Covid-19: four fifths of cases are asymptomatic, China figures indicate: Is economic meltdown a price worth paying to halt or delay what is already amongst us?

The BMJ ^ | 04/05/2020 | Michael Day

[SeekAndFind]

New evidence has emerged from China indicating that the large majority of coronavirus infections do not result in symptoms.

Chinese authorities began publishing daily figures on 1 April on the number of new coronavirus cases that are asymptomatic, with the first day’s figures suggesting that around four in five coronavirus infections caused no illness. Many experts believe that unnoticed, asymptomatic cases of coronavirus infection could be an important source of contagion.

A total of 130 of 166 new infections (78%) identified in the 24 hours to the afternoon of Wednesday 1 April were asymptomatic, said China’s National Health Commission. And most of the 36 cases in which patients showed symptoms involved arrivals from overseas, down from 48 the previous day, the commission said.

China is rigorously testing arrivals from overseas for fear of importing a fresh outbreak of covid-19.

Tom Jefferson, an epidemiologist and honorary research fellow at the Centre for Evidence-Based Medicine at the University of Oxford, said the findings were “very, very important.” He told The BMJ, “The sample is small, and more data will become available. Also, it’s not clear exactly how these cases were identified. But let’s just say they are generalisable. And even if they are 10% out, then this suggests the virus is everywhere. If—and I stress, if—the results are representative, then we have to ask, ‘What the hell are we locking down for?’”

Jefferson said that it was quite likely that the virus had been circulating for longer than generally believed and that large swathes of the population had already been exposed.

Users of Chinese social media have expressed fears that carriers with no symptoms could be spreading the virus unknowingly, especially now that infections have subsided and authorities have eased curbs on travel for people in previous hotspots in the epidemic.

Zhong Nanshan, a senior medical adviser to the Chinese government, said that asymptomatic infections would not be able to cause another major outbreak of covid-19 if such people were kept in isolation. Officials have said this is usually for 14 days.

Nanshan said that once asymptomatic infected people were identified, they and their contacts would be isolated and kept under observation.

Citing classified data, the South China Morning Post said that China had already found more than 43 000 cases of asymptomatic infection through contact tracing.

The latest findings seem to contradict a World Health Organization report in February that was based on covid-19 in China. 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.”1

But since that WHO report other researchers, including Sergio Romagnani, a professor of clinical immunology at the University of Florence, have said they have evidence that most people infected by the virus do not show symptoms. Romagnani led the research that showed that blanket testing in a completely isolated village of roughly 3000 people in northern Italy saw the number of people with covid-19 symptoms fall by over 90% within 10 days by isolating people who were symptomatic and those who were asymptomatic.2

In an article on the website of the Centre for Evidence-Based Medicine, Jefferson and Carl Heneghan, director of the centre and editor of BMJ EBM, write, “There can be little doubt that covid-19 may be far more widely distributed than some may believe. Lockdown is going to bankrupt all of us and our descendants and is unlikely at this point to slow or halt viral circulation as the genie is out of the bottle.

“What the current situation boils down to is this: is economic meltdown a price worth paying to halt or delay what is already amongst us?”3

References

1. ↵
   World Health Organization. Report of the WHO-China Joint Mission on coronavirus disease 2019 (COVID-19). 2020. https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf.
2. ↵
   1. Day M

   . Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village. BMJ2020;368:m1165. doi:10.1136/bmj.m1165 pmid:32205334

   OpenUrlFREE Full Text
3. ↵
   Jefferson T, Hennegan C. Covid-19—The tipping point? Mar 2020. Centre for Evidence-Based Medicine. Mar 2020. https://www.cebm.net/2020/03/covid-19-the-tipping-point.

View Abstract

[xkaydet65]

In NY. NJ it’s 60% negative. But we only test multi symptom or known direct contact. Now however if you call with fever and shortness of breath you are presumed to have it and not tested unless you need the hospital. You are told to Q for 14 days with anyone in the household and monitor changes in symptoms. I know two people who are in that mode now.

[zipper]

Great idea, let’s just give in and let a couple of million Americans die, so we can all have immunity.

Think of how many suicides would be prevented!

By the way, you go first. Go lick a toilet, and get back to me in two weeks.

[Paladin2]

We need mortality rates bases on all of those infected[of well selected samples], not just those tested “because symptoms” by age cohort to correctly assess risk.

That will, by definition, involve even more negative test results.

We can spend billion$ on testing and avoid spending trillion$ to fix much that isn’t broken.

[GrandJediMasterYoda]

I think in a few more weeks this will be all over with. Already it’s slowing down, but the thing is what are democrats going to try after this? Are they going to set off a nuke? They are getting more and more desperate to get Trump out of office, nothing seems to work so they are taking more and more radical actions. If they colluded with China to start a pandemic, why not collude with Russia to nuke the country?

[BunnySlippers]

What is a BJM? Does nit sound like a periodical.

[Paladin2]

"US peak is around 15 April"

NOT in every geographical location ---> NOT at every hospital.

That date is based on the weight of NYC.

[Paladin2]

"Already it’s slowing down"

NO, not everywhere. Some States are now scheduled to peak in the middle of May.

[datura]

China got the less virulent version, but sent the finished one to Italy and the US.

Everyone needs to read the genome sequencing report.

This source article has Panda all over it.

[abigkahuna]

Test as many as possible and give HCQ as prophylactic to whoever requests it from their physician.

---

Totally agree. My wife and I would take it if it meant we could get back to work at fairs. Although there are side effects for those with heart conditions.

My thinking is to provide HCQ to all the ill asap to reduce the need for ventilators. I mean once you get on those things, the chances you surviving is not good. Why not use HCQ now...If it works, it works...if it doesn’t then no better off...

[SeekAndFind]

RE: China got the less virulent version, but sent the finished one to Italy and the US.

That is, if you believe the infection and death rate figures from China.

Not even the Wuhan citizens believe this.

[BradyLS]

Right. ...But I am trying giving credit to folks for keeping places like grocery stores, gas stations, etc., open, stocked, and the engine for essential good and services going during this time. And that, I think, is not inconsiderable.

[SeekAndFind]

RE: give HCQ as prophylactic to whoever requests it from their physician.

You are assuming that physicians would DARE to prescribe it as prophylactic. Many states don’t allow this application of HCQ at all. Physicians will be reluctant to endanger their license to practice.

[Atticus]

Chinese evidence? No thanks. Start testing Americans for antibodies now! And remind everyone that in late February the revered Dr. Fauci said the risk to the U.S. was “minuscule.”

[KeyLargo]

“What is known is that more than 647,000 people per year die from heart disease in this country, according to the CDC; and more than 599,000 die from cancer.
What is also obvious is that many if not most Americans are now living in fear of the newest disease to threaten in ways they never lived in fear of those old, established diseases.”

https://mustreadalaska.com/an-infection-of-fear/

[DennisR]

Yeah...you have a valid point there. Plus, in USSR-WA, pot shops are considered to be essential businesses right along with grocery stores, gas stations, ...

[JohnBovenmyer]

BMJ = British Medical Journal. It’s been around 180 years.

[null and void]

CHINESE DATA!</warning label>

Bring Out Your Dead

Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.

The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.

The false positive rate was 100%.

At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.

*sigh* Such is life, and death...

If a quarantine saves just one child's or one old fart’s life, it's worth it.

[SoCal Pubbie]

Do you always post stupid comments, or just when you’re feverish?

[libertylover]

In about 10 days, I think it’s time to isolate NYC and a few other hotspots and for the of us can get back to work.

We have much more to fear from Comrade Mayors and Comrade Governors than we do from the virus, like stomping on our Constitutional rights. Prediction: Comrade Cuomo and Comrade de Blasio will hang onto the powers for as long as they can. Also, they’re not the only ones.

[proxy_user]

As a communist dictatorship, China can say they don’t care how many people die, especially older people, because we’ve got plenty of people.

This obviously wouldn’t fly in a Western democracy.