4 of us are immune. (It can continue spreading for some time after that point.) I calculated that from the fact that 1 - 1/1.3 = 0.23076923076923076... R0 for COVID-19 is likely around 5.6 +- 0.9 per https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.If https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v... we take the middle of that range, over 82% of us have to get it before herd immunity starts to work in our favor.
      - dmoy 7y ago
        This is also why people refusing the MMR vaccine is really, really hurtful to vulnerable populations. Measles R0 is like 15 or something - it's crazy infectious. So one kid in a daycare or class of 20 with parents who don't believe in vaccines is enough to push you under herd immunity. Bake in the fact that MMR vaccine is only ~97% good against measles, and you end up with a bunch of dead kids. We got lucky last time around in Seattle area, in that it only cost us $1m and 0 deaths to get it under control.
      - networkimprov 7y ago
        Herd immunity is derived from R0 and "susceptibility" percentage. The value for the latter also varies with disease and strain. If you look at the Italian data, their % positive level never crossed ~30%, and overall averaged <20%. That might indicate that susceptibility for this agent is well below 50%. https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...
        btilly 7y ago
        If you look at the Italian data, their % positive level never crossed ~30%, and overall averaged <20%. That might indicate that susceptibility for this agent is well below 50%. The more likely explanation is that social distancing was implemented early enough, and tests were given to people who might or might not have had it. There is no reason to believe that we burned through most of the vulnerable people in the population.
      - Mvandenbergh 7y ago
        Could you post a working version of that link? Most R0 estimates I have seen are between 2.5 and 3.5. 5.6 seems really high to me. It is worth considering that even if the % immune is lower than the herd immunity level, it still slows the outbreak and reduces Re. That gives us a much slower ramp up and gives other measures like less restrictive social distancing, contact tracing, etc. a chance to work. Even if all those together only get Re down to between 1 and 2, we still benefit since it means we might only need another 1 or 2 lockdown periods before we get an effective vaccine.
  - pesfandiar 7y ago
    Those death rates in US are optimistic in my opinion. What if the actual rate is higher because of worse health in impoverished demographics, or the simple fact people might avoid healthcare because of its prohibitive costs?
    - glofish 7y ago
      these death rates come from published research if anything the death rates over across all age groups are even lower - this is a very common observation as initially most non-symptomatic are missed. there is a very strong age dependence with this disease, and probably many other risk factors - predisposition to pneumonia etc.
      - pesfandiar 7y ago
        If I understand correctly, research about the death rate is based on people who were tested positive (any source that's based on the general population?). This, depending on the region, could mean people with severe symptoms or non-randomly-selected test takers only. This adds much uncertainty to the estimated overall infection numbers.
    - three_seagrass 7y ago
      Lots of people in NYC are getting dragged out of their homes in body bags that will never get tested. https://www.yahoo.com/news/teams-retrieving-280-bodies-day-170100636.html https://www.yahoo.com/news/teams-retrieving-280-bodies-day-1...
      - radioactivist 7y ago
        They are now including many of the suspected (but untested) cases in their reported numbers now. It increased the total from New York by a significant amount, see [1]. The increase is roughly in line with similar estimates from excess mortality [2], so I would guess they are catching most of the deaths with the new reporting scheme. [1] https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-confirmed-probable-daily-04142020.pdf https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d... [2] https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
  - IAmEveryone 7y ago
    That’s 3% of population. Meaning it would 25x times as many deaths to get to “herd immunity”. That’s 750,000 deaths. Good news?
    - glofish 7y ago
      not sure what you are getting at, having 10x more infections yet the situation is still manageable is actually pretty good news
jobigoud 7y ago
> This is because they're testing the entire population Not really, they are testing a population of only young, healthy and fit individuals with an obesity rate and other conditions absolutely not in line with the general population.

glofish 7y ago

I find this to be good even excellent news. It is quite possible the virus is not nearly as dangerous and lethal as people fear. If the young have nothing to worry about the prospects are pretty good. The best way to reach herd immunity is to have lots of immune people around you.

jbotz 7y ago
Since about a week ago data has been coming in from antibody testing in Europe... and the results are that IFR (infection fatality rate) is clearly less than 0.5% (0.37% in one city in germany[1]) and the number of actually infected people at least 15 times to 30 times higher than the confirmed number of cases. [1] https://www.n-tv.de/wissen/Heinsberg-Studie-entraetselt-Coronavirus-article21704605.html https://www.n-tv.de/wissen/Heinsberg-Studie-entraetselt-Coro...
- endymi0n 7y ago
  Note though that the study, its methods and especially its politically charged presentation by repeat social media offenders are still disputed [1] [1] https://www1.wdr.de/nachrichten/offene-fragen-heinsberg-studie-corona-100.html https://www1.wdr.de/nachrichten/offene-fragen-heinsberg-stud...
  - Barrin92 7y ago
    Today there's been a new result from antibody tests in the netherlands done on blood dononrs which showed about 3% infection rate. Extrapolated to the population that would imply 500k infections, 20x higher than the official stats. The Heinsberg study isn't the only source pointing to this. Almost a month ago the NYT also ran a story on randomly tested Iranian airplane passengers which suggested that as of that time there may already have been 500k-5mil infections in the country. https://www.straitstimes.com/world/europe/dutch-study-suggests-3-per-cent-of-population-may-have-coronavirus-antibodies https://www.straitstimes.com/world/europe/dutch-study-sugges...
    - 7y ago

blakesterz 7y ago

>> The majority of the positive cases so far are among sailors who are asymptomatic, officials say. I don't know much about this kind of thing, but isn't the most important word in that sentence "sailors"? I would think people living on an aircraft carrier are, on average, way different in many major ways than the average American. So it seems like making any kinds of assumptions based on this wouldn't be super reliable.

richardw 7y ago
It probably means this is your best possible case outside of an Olympic village.
- edmundsauto 7y ago
  If it's true that men are more susceptible to infection/complications/death, the only way the population could be better would be if the ship were staffed entirely by women. That would be an interesting scenario for military leadership to plan.
londons_explore 7y ago
I'd take issue at the use of the word 'sailor', when it's been an awfully long time since the navy used sails to get into battle...
- delecti 7y ago
  Sailor - noun: a person whose job it is to work as a member of the crew of a commercial or naval ship or boat, especially one who is below the rank of officer. Language evolves. Computers used to be people, my cellular telephone rarely conveys my voice, my laptop seldom touches my lap, I virtually never write anything at my desk. https://en.wikipedia.org/wiki/Computer_(job_description) https://en.wikipedia.org/wiki/Computer_(job_description) https://en.wiktionary.org/wiki/telephone#Etymology https://en.wiktionary.org/wiki/telephone#Etymology https://en.wikipedia.org/wiki/Desk#Etymology https://en.wikipedia.org/wiki/Desk#Etymology
- 7y ago

Leary 7y ago

Sailors are very young. You can't assume that the proportion of people who are asymptomatic to be the same for every age group. The 60% asymptomatic percentage is also a lot lower than some of the assumptions flowing around the internet (~90%).

elihu 7y ago
Yep. From the article: > Still, the case of the Theodore Roosevelt offers a case study for researchers about how the virus spreads asymptomatically in a confined environment among mostly younger adults. ...but they don't mention what the average age is. Presumably someone has the data to produce an interesting scatterplot of age versus symptom severity.
- jki275 7y ago
  Average age is probably early 20s. Huge number of first term Sailors between 18 and 22.

m0zg 7y ago

Young people in the best shapes of their lives tolerate C19 well. I thought it was common knowledge.

manifestsilence 7y ago

So people who are fit enough to pass active duty basic training tend not to have symptoms. Solution: put everyone through basic training?

Loughla 7y ago
Solution: put everyone through basic training. Corequisite Solution: make everyone be 18-34 years old.
- youareostriches 7y ago
  Carrousel! https://scifi.stackexchange.com/questions/22080/what-did-the-crowd-think-it-took-to-win-renewal-in-carrousel https://scifi.stackexchange.com/questions/22080/what-did-the...
sethammons 7y ago
The same for people who want to be taller: get them into the NBA as data shows basketball players tend to be tall.
trhway 7y ago
>Solution: put everyone through basic training? i'm afraid the fatality rate caused by basic training, i.e. elderly and severe diabetes/hypertension/etc., may happen to be pretty close to the covid. Btw, i think the aircraft carrier commander is an outstanding and exceptional guy - he put the lives of his sailors above his career.
nradov 7y ago
I know you're joking, but putting everyone on a daily fitness regimen would likely save lives. (Obviously not something we can mandate.)
- drusepth 7y ago
  A friend and I were having a tangentially related conversation about net-healthy processes that could theoretically be mandated during a pandemic and their effects on the populace at large. Putting everyone on a daily fitness regimen would almost certainly save lives, even outside of our current pandemic. Likewise, if things got bad enough that grocery stores had to close and the national guard / army / gov were called in to deliver daily rations to households, I wonder what kind of effect that'd have on the country's obesity problem long-term, also. Ignoring the completely dystopic dictatorship and near-apocalyptic context that'd be required for such a scenario, of course.

eximius 7y ago

This is mixed news. While this indicates the death rate may be lower and the infection rate higher among the general population, the demographic of individuals in the US military are going to be of significantly higher health than the general population. So, it doesn't necessarily ease the risk for demographics already identified as 'at-risk'. If anything, their risk might be understated given the higher infection rate.

scarface74 7y ago
Especially once you consider all of the pre-existing conditions that make you ineligible to be in the military.
- cryoshon 7y ago
  this is a really good point. AFAIK, 100% of the canonical pre-existing conditions which are highly dangerous with COVID are disqualifiers for joining the military. this cohort will give us a much better picture of how the virus impacts a totally healthy and young population. as with countless other pieces of evidence, it should also help to put the "it's just a flu bro" falsehood to bed.
  - jjtheblunt 7y ago
    Does the mortality rate across entire population (not particular subpopulations) exceed that of the flu?
    - TheCoelacanth 7y ago
      Almost certainly. The US had 27k deaths in the past two weeks. That's more than some entire years of flu related deaths. Give it another few weeks and it will be more than any recent year.
    - ashtonkem 7y ago
      Yes. Current understanding of the mortality rate is that it’s roughly 10x more lethal than the flu across all age demographics. This means you might only have a 0.2% of dying as a 20 year old, but you only had a 0.02% chance of dying of the flu. The caveat is that mortality rate is intimately tied with the availability of certain types of care; if you need a vent and the hospital is full, you die even if otherwise you would’ve lived. Thus case mortality rate will change dramatically once the hospitals fill up.

andrewla 7y ago

There's always the chance that the test itself is not particularly good and just has a high false positive rate. Although it is difficult for a PCR test to produce a match if there is no genetic material present, it may amplify trace signals, depending on the cutoffs chosen.

JackFr 7y ago
This seems to me the most obvious implication. That when you only test symptomatic people, the test might be accurate, but in testing everyone the false positive rate is much higher.
ImaCake 7y ago
I looked into this a few weeks ago. The PCR test has an incredibly low false positive rate, below 1%. It is low enough that it is feasible to test a 100,000 people and expect basically zero false positives. The false negative rate is somewhere around 30%. So the real danger with PCR is that you will miss cases. The opposite is true for the antibody tests. The false negative rate is around 10% and the false positive rate is also around 10%. So in 100,000 tests, you would expect to miss about 1,000 true positives. But, and this is critical, you would also mistakenly get 1,000 false positives - even if only 1/100,000 people are actually infected! Next time you see someone claiming 50% asymptomatics. First thing to ask is whether they used PCR. Or if they used an assay with a terrible false positive rate.
- danieltillett 7y ago
  If not done well PCR has an incredibly high false positive rate. If you contaminate your set up area (or equipment) with past PCR amplification material you will get a very high rate of PCR positivity. Of course if you do things correctly this shouldn’t happen, but if the average pathology lab technician is as skilled as my ex-students and colleagues (and myself) then I would be not be so keen to rule out false positives. Yes there is a major issue with false negatives, especially when the swab was not performed or stored correctly. RNA is not very stable and it is very easy to destroy all the viral RNA if you are not careful.

alkonaut 7y ago

Were they testing for the virus or for antibodies? If it was testing for the virus tests only show positive for a few days then testing everyone on board will miss those who already had it, correct?

greedo 7y ago
According to the Captain's email, sailors were tested, and results known the next day. I don't know what equipment they had onboard the Roosevelt, but the quick turnaround might indicate the type of test. These tests were also performed around Mar29.
- alkonaut 7y ago
  Sounds like RT-PCR tests. Serological tests probably aren’t available in that scale yet (unsure). Regardless, it’s going to be extremely interesting now that countries start doing random serological tests. I read today about a group of Swedish athletes who visited a competition in Wuhan in October and some developed severe respiratory issues afterwards that couldn’t be diagnosed. Edit: 5 were tested and 1 was positive which was interpreted as being a later infection. So no October infection.

scythe 7y ago

Do we know if these cases are truly asymptomatic or just presymptomatic as was observed on the Diamond Princess? 48% asymptomatic initially: https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-... 18% asymptomatic retrospectively: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/ Also, 58% of asymptomatic COVID-19 infections still show damage to the lungs on CT: https://appliedradiology.com/articles/study-investigates-diamond-princess-cruise-ship-covid-19-findings https://appliedradiology.com/articles/study-investigates-dia...

danieltillett 7y ago
Do you know any studies of the outcome of the 32 Diamond Princess patients that were the ICU at the time the boat was emptied? I have been looking and I can’t find any data on what was the final clinical outcome of all patients on the Diamond Princess?
- iso947 7y ago
  Wiki said there have been 14 deaths so far, most recently just 3 days ago.
  - danieltillett 7y ago
    It seems they are only tracking the Japanese deaths. It doesn’t seem like anyone is tracking the seriously ill who were transported home, or those that became ill once they got home. Even on these incomplete number the true death rate is 2%.
- scythe 7y ago
  I know this is a rather unorthodox source, but 538 reports a death rate of 1.2%. https://fivethirtyeight.com/features/a-comic-strip-tour-of-the-wild-world-of-pandemic-modeling/ https://fivethirtyeight.com/features/a-comic-strip-tour-of-t...

btilly 7y ago

This figure does not surprise me. It is in line with Iceland finding that 50% of people they tested were asymptomatic. However as https://www.propublica.org/article/what-we-need-to-understand-about-asymptomatic-carriers-if-were-going-to-beat-coronavirus https://www.propublica.org/article/what-we-need-to-understan... notes, in other samples about 75% of people who were asymptomatic at the time of the test went on to develop symptoms. So the fact that these sailors are currently asymptomatic does not mean that they will remain so. See https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/ https://www.cebm.net/covid-19/covid-19-what-proportion-are-a... for more on how different data points are all over the place.

lbeltrame 7y ago
Are there any data on the severity of the symptoms? From what I've gathered, but without any hard data, in non-severe cases (i.e. not needing hospitalization) they can vary from a slight sore throat, dry cough and mild fever, to the same with a high fever and general sense of exhaustion.
- lazyasciiart 7y ago
  Non-severe covers bronchitis, pneumonia, etc. My friend (who tested positive but was not hospitalized) described it as "chest pain, difficulty breathing, if I do something silly like walk 10 feet to the kitchen I get lightheaded and hold on to the wall" - for about ten days.
  - acdha 7y ago
    The question I had was whether there’s a connection between delay and severity: if you’re one of those asymptomatic cases for a week or two, how does that change the likelihood of ending up on the worse end of the spectrum?
  - ajross 7y ago
    What has gone wrong with this site? Why is this comment grayed out form downvotes? It's a straightforward testimony of real experience, and it doesn't even vary significantly form the consensus set of symptoms. I see this all the time, on a site that used to be a really good spot for rational discussion.

Mikeb85 7y ago

All the data points to the fact that coronavirus is more widespread and less deadly than most outlets are reporting (after all, increase the denominator, the % goes down). The countries with the lowest death rates are also the countries that did the most comprehensive testing. Ditto for this aircraft carrier. Of course governments and outlets are fearmongering lest they be accused of not doing enough, but this thing is way overblown and I fear we'll be living with the consequences for an entire generation.

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coherentpony 7y ago
Are you of the opinion that this is simply just a slightly worse flu? > All the data points to the fact that coronavirus is more widespread and less deadly than most outlets are reporting You couldn't be more wrong. There are nurses and doctors working on the front lines dealing with patients, and they're completely and utterly overloaded. Lack of resources. Lack of help from local and federal governments. They're the ones telling us this is way more deadly than it seems.
- Mikeb85 7y ago
  > Are you of the opinion that this is simply just a slightly worse flu? I mean I'm about 95% sure I already had it. Had literally every single symptom but the local health authority (Alberta, Canada) wouldn't test me. My SO had it worse but again, they wouldn't test her. Felt like a worse flu + more coughing and shortness of breath. Worse fever. My symptoms were bad for about 3 days, then felt like a cold for about a week, then a cough stuck around another week or two after. My SO had bad symptoms for about a week, was moderately sick for another week and a bit, but her symptoms disappeared pretty quickly afterwards. In either case, because we didn't require hospitalisation, AHS wouldn't test us. Anyhow, there's a massive body of evidence that there's many times more people infected than confirmed cases. Are you disputing that? Do you actually think there is no one infected other than confirmed cases? Our health authority, until a few days ago, wouldn't test anyone that wasn't a severe case or an at-risk group... You could literally have every single symptom and they'd simply tell you to stay home. Now they've only expanded testing because there's way less hospitalisations than their models predicted... Edit > There are nurses and doctors working on the front lines dealing with patients, and they're completely and utterly overloaded. Lack of resources. Lack of help from local and federal governments. Maybe that's a failing of your health care system? In Canada hospitalisation rates are way less than predicted. Our province also gave away a bunch of PPE because it doesn't appear as though they'll get used. Edit 2 - described more symptoms

ivoras 7y ago

Adding to that, Netherlands' study of antibodies in blood donors' samples shows about 10x difference between the number of reported / tested cases and actual cases in the general population (i.e. a lot more people got it and were not sick): https://www.nytimes.com/reuters/2020/04/16/world/europe/16reuters-health-coronavirus-netherlands-study.html https://www.nytimes.com/reuters/2020/04/16/world/europe/16re...?

feral 7y ago
The Netherlands has 3.3k deaths vs 29k confirmed cases, which would give a CFR of ~10% I.e. the Netherlands aren't testing much. A 10x reduction there brings it back to the CFR range we see in countries with bigger testing programs. I'm not a specialist but have been following this for a while, and have yet to see evidence the IFR for this isnt around 0.5-1% (assuming decent healthcare). That's what we saw in the Diamond Princess data, and a bunch of other places.
- Gibbon1 7y ago
  My current bet is younger healthy people are more likely to be asymptomatic. And older people much less so. Theodore Roosevelt with likely a young population, most are asymptomatic. Diamond Princess much older population most are symptomatic.
  - alexbanks 7y ago
    This is a thing I've been thinking about a lot. We're quick to say "We're not testing enough", but also quick to throw statistics around "disproving" the amount of asymptomatic cases. I am on the side of "It's probably orders of magnitude widespread than most countries think", and the number of totally asymptomatic cases is actually far far higher. You can't test only the old and the already sick and then accurately assess likelihood to develop symptoms. Your sample is totally wrong.
    - feral 7y ago
      Humanity's understanding of this disease is much more sophisticated than the two comments above this would imply. Researchers are not stupidly looking at Diamond Princess and getting confused because the population is old. Rather it's a powerful dataset because it enables us to quantify the asymptomatic people of all ages, because people were tested fairly exhaustively before being allowed leave, regardless of symptoms, and because we've had enough time for many of the cases to play out. The diamond princess data revealed a large number of asymptomatic cases in China, the absence of which were skewing the detected cases in China much older. Anyway, you don't need to think anything complicated about correcting for ages, etc You can just look at the data from the Netherlands where they conclude they have 3% population infection, by looking at the random serological testing, and then look at the number of confirmed deaths they have, and do the very simple math. It's very hard to do that and then say we're missing say 10x higher numbers of asymptomatic cases all over the place. This blog post I wrote a while back is Ireland specific but has figures on CFR and IFR I think are still valid, and references to the academic articles I got them from: https://medium.com/@fergal.reid/predicting-the-impact-of-coronovirus-on-ireland-bff1b6d00d6a https://medium.com/@fergal.reid/predicting-the-impact-of-cor...

icedchai 7y ago

Nothing new here. People were talking about asymptomatic spread by younger people for months. Why is Esper surprised?

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mrfusion 7y ago

Could past infections from other corona viruses be Protecting people? I’d like to see research on that.

vardump 7y ago
Like https://en.wikipedia.org/wiki/Human_coronavirus_NL63 https://en.wikipedia.org/wiki/Human_coronavirus_NL63. "Human coronavirus NL63 (HCoV-NL63) is a species of coronavirus that was identified in late 2004 in a seven-month-old child with bronchiolitis in the Netherlands.[1] The virus is an enveloped, positive-sense, single-stranded RNA virus which enters its host cell by the ACE2 receptor." To add, I also wonder whether those with contacts to disease super spreaders (aka toddlers in kindergarten) have better immunity against covid-19, just by being previously infected by other coronaviruses. Possibly some currently unknown ones as well.

paypalcust83 7y ago

There are multiple, dynamic risk-factors being discovered, treatment options, and different genomes of this species of virus circulating. 1) Being overweight is a major risk-factor for requiring critical care, and most US military folks aren't weight-enabled. 2) Being older is another risk factor. Also, most US military folks aren't well-aged either, typically in their 20's-30's. 3) Having type A blood group is a potential risk factor. Type O blood group is a potential protection factor. 4) Being male was a risk-factor for the L-strain. It's possible the military folks caught an S-strain that has less gender specificity, but it also may have nothing to do with it. 5) SARS-CoV-2 as a species maybe drifting genetically towards more communicability but less virulence. H1N1, HIV and others have also shown this pattern. 6) COVID-19 may not be best helped with non/invasive high-pressure ventilation that causes extreme barotrauma. In fact, it may not even be the same as previous instances of ARDS. 7) It's possible they were exposed to a variant of one of the newer genomes of S-strain that goes up to 78% "asymptomatic" community spread. 8) "Asymptomatic" means subclinical in terms of manifested, obvious symptoms. There is still the real possibility of internal organ damage regardless. Only a vaccine will be able to end this threat.

empath75 7y ago
> 5) SARS-CoV-2 as a species maybe drifting genetically towards more communicability but less virulence. H1N1, HIV and others have also shown this pattern. This is not true for either of those diseases.

manfredo 7y ago

Random testing in Germany has also revealed higher than expected rates of people with antibodies. Their IFR (infected fatality rate) was 2% overall based on non-random testing. Random testing has yielded an IFR or 0.37%. This does not increase the risk. These tests only test people who had coronavirus. The larger this portion, the more herd immunity there is in the population. It implies that there were a larger than expected number of people who had the virus, at some point in time. But that's a lagging indicator.

jaynetics 7y ago
The lower rate was calculated based on only 7 or 8 fatalities. Also the people in Gangelt, where that test was carried out, are significantly younger than the average German. Their share of people over 75 is 17% below the national average.
- arcticbull 7y ago
  That isn't what I saw when I looked up their demographics, it looked roughly in line, skewing older even. [1] They had 12.8% over 75 as compared to for instance, 9% in Frankfurt [2]. Also in a population of 10,000-ish the number of fatalities would have to be by definition closer to 40. [1] https://www.citypopulation.de/en/germany/census/nordrhein_westfalen/05370008__gangelt/ https://www.citypopulation.de/en/germany/census/nordrhein_we... [2] https://www.citypopulation.de/en/germany/hessen/frankfurt_am_main/06412000__frankfurt_am_main/ https://www.citypopulation.de/en/germany/hessen/frankfurt_am...
  - jaynetics 7y ago
    Well, you divided the much lower 2011 population by the size of an age group in 2018, and compared that with a random city? For the German average, see https://cdn.britannica.com/34/184234-050-91AEB8AF/age-breakdown-bar-graph-Germany.jpg https://cdn.britannica.com/34/184234-050-91AEB8AF/age-breakd...
system2 7y ago
If 0.37% is true, why are the hospitals in this shape?

JPKab 7y ago

Might also be important to note that sailors on an aircraft carrier are primarily college-aged.

tropo 7y ago
Also 0% with asthma, obesity, diabetes, etc.
- rootusrootus 7y ago
  Not true. For various reasons, the military grants medical waivers and allows some people with asthma and other afflictions to remain enlisted.
  - dguaraglia 7y ago
    Yeah, but that number is going to be way lower than the average population.
  - jki275 7y ago
    Asthma, no. Diabetes, no. There is not a single person on that ship with either, they’re both disqualifying from shipboard service. There are probably some people who are overweight to a varying degree, but again people who get overweight and don’t get back within standards get removed from the Navy.
rootusrootus 7y ago
~50% of enlisted sailors are 25 or younger, with each successive age bracket getting smaller. For officers it is more like ~13% and it's evenly distributed by age bracket.

JetBen 7y ago

This was a bioweapon launched against us by the evil Chinese Communist party. We just watched China murder over 145,000 people. We must punish their horrible regime severely!

twomoretime 7y ago

Now hopefully we can get a better estimate of the range of the latent period. That these cases are asymptomatic does not mean they won't show symptoms at some later date. It also does not mean they are invulnerable to reinfection, and if this virus indeed has Antibody Dependent Enhancement like SARS, this could create an extremely dangerous setup for a second wave with a significantly higher, order of magnitude, death rate. All of the bits and pieces are floating around in papers, hopefully they won't be confirmed like everything else that started as errant literature.

dboreham 7y ago

People reading here may be interested in recent UK statistical office data, analyzed here: https://youtu.be/F39kVKSCP40 https://youtu.be/F39kVKSCP40 This is data that examines among other things the overall death rate irrespective of reported cause.

syntaxing 7y ago

Is it possible that more people are asymptomatic because the sample population is more athletic? I would imagine there's a certain physique that's maintained and required for the military.

gdubs 7y ago

Stanford’s study should give us more info soon. They recently screened a decent sized group in Santa Clara County to get a sense of how widespread it is, using their newly developed finger-prick test which looks for both antigens and antibodies (whether you have it / had it and recovered). Currently the test is being prioritized for frontline healthcare workers while they work on scaling up: https://www.stanforddaily.com/2020/04/04/stanford-researchers-test-3200-people-for-covid-19-antibodies/ https://www.stanforddaily.com/2020/04/04/stanford-researcher...

zephyrnh 7y ago
It's been 12 days since they tested everyone. My understanding is that the results for serological tests are available right away, so I was expecting them to publish results within a few days. Any idea why they haven't yet?
- usaar333 7y ago
  Perhaps they can't get statistical significance. You'd ballpark a 0.5% infection rate in the Bay Area going by deaths and current best guesses for IFR. Your false positive rate might exceed that. These tests are better done in highly infected areas like NYC.
  - oldgradstudent 7y ago
    > current best guesses for IFR The entire point of the study is that we don't have good estimates of the IFR.
    - usaar333 7y ago
      We have randomized PCR studies and ships where everyone got tested. Yes, there is error there (false negatives), but there's an upper bound to how much there can be.
- xorfish 7y ago
  They would need to collect data again now to get a better result. Otherwise the data is the same as on the day the test was made.

jyounker 7y ago

We can't tell anything from the article. * We don't know how many people were tested. * We don't know how many people tested positive. * We don't know the false positive rate for the test.

badfrog 7y ago
> We don't know how many people were tested. > We don't know how many people tested positive. Both of those are in the article.

asdf21 7y ago

I'm calling it now, I bet many people (>20%) have had it, whether they realize it or not. To be honest, I think it was all over the Bay Area in late December, Early January (when I'm pretty sure I had it) and Feb.

adjkant 7y ago
Given that Wuhan did not even report its first case publicly until the 31st, this seems highly unlikely. Even if you believe China was 15-30 days behind in reporting (pushing it) and that somehow a near patient zero traveler from there ended up in the bay, having it spread to "all over the bay" levels by late December would be incredibly contagious. No timeline supports your claim here. https://www.who.int/news-room/detail/08-04-2020-who-timeline---covid-19 https://www.who.int/news-room/detail/08-04-2020-who-timeline...
JshWright 7y ago
How do you explain the hospitalization rate not climbing until a couple months later?
- phkahler 7y ago
  There are 2 strains?
  - JshWright 7y ago
    That would be a very obvious thing to detect (and we have not seen evidence of that).
    - serf 7y ago
      evidence of what? two separate strains? this paper mentions two strains[0], 'L' and 'S' type, was it refuted? [0]: https://academic.oup.com/nsr/article/doi/10.1093/nsr/nwaa036/5775463 https://academic.oup.com/nsr/article/doi/10.1093/nsr/nwaa036...
      - 7y ago

aazaa 7y ago

Nowhere does the article mention which kind of test was run. Was it qPCR or serological? The latter tests whether you have had an infection. The former tests whether you currently have one. The distinction between presymptomatic and asymptomatic is tricky as well, but is less of an issue with a serological test than a qPCR.

ngcc_hk 7y ago

Is this related to the three strain theory?

deleted 7y ago

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surge 7y ago

This was what was coming out when it was blowing through China, this was what the big concern back February. This isn't news. A good deal of people will never notice they have it which is why the spread of this thing is so difficult to contain. I guess maybe people doubted it really was that hard to stop or were not paying attention before, but its why its is absolutely critical everyone isolate even without symptoms.

nednar 7y ago

It's the first time I see news about the aircraft carrier. Could someone summarize why the captain got fired for testing his whole crew in an environment where a lot of people have to live very closely together? My first assumption is that it was a really good decision.

WrtCdEvrydy 7y ago
He sent an email to his commander and his commander's commander about how the situation was deteriorating... which were then leaked to the press and was promptly relieved of command by Acting Navy Secretary Thomas Modly who later on resigned. Most people think it was a good call but it also may have compromised the safety of the carrier because now it's known they may be operating under less than perfect condition.
- khuey 7y ago
  The Washington Post managed to get the original letter: https://twitter.com/DanLamothe/status/1250840016806445056 https://twitter.com/DanLamothe/status/1250840016806445056 It's pretty clear he was canned by a political appointee for political reasons.
  - philwelch 7y ago
    Yes and no. He was relieved because he went around the chain of command, which is a universal career-ending move in the military even if you do it for all the right reasons—which he did. Also, although he was relieved of command, he wasn’t “fired” or “canned” or discharged from the Navy. He will undoubtedly go into an early retirement with a full pension at his current rank of Captain. That doesn’t change the fundamental unfairness of how he’s been treated, but he’s going to be fine. And I think he knew and accepted the consequences of his actions.
    - michaelt 7y ago
      Do you mean e-mailing your commander's commander is a universal career-ending move in the navy? Or was he discharged on evidence or assumption he leaked to the press himself?

dcaisen 7y ago

Is there any info on the sensitivity/specificity of this test and/or on how they confirm that positive results aren't false positives?

vrtx0 7y ago

IMHO, this article is intentionally misleading. The incubation period is currently estimated to be 2-14 days (mean is 5.6 days per CDC, similar per WHO). The article doesn’t mention any dates or time frames, but does mention: ”Roughly 60 percent of the over 600 sailors who tested positive so far have not shown symptoms of COVID-19” — note how “so far” is ambiguous in that sentence. It also states, “The Navy’s testing of the entire 4,800-member crew of the aircraft carrier - which is about 94% complete...”, which seems to indicate nowhere near enough time has elapsed to draw any sort of conclusion. This paper [1] found that testing of all pregnancy patients in a hospital yielded 34% asymptomatic cases. That number drops to 8% “shortly after discharge”, and could be lower than 8% (Again, no timeframe is stated). [1] https://www.sciencedirect.com/science/article/pii/S2589933320300483 https://www.sciencedirect.com/science/article/pii/S258993332...

nostromo 7y ago
Just as one data point, the captain of the ship raised alarms about the virus spreading late last month. So it’s not exactly a recent outbreak. Of course, without testing from that period it’s impossible to know.
- fragmede 7y ago
  The general public may have had little to no access to testing back then, but the military certainly did. They may choose not to release numbers from back then, but the limited testing capacity existed is, IMO, quite justifiably used on people in the military. There’s plenty to criticize about the country’s response but lack of testing in the military isn’t one Of them, at least not relative to the broader (lack of) availability of testing to the wider public .
- xorfish 7y ago
  If the virus spreads exponentially, you would expect most cases to be presymptomatic at any given time.
  - Traster 7y ago

thesz 7y ago

Let me cite full abstract of the research on CT scans of symptom-free COVID-19 patients [1] Purpose To evaluate the chest CT findings in an environmentally homogeneous cohort from the cruise ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19). Materials and Methods This retrospective study comprised 104 cases (mean age, 62 years ± 16, range 25-93) with COVID-19 confirmed with RT-PCR. CT images were reviewed and the CT severity score was calculated for each lobes and the entire lung. CT findings were compared between asymptomatic and symptomatic cases. Results Of 104 cases, 76 (73%) were asymptomatic, 41 (54%) of which had lung opacities on CT. Other 28 (27%) cases were symptomatic, 22 (79%) of which had abnormal CT findings. Symptomatic cases showed lung opacities and airway abnormalities on CT more frequently than asymptomatic cases [lung opacity; 22 (79%) vs 41 (54%), airway abnormalities; 14 (50%) vs 15 (20%)]. Asymptomatic cases showed more GGO over consolidation (83%), while symptomatic cases more frequently showed consolidation over GGO (41%). The CT severity score was higher in symptomatic cases than asymptomatic cases, particularly in the lower lobes [symptomatic vs asymptomatic cases; right lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-4); left lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-3); total score: 7 ± 5 (1-17) vs 4 ± 2 (1-11)]. Conclusion This study documented a high incidence of subclinical CT changes in cases with COVID-19. Compared to symptomatic cases, asymptomatic cases showed more GGO over consolidation and milder extension of disease on CT. [1] https://pubs.rsna.org/doi/full/10.1148/ryct.2020200110?fbclid=IwAR10SZ4I0ORtt5eu9wz55JaMJLfeRhg-mgfNsABwnbksoSClINKVXvHA7OU& https://pubs.rsna.org/doi/full/10.1148/ryct.2020200110?fbcli... One with asymptomatic illness very probably (3/4) will get lungs damage.

kavalg 7y ago
When you say damage, do you mean permanent damage? Or maybe it is still not clear?
- officialjunk 7y ago
  permanent https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w...
  - 7y ago

misja111 7y ago

This is not news. The same was already reported one month ago in the Italian village of Vo, where the entire population was tested for Corona. Summary is here: https://www.bmj.com/content/368/bmj.m1165 https://www.bmj.com/content/368/bmj.m1165 "In an open letter to the authorities in the Tuscany region,1 Romagnani wrote that the great majority of people infected with covid-19—50-75%—were asymptomatic, but represented “a formidable source” of contagion." In the same report was another interesting paragraph as well: He noted that Romagnani’s findings appeared to contradict a WHO report based on covid-19 in China.2 This suggested that “the proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.” edit: really, downvoted? Because of the mentioning of China?

buboard 7y ago

There's another air craft carrier in france where 1/3 of soldiers got it. That said, soldiers everywhere are young and healthy , and usually vaccinated extra

LatteLazy 7y ago

While this is interesting... * Sailors are not in any way representative of the general population. * Sailors in the US Navy are notoriously overworked and there is a strong culture of working when sick. So we're they actually asymptomatic or did they report for work shivering and sweating and semi delerious?

Bombthecat 7y ago

Super healthy trained people can fight the virus easier? Who would have thought...

rezeroed 7y ago

Clue to what? Are we still pretending this isn't an old people, unhealthy people sickness?