12 ms·

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/a

by 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.
  - lbeltrame 7y ago
    I don't know about the US, but usually getting pneumonia here (in normal non epidemic-conditions) gets you at least a visit to the hospital if not straight up hospitalization.
- ineedasername 7y ago
  Pretty much everyone I've heard talk about it that had it without being hospitalized still said it was the worst they've ever felt.
  - goblin89 7y ago
    Don’t you think that anyone who got the “slight sore throat, dry cough and mild fever” or milder symptom variation would be unlikely to get tested or talk about it? The disconnect between the definitions of “mild” as in “passing without hospitalization” and “mild” as in “easy to bear for most people” is part of what grants weight to the message that the new virus is extremely bad even in the mild version. It could be worth applying the falsifiability check here. What are the chances you could hear a message contradicting this observation? I’m going to imagine a possible counter-message and its optics. “I was exposed and got sick, symptoms seemed to match up but they were really weak and not enough to get tested”—this would be unlikely to gain any positive attention. On facts it’d be very unspecific by the nature of it, on emotional level it might seem unfair to the suffering of other patients, from social/mass media point of view it’d just not be news- (or share-) worthy at all. Even if this case was much more common, the message has virtually no chances of ever being expressed and heard under current circumstances. This line of thought, of course, should not lead to a conclusion that the prevailing variation of the virus is really mild. It only points out that the accounts we get the chance to hear may not be enough to judge the general severity of the symptoms.
    - lbeltrame 7y ago
      > Don’t you think that anyone who got the “slight sore throat, dry cough and mild fever” or milder symptom variation would be unlikely to get tested or talk about it? That's my opinion, as well, there's clearly under-reporting of these cases, and that's why specific serological tests are important. Anecdata: a partner of an acquaintance of mine had fever (but rather mild) for a couple of days, then developed anosmia. The doctor told him to stay at home and that's it. He was never tested so the doubt lingers (happened well over a month ago, so one can't discount a flu, either).
Lewton 7y ago
bingo It seems like most everyone keep glossing over the fact that if you have a disease that doubles its infection count every x days, and it takes around x days to show symptoms you would always expect about 50% of infected to be asymptomatic at the time of testing
- ImaCake 7y ago
  I feel that the asymptomatic thing is more wishful thinking in places where infection control has failed. Other countries have shown that you can contain the spread of Covid19, even if there are asymptomatic (or more realistic, low symptom severity) cases.
  - bhouston 7y ago
    We need widespread antigen testing in a place like Italy or NYC or Sweden. Would be so informative.
    - azinman2 7y ago
      Some percent of confirmed recovered cases never develop antibodies it seems.
      - mabbo 7y ago
        Then how did they recover? If your body has no antibodies to the virus then why would the virus ever stop spreading within you?
        frank2 7y ago
        Antibodies are produced by the humoral arm of the immune system, but there is another arm: https://en.wikipedia.org/wiki/Cell-mediated_immunity https://en.wikipedia.org/wiki/Cell-mediated_immunity Basically this other arm tells infected cells to kill themselves, and they comply.
        aaron_m04 7y ago
gopalv 7y ago
> 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. There's also a wide range of symptoms from 102F fever all the way to sp02 dropping below 80, with varying impacts on the health-care infrastructure. At this point, conserving health infrastructure for normal incidence is as much of a problem (i.e even in the best case outcomes, there will be some cases of "stay at home, never catch the disease, but die from delayed response to a stroke"). If the asymptomatic people get immune, then this might drop the other multiplier of the R0. Oof, optimism is hard to come by in these times.
Jommi 7y ago
Yeah, I think we should be more careful with using the word "asymptomatic" as that is quite different from "presymptomatic". AFAIK COVID seems to have some case where people are purely "asymptomatic", but with this current hot topic of symptoms or not, lots of articles are writing about presymptomatic people they assume will be asymptomatic. Confusing.
- takeda 7y ago
  It is, but I don't think the tests are able to tell how long a given person was infected. That two weeks incubation makes a lot of things harder. For example after implementing shelter at home or didn't look like it has much impact, but suddenly after two weeks it became very visible. It makes things scary when we lift stay home, it will take again two weeks, and things can get bad quickly over that time.
  - jmckib 7y ago
    We also don't know yet (or at least I don't) how easily asymptomatic people are able to transmit the infection, which is why I'm perplexed by this quote from the article. > “With regard to COVID-19, we’re learning that stealth in the form of asymptomatic transmission is this adversary’s secret power,” said Rear Admiral Bruce Gillingham, surgeon general of the Navy.
    - gvjddbnvdrbv 7y ago
      The know that presymtomatic people are highly contagious.
      - jmckib 7y ago
        I don't doubt it, but where did you hear that?
        gvjddbnvdrbv 7y ago
        The WHO back in February. Maybe the advice has changed...
cameldrv 7y ago
Agree on the asymptomatic/presymptomatic thing. Also, I'd imagine the doubling time on an aircraft carrier is a lot shorter than in normal society. There are a lot of people packed into very small spaces. Suppose the doubling time on an aircraft carrier is 5 days. That means half your infections are in the 5 day presymptomatic window.
- paul_f 7y ago
  I guess we will know in about a week?
maxerickson 7y ago
It is in line with Iceland finding that 50% of people they tested were asymptomatic. That's imprecisely stated. 50% of the people that tested positive were asymptomatic. Most of the people tested, both in Iceland and on the Theodore Roosevelt, have tested negative. Esper's comments are ridiculous. It's been clear for months that there is some significant degree of asymptomatic spread, it's not new information.
- mrpopo 7y ago
  Yes. Extensive testing was done in Korea and Taiwan in February and the same results came out. With extensive contact tracing, it became clear that asymptomatic cases played a big role in spreading the virus. This data is not different or new, not even better.
  - royroyroys 7y ago
    Patient 31 was very symptomatic and was the cause of first large outbreak
- xorcist 7y ago
  At time of testing. Most of these showed symptoms later on. That's not enough to estimate how that affects the spread of the disease however. What's interesting is how contagious {a,pre}symptomatic people are. They are probably less contagious than people who developed symptoms, but just how much remains to be seen.
nradov 7y ago
Well we'll know whether they were asymptomatic or presymptomatic in about five days after the typical incubation period has passed.
- ajross 7y ago
  The point was more that the "typical incubation period" you are citing seems to be wrong, and not the presentation of the disease. Obviously yes, we'll know more with more data, but that's not an independent variable you're introducing.
  - nradov 7y ago
    What is your basis for claiming that the typical incubation period stated by the WHO is wrong? https://www.who.int/news-room/q-a-detail/q-a-coronaviruses https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
    - ajross 7y ago
      It was the contention to which you were responding, in a conversation which was similarly challenging the WHO (and everyone else's) estimate on the severity. And I was pointing out that you can't do that, logically your argument was a tautology. The same effect you were arguing against would argue against your evidence.
      - nradov 7y ago
        You misunderstood my argument. I made no claim about severity. Merely than in about five days it will be clear which patients were presymptomatic versus asymptomatic.
        iso947 7y ago
        our assumption is something like “45% will show symptoms within 5 days, 5% after 5 days, 50% will not show symptoms in 100 years” If that’s wrong, and it’s 45% in 5 days 45% after 5 days and less than 90 days 10% don’t show symptoms within 100 years That would change things. I’m not aware of any evidence that that is the case.
sharemywin 7y ago
Not to mention. There's a giant filter called basic training which going to skew the numbers. you have a bunch of kids running around in the best shape of there lives and hey what do you know they handle the virus better than average.
- dguaraglia 7y ago
  Bingo.
- capkutay 7y ago
  What about pregnant women? They're known to be more vulnerable to certain types of illnesses (especially viral infections), yet 29 out of 33 pregnant women who tested positive of COVID-19 in NY were still asymptomatic: https://www.medpagetoday.com/infectiousdisease/covid19/85965 https://www.medpagetoday.com/infectiousdisease/covid19/85965
  - enkid 7y ago
    Pregnant women are going to be younger on average, and this affects older people the most. Also, same thing as the comment above says, just because they dont have symptoms now does not mean they will never have symptoms.
  - Scipio_Afri 7y ago
    Women are less effected overall. It is thought it is due to ACE2 receptor distribution in the body being different than men, but they don't know. However there is statistically significant worse outcomes/disease severity for men. Pregnant women basically puts the cap of the upper age at around 40. This disease the virus causes in the body is very much worse for those that are older. The study tested pregnant women admitted to the hospital to give birth. There are a lot of doctor appointments and lab work to check things in their last trimester. So they could've contracted it through those high risk places or routine contact with health care workers who I would say are also high risk. Still, the study showed on admission that they were positive so they probably didn't get it from the hospital, unless on admission actually means some time after. That assumes it might be able to be detected so soon into the infect as well. It is a bit strange in that regard that it is such a high number.
8ytecoder 7y ago
According to a paper published yesterday[1], the pre-symptomatic period is about 2.3 days[2]. [1] https://www.nature.com/articles/s41591-020-0869-5 https://www.nature.com/articles/s41591-020-0869-5 [2] "we inferred that infectiousness started from 2.3 days (95% CI, 0.8–3.0 days) before symptom onset and peaked at 0.7 days (95% CI, −0.2–2.0 days) before symptom onset "
- hcknwscommenter 7y ago
  That's the pre-symptomatic infectious period. Which is not the same as the pre-symptomatic period.
partiallypro 7y ago
My question is, of these asymptomatic people that do go on to have symptoms...how many are so severe that they would have likely missed work or gone to a doctor? I think that is important too. How do we know if a bunch of people have had it, but had such minor symptoms that they just went on about their day? I had a spout of shortness of breath around late Feb - early March, I just chalked it up as allergies. Maybe it was? I have no idea, but how many people that get COVID19 have similar situations where symptoms are so mild they just think it's nothing. That seems important when we look back in time where people weren't on edge and on the look out for any type of symptom. Of course asymptomatic people are going to show symptoms, but does that mean they would have reported it were they not told by a doctor to report anything out of ordinary?
- jacob019 7y ago
  We need widespread home antibody tests. I had a bad chest cold for a month recently, probably just a cold but I sure wish I knew for sure. If I found that I have antibodies I would try to volunteer to help in the fight and donate plasma. It would completely change my behavior, but I may never know unless I get sick as a dog with usual symptoms.
deleted 7y ago
[deleted]

by btilly 7y ago

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.
- lbeltrame 7y ago
  I don't know about the US, but usually getting pneumonia here (in normal non epidemic-conditions) gets you at least a visit to the hospital if not straight up hospitalization.
ineedasername 7y ago
Pretty much everyone I've heard talk about it that had it without being hospitalized still said it was the worst they've ever felt.
- goblin89 7y ago
  Don’t you think that anyone who got the “slight sore throat, dry cough and mild fever” or milder symptom variation would be unlikely to get tested or talk about it? The disconnect between the definitions of “mild” as in “passing without hospitalization” and “mild” as in “easy to bear for most people” is part of what grants weight to the message that the new virus is extremely bad even in the mild version. It could be worth applying the falsifiability check here. What are the chances you could hear a message contradicting this observation? I’m going to imagine a possible counter-message and its optics. “I was exposed and got sick, symptoms seemed to match up but they were really weak and not enough to get tested”—this would be unlikely to gain any positive attention. On facts it’d be very unspecific by the nature of it, on emotional level it might seem unfair to the suffering of other patients, from social/mass media point of view it’d just not be news- (or share-) worthy at all. Even if this case was much more common, the message has virtually no chances of ever being expressed and heard under current circumstances. This line of thought, of course, should not lead to a conclusion that the prevailing variation of the virus is really mild. It only points out that the accounts we get the chance to hear may not be enough to judge the general severity of the symptoms.
  - lbeltrame 7y ago
    > Don’t you think that anyone who got the “slight sore throat, dry cough and mild fever” or milder symptom variation would be unlikely to get tested or talk about it? That's my opinion, as well, there's clearly under-reporting of these cases, and that's why specific serological tests are important. Anecdata: a partner of an acquaintance of mine had fever (but rather mild) for a couple of days, then developed anosmia. The doctor told him to stay at home and that's it. He was never tested so the doubt lingers (happened well over a month ago, so one can't discount a flu, either).

Lewton 7y ago

bingo It seems like most everyone keep glossing over the fact that if you have a disease that doubles its infection count every x days, and it takes around x days to show symptoms you would always expect about 50% of infected to be asymptomatic at the time of testing

ImaCake 7y ago
I feel that the asymptomatic thing is more wishful thinking in places where infection control has failed. Other countries have shown that you can contain the spread of Covid19, even if there are asymptomatic (or more realistic, low symptom severity) cases.
- bhouston 7y ago
  We need widespread antigen testing in a place like Italy or NYC or Sweden. Would be so informative.
  - azinman2 7y ago
    Some percent of confirmed recovered cases never develop antibodies it seems.
    - mabbo 7y ago
      Then how did they recover? If your body has no antibodies to the virus then why would the virus ever stop spreading within you?
      - frank2 7y ago
        Antibodies are produced by the humoral arm of the immune system, but there is another arm: https://en.wikipedia.org/wiki/Cell-mediated_immunity https://en.wikipedia.org/wiki/Cell-mediated_immunity Basically this other arm tells infected cells to kill themselves, and they comply.
      - aaron_m04 7y ago

gopalv 7y ago

> 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. There's also a wide range of symptoms from 102F fever all the way to sp02 dropping below 80, with varying impacts on the health-care infrastructure. At this point, conserving health infrastructure for normal incidence is as much of a problem (i.e even in the best case outcomes, there will be some cases of "stay at home, never catch the disease, but die from delayed response to a stroke"). If the asymptomatic people get immune, then this might drop the other multiplier of the R0. Oof, optimism is hard to come by in these times.

Jommi 7y ago

Yeah, I think we should be more careful with using the word "asymptomatic" as that is quite different from "presymptomatic". AFAIK COVID seems to have some case where people are purely "asymptomatic", but with this current hot topic of symptoms or not, lots of articles are writing about presymptomatic people they assume will be asymptomatic. Confusing.

takeda 7y ago
It is, but I don't think the tests are able to tell how long a given person was infected. That two weeks incubation makes a lot of things harder. For example after implementing shelter at home or didn't look like it has much impact, but suddenly after two weeks it became very visible. It makes things scary when we lift stay home, it will take again two weeks, and things can get bad quickly over that time.
- jmckib 7y ago
  We also don't know yet (or at least I don't) how easily asymptomatic people are able to transmit the infection, which is why I'm perplexed by this quote from the article. > “With regard to COVID-19, we’re learning that stealth in the form of asymptomatic transmission is this adversary’s secret power,” said Rear Admiral Bruce Gillingham, surgeon general of the Navy.
  - gvjddbnvdrbv 7y ago
    The know that presymtomatic people are highly contagious.
    - jmckib 7y ago
      I don't doubt it, but where did you hear that?
      - gvjddbnvdrbv 7y ago
        The WHO back in February. Maybe the advice has changed...

cameldrv 7y ago

Agree on the asymptomatic/presymptomatic thing. Also, I'd imagine the doubling time on an aircraft carrier is a lot shorter than in normal society. There are a lot of people packed into very small spaces. Suppose the doubling time on an aircraft carrier is 5 days. That means half your infections are in the 5 day presymptomatic window.

paul_f 7y ago
I guess we will know in about a week?

maxerickson 7y ago

It is in line with Iceland finding that 50% of people they tested were asymptomatic. That's imprecisely stated. 50% of the people that tested positive were asymptomatic. Most of the people tested, both in Iceland and on the Theodore Roosevelt, have tested negative. Esper's comments are ridiculous. It's been clear for months that there is some significant degree of asymptomatic spread, it's not new information.

mrpopo 7y ago
Yes. Extensive testing was done in Korea and Taiwan in February and the same results came out. With extensive contact tracing, it became clear that asymptomatic cases played a big role in spreading the virus. This data is not different or new, not even better.
- royroyroys 7y ago
  Patient 31 was very symptomatic and was the cause of first large outbreak
xorcist 7y ago
At time of testing. Most of these showed symptoms later on. That's not enough to estimate how that affects the spread of the disease however. What's interesting is how contagious {a,pre}symptomatic people are. They are probably less contagious than people who developed symptoms, but just how much remains to be seen.

nradov 7y ago

Well we'll know whether they were asymptomatic or presymptomatic in about five days after the typical incubation period has passed.

ajross 7y ago
The point was more that the "typical incubation period" you are citing seems to be wrong, and not the presentation of the disease. Obviously yes, we'll know more with more data, but that's not an independent variable you're introducing.
- nradov 7y ago
  What is your basis for claiming that the typical incubation period stated by the WHO is wrong? https://www.who.int/news-room/q-a-detail/q-a-coronaviruses https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
  - ajross 7y ago
    It was the contention to which you were responding, in a conversation which was similarly challenging the WHO (and everyone else's) estimate on the severity. And I was pointing out that you can't do that, logically your argument was a tautology. The same effect you were arguing against would argue against your evidence.
    - nradov 7y ago
      You misunderstood my argument. I made no claim about severity. Merely than in about five days it will be clear which patients were presymptomatic versus asymptomatic.
      - iso947 7y ago
        our assumption is something like “45% will show symptoms within 5 days, 5% after 5 days, 50% will not show symptoms in 100 years” If that’s wrong, and it’s 45% in 5 days 45% after 5 days and less than 90 days 10% don’t show symptoms within 100 years That would change things. I’m not aware of any evidence that that is the case.

sharemywin 7y ago

Not to mention. There's a giant filter called basic training which going to skew the numbers. you have a bunch of kids running around in the best shape of there lives and hey what do you know they handle the virus better than average.

dguaraglia 7y ago
Bingo.
capkutay 7y ago
What about pregnant women? They're known to be more vulnerable to certain types of illnesses (especially viral infections), yet 29 out of 33 pregnant women who tested positive of COVID-19 in NY were still asymptomatic: https://www.medpagetoday.com/infectiousdisease/covid19/85965 https://www.medpagetoday.com/infectiousdisease/covid19/85965
- enkid 7y ago
  Pregnant women are going to be younger on average, and this affects older people the most. Also, same thing as the comment above says, just because they dont have symptoms now does not mean they will never have symptoms.
- Scipio_Afri 7y ago
  Women are less effected overall. It is thought it is due to ACE2 receptor distribution in the body being different than men, but they don't know. However there is statistically significant worse outcomes/disease severity for men. Pregnant women basically puts the cap of the upper age at around 40. This disease the virus causes in the body is very much worse for those that are older. The study tested pregnant women admitted to the hospital to give birth. There are a lot of doctor appointments and lab work to check things in their last trimester. So they could've contracted it through those high risk places or routine contact with health care workers who I would say are also high risk. Still, the study showed on admission that they were positive so they probably didn't get it from the hospital, unless on admission actually means some time after. That assumes it might be able to be detected so soon into the infect as well. It is a bit strange in that regard that it is such a high number.

8ytecoder 7y ago

According to a paper published yesterday[1], the pre-symptomatic period is about 2.3 days[2]. [1] https://www.nature.com/articles/s41591-020-0869-5 https://www.nature.com/articles/s41591-020-0869-5 [2] "we inferred that infectiousness started from 2.3 days (95% CI, 0.8–3.0 days) before symptom onset and peaked at 0.7 days (95% CI, −0.2–2.0 days) before symptom onset "

hcknwscommenter 7y ago
That's the pre-symptomatic infectious period. Which is not the same as the pre-symptomatic period.

partiallypro 7y ago

My question is, of these asymptomatic people that do go on to have symptoms...how many are so severe that they would have likely missed work or gone to a doctor? I think that is important too. How do we know if a bunch of people have had it, but had such minor symptoms that they just went on about their day? I had a spout of shortness of breath around late Feb - early March, I just chalked it up as allergies. Maybe it was? I have no idea, but how many people that get COVID19 have similar situations where symptoms are so mild they just think it's nothing. That seems important when we look back in time where people weren't on edge and on the look out for any type of symptom. Of course asymptomatic people are going to show symptoms, but does that mean they would have reported it were they not told by a doctor to report anything out of ordinary?

jacob019 7y ago
We need widespread home antibody tests. I had a bad chest cold for a month recently, probably just a cold but I sure wish I knew for sure. If I found that I have antibodies I would try to volunteer to help in the fight and donate plasma. It would completely change my behavior, but I may never know unless I get sick as a dog with usual symptoms.

deleted 7y ago

[deleted]