Asymptomatic vs pre-symptomatic

gabeeg · 21-08-2020 12:17pm #1

There seems to be a large cohort of people on boards who have some of the basics of covid wrong.
It's confusing in fairness when, following the recent outbreaks in factories, the media has often reported that those found to have the virus were asymptomatic.

They're generally just quoting the factory owners though, who of course would say that they're all asymptomatic. They're covering their arses.

Walsh Mushrooms said in a statement this evening that "the level of asymptomatic positive results is a concern for the business" and it is awaiting confirmation of all test results from the HSE.

https://www.rte.ie/amp/1159676/

That's actually to be expected, as most will still be in the incubation period of the disease.

The incubation period of COVID-19, which is the time between exposure to the virus and symptom onset, is on average 5-6 days, but can be as long as 14 days.

https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

I have no idea how many factory workers have gone on to have some symptoms or indeed get very sick, but the good news there is that we haven't seen a spike in hospitalisation.

The largest figure I've seen for asymptomatic rates in a study is 40%
https://www.sciencedaily.com/releases/2020/06/200630103557.htm

So it's safe to say that the majority went on to have a "mild" illness.

For those that are genuinely asymptomatic throughout the duration of their infection, well there's bad news there too.

The study looked at 100 patients (median age of just 49) who recently recovered from Covid-19, most of whom were asymptomatic or had just mild symptoms.

The researchers, who performed MRI scan of their hearts an average of 2 months after they first were diagnosed with Covid-19, uncovered some concerning findings: 78% of patients had ongoing heart abnormalities and 60 percent had myocarditis, inflammation of the heart muscle.

Even more concerning was that the extent of myocarditis was not related to the severity of the initial illness or overall course of the illness.

https://www.google.com/amp/s/www.forbes.com/sites/robertglatter/2020/08/17/covid-19-can-cause-heart-damageeven-if-you-are-asymptomatic/amp/

As the evidence mounts on the potential long-term effects of covid, conversely I'm seeing confidence grow in a lot of people that they are sure to be ok if they get it.
This confidence is misplaced.

Please do all you can to avoid getting this bastard of a virus

FintanMcluskey · 21-08-2020 12:48pm

gabeeg wrote: »

Please do all you can to avoid getting this bastard of a virus

I really must give up sugar, alcohol, occasional smoking, and fatty foods.

We need to get to back to life.

The biggest health effects of the golfing excursion in the west of Ireland was the rich food and pints. Not Covid.

gabeeg · 21-08-2020 12:51pm

Fine. Get back to life.

Just don't be telling everyone it's safe to do so

greenspurs · 21-08-2020 12:52pm

But you can tell everyone how bad it is ?

gabeeg · 21-08-2020 12:58pm

greenspurs wrote: »

But you can tell everyone how bad it is ?

Yeah, I just did.

By all means contradict me. I'd love to be wrong.

greenspurs · 21-08-2020 1:02pm

https://www.rte.ie/news/coronavirus/summary/

27,676 cases.
1,776 covid Related (not all are because OF covid) deaths
3,394 hospitalised.
443 were treated in ICU

On average, in a 'normal' year 30,000 people die in Ireland .
https://statbank.cso.ie/multiquicktables/quickTables.aspx?id=vsa02_vsa09_vsa18

Theres the figures.

gabeeg · 21-08-2020 1:06pm

greenspurs wrote: »

https://www.rte.ie/news/coronavirus/summary/

27,676 cases.
1,776 covid Related (not all are because OF covid) deaths
3,394 hospitalised.
443 were treated in ICU

On average, in a 'normal' year 30,000 people die in Ireland .
https://statbank.cso.ie/multiquicktables/quickTables.aspx?id=vsa02_vsa09_vsa18

Theres the figures.

It's not a binary issue of life and death. I didn't even mention death in my post above, so this doesn't really address any of my points in any way whatsoever.

Have you anything relevant to what I'm talking about or shall we just move on?

lainey_d_123 · 21-08-2020 1:11pm

Hasn't it long been established that a significant proportion of people who test positive are genuinely asymptomatic? As in, never develop any symptoms in the entire 14 day period after the positive test.

FintanMcluskey · 21-08-2020 1:15pm

lainey_d_123 wrote: »

Hasn't it long been established that a significant proportion of people who test positive are genuinely asymptomatic? As in, never develop any symptoms in the entire 14 day period after the positive test.

Yes for a number of months now thats been the case.

Its not so common knowledge in Ireland, the figures released here are smoke and mirrors stuff.

A positive test is not an indication of any ill health

gabeeg · 21-08-2020 1:16pm

lainey_d_123 wrote: »

Hasn't it long been established that a significant proportion of people who test positive are genuinely asymptomatic? As in, never develop any symptoms in the entire 14 day period after the positive test.

Yeah, that's a fact. What percentage though - nobody could accurately tell you yet.
As I posted above, the study with the highest figure I've seen so far is 40%

The other thing to bear in mind is that asymptomatic does not mean unaffected. You can have felt nothing, had no visible symptoms at all but still have considerable damage done to your heart

gabeeg · 21-08-2020 1:23pm

https://twitter.com/AdrianAmcgold/status/1295829080760295424?s=19

https://www.nytimes.com/2020/08/17/opinion/covid-19-heart-disease.html#click=https://t.co/OySMJpybbJ

FintanMcluskey · 21-08-2020 1:28pm

gabeeg wrote: »

https://twitter.com/AdrianAmcgold/status/1295829080760295424?s=19

https://www.nytimes.com/2020/08/17/opinion/covid-19-heart-disease.html#click=https://t.co/OySMJpybbJ

I hope we don't end up with post influenza hysteria if a vaccine is found for Covid and some of these guys need to stay relevant

Where there's life there's illness

greenspurs · 21-08-2020 2:28pm

gabeeg wrote: »

Yeah, that's a fact. What percentage though - nobody could accurately tell you yet.
As I posted above, the study with the highest figure I've seen so far is 40%

The other thing to bear in mind is that asymptomatic does not mean unaffected. You can have felt nothing, had no visible symptoms at all but still have considerable damage done to your heart

Are you a cardiologist ?

"MAY" … "CAN lead to " … "MIGHT" … etc etc ….

From HSE -
As the CDC5 point out, since asymptomatic persons are not routinely tested, the prevalence of asymptomatic infection and detection of pre-symptomatic infection is not well understood. The WHO1 suggest that based upon the data available, 80% of COVID-19 infections are mild or asymptomatic. An analysis of available data published by the CEBM22 on April 6th suggested that 5% and 80% of people testing positive for SARS-CoV-2 may be asymptomatic

gabeeg · 21-08-2020 2:39pm

greenspurs wrote: »

Are you a cardiologist ?

"MAY" … "CAN lead to " … "MIGHT" … etc etc ….

From HSE -
As the CDC5 point out, since asymptomatic persons are not routinely tested, the prevalence of asymptomatic infection and detection of pre-symptomatic infection is not well understood. The WHO1 suggest that based upon the data available, 80% of COVID-19 infections are mild or asymptomatic. An analysis of available data published by the CEBM22 on April 6th suggested that 5% and 80% of people testing positive for SARS-CoV-2 may be asymptomatic

Mild in a medical context does not mean what you think it means. It just means the person doesn't require immediate hospitalisation.

Oh and you're very selective with what you quote

As the CDC5 point out, since asymptomatic persons are not routinely tested, the prevalence of asymptomatic infection and detection of pre-symptomatic infection is not well understood. The WHO1 suggest that based upon the data available, 80% of COVID-19 infections are mild or asymptomatic. An analysis of available data published by the CEBM22on April 6th suggested that 5% and 80% of people testing positive for SARS-CoV-2 may be asymptomatic, that symptom-based screening will miss cases, perhaps many cases, and that asymptomatic cases may become symptomatic . Similarly, an Evidence Summary from HIQA published on 21 April notes the difficulties inherent in identifying truly asymptomatic carriers. There is significant variability in the data arising from the original studies. Much of the data from original studies is derived from closed settings, such as cruise ships, prisons and long term care facilities, which may limit the generalisability. Two American papers have been published regarding older people who are asymptomatic8, 9.

Thanks for helping me make my point. Though that's from back in March.

greenspurs · 21-08-2020 2:49pm

Okie doke ---

Allowing for the flu to show up as Covid on these tests ?

Government spin on Boards, its nothing new.

I know what I prefer to believe.

gabeeg · 21-08-2020 2:53pm

greenspurs wrote: »

Okie doke ---

Government spin on Boards, its nothing new.

I know what I prefer to believe.

Wtf?

You're there one that started quoting a government agency.
Didn't work out well for you, but still, point stands.

It's pretty clear what you'd prefer to believe, unfortunately it's completely and utterly baseless.

Behind your bravado is just denial and fear.

greenspurs · 21-08-2020 3:20pm

gabeeg wrote: »

Wtf?

You're there one that started quoting a government agency.
Didn't work out well for you, but still, point stands.

It's pretty clear what you'd prefer to believe, unfortunately it's completely and utterly baseless.

Behind your bravado is just denial and fear.

Youre the person spinning fear about long term heart damage !
Completely based on government suspicions ?

gabeeg · 21-08-2020 3:35pm

greenspurs wrote: »

Youre the person spinning fear about long term heart damage !
Completely based on government suspicions ?

No, it's from a bunch of doctors based in Germany.

Here's the link to the report
https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

21-08-2020 3:51pm

I seem to have got Covid early in March, but was never tested. Got the extreme breathlessness, low oxygen, fever etc, had travelled. Recovered in 5-6 weeks, although I got a superimposed bacterial infection which responded well to antibiotics. However, I have have subsequent episodes of cardiac arrhythmia, some of it severe and once or twice almost causing me to pass out. I did already have a history of Atrial Fibrillation, but this became more significant during and after my viral infection.

gabeeg · 21-08-2020 3:58pm

[Deleted User] wrote: »

I seem to have got Covid early in March, but was never tested. Got the extreme breathlessness, low oxygen, fever etc, had travelled. Recovered in 5-6 weeks, although I got a superimposed bacterial infection which responded well to antibiotics. However, I have have subsequent episodes of cardiac arrhythmia, some of it severe and once or twice almost causing me to pass out. I did already have a history of Atrial Fibrillation, but this became more significant during and after my viral infection.

Sorry to hear that. Did you not meet the testing criteria back in March?

My partners first cousin (24) is still in a very bad way having caught the virus in March too. Looking like the heart.

Have you found doctors etc receptive to your fears?

21-08-2020 4:55pm

gabeeg wrote: »

Sorry to hear that. Did you not meet the testing criteria back in March?

My partners first cousin (24) is still in a very bad way having caught the virus in March too. Looking like the heart.

Have you found doctors etc receptive to your fears?

I was in a remote African desert when I got sick, then when I came home on a Saturday I phoned the out of hours service and was asked "what do you expect from us?" To which I replied "well you tell me". There was almost zero response, and my own GP was away at the time. I was just told to phone an ambulance if I was worried. When my own GP returned to work some weeks later, after being away due to personal reasons, he was not pleased that I had not been tested. He sent me for a test then, but it was negative. I had by then developed intestinal symptoms and was sent to an ED for CT scan. Another person in my group was unwell also, our first symptoms being loss of taste. We were both complaining that the food had been one ever less tasty as we went into the desert and we put it down to the weather until the illness manifested.

s1ippy · 22-08-2020 10:58am

Paul Cullen put up two articles last night in the Irish Times.

One story interviewing patients:

My recovery is worse than my initial experience
https://www.irishtimes.com/news/health/coronavirus-my-recovery-is-worse-than-the-initial-experience-1.4335815

And one about actual research that's emerging.

Half of Covid-19 pneumonia patients need follow-up care (via @IrishTimes) https://www.irishtimes.com/news/health/half-of-covid-19-pneumonia-patients-need-follow-up-care-1.4335823

By all means tell yourself it's not a big deal and take a gamble with it. I won't, I have this one body for the rest of my life and eating sweets and chips, or getting in the car or on the trampoline isn't going to cripple me in the medium to short term. This really might though. No thanks.

MickeyLeari · 22-08-2020 11:03am

[Deleted User] wrote: »

I seem to have got Covid early in March, but was never tested. Got the extreme breathlessness, low oxygen, fever etc, had travelled. Recovered in 5-6 weeks, although I got a superimposed bacterial infection which responded well to antibiotics. However, I have have subsequent episodes of cardiac arrhythmia, some of it severe and once or twice almost causing me to pass out. I did already have a history of Atrial Fibrillation, but this became more significant during and after my viral infection.

What is the treatment for this? Does it necessitate lifestyle change?

gabeeg · 22-08-2020 11:03am

s1ippy wrote: »

Paul Cullen put up two articles last night in the Irish Times.

One story interviewing patients:

My recovery is worse than my initial experience
https://www.irishtimes.com/news/health/coronavirus-my-recovery-is-worse-than-the-initial-experience-1.4335815

And one about actual research that's emerging.

Half of Covid-19 pneumonia patients need follow-up care (via @IrishTimes) https://www.irishtimes.com/news/health/half-of-covid-19-pneumonia-patients-need-follow-up-care-1.4335823

By all means tell yourself it's not a big deal and take a gamble with it. I won't, I have this one body for the rest of my life and eating sweets and chips, or getting in the car or on the trampoline isn't going to cripple me in the medium to short term. This really might though. No thanks.

I agree on everything there apart from the trampoline bit.

Danger aside, there's no dignity to be had on a trampoline after a certain age. Your face goes all weird.

s1ippy · 22-08-2020 11:04am

gabeeg wrote: »

I agree on everything there apart from the trampoline bit.

Danger aside, there's no dignity to be had on a trampoline after a certain age. Your face goes all weird.

Wear a mask

gabeeg · 22-08-2020 11:05am

s1ippy wrote: »

Wear a mask

God damn you

AUDI20 · 22-08-2020 11:08am

FintanMcluskey wrote: »

I really must give up sugar, alcohol, occasional smoking, and fatty foods.

We need to get to back to life.

The biggest health effects of the golfing excursion in the west of Ireland was the rich food and pints. Not Covid.

You are 100% correct there Fintan

MadYaker · 22-08-2020 11:22am

Deleted User wrote: »

I seem to have got Covid early in March, but was never tested. Got the extreme breathlessness, low oxygen, fever etc, had travelled. Recovered in 5-6 weeks, although I got a superimposed bacterial infection which responded well to antibiotics. However, I have have subsequent episodes of cardiac arrhythmia, some of it severe and once or twice almost causing me to pass out. I did already have a history of Atrial Fibrillation, but this became more significant during and after my viral infection.

This sounds very very similar to a friend of my dad. He tested positive though. I wonder what % of cases have this experience. I can't find much data on it. It would seem to be low enough.

xhomelezz · 22-08-2020 11:30am

MadYaker wrote: »

This sounds very very similar to a friend of my dad. He tested positive though. I wonder what % of cases have this experience. I can't find much data on it. It would seem to be low enough.

I'd say it's gonna take time to see what long term impact covid is causing. But as the other poster said, we have just one body for lifetime to play with.

lainey_d_123 · 22-08-2020 12:15pm

xhomelezz wrote: »

I'd say it's gonna take time to see what long term impact covid is causing. But as the other poster said, we have just one body for lifetime to play with.

But also, mental health is a thing. I've spent 6 months cooped up in a tiny bedroom (bar one awful, stressful trip home to visit my dysfunctional family) and I just can't cope with it anymore. The depression, anxiety and loneliness are starting to outweigh the risk for me now.

gabeeg · 22-08-2020 12:17pm

lainey_d_123 wrote: »

But also, mental health is a thing. I've spent 6 months cooped up in a tiny bedroom (bar one awful, stressful trip home to visit my dysfunctional family) and I just can't cope with it anymore. The depression, anxiety and loneliness are starting to outweigh the risk for me now.

That's awful. Are you at high risk?

lainey_d_123 · 22-08-2020 12:41pm

gabeeg wrote: »

That's awful. Are you at high risk?

Higher than most my age, yes.

owlbethere · 22-08-2020 12:46pm

Does the authorities for public health or those responsible for public health, follow up on people who test positive and are asymptomatic? To establish that they remain asymptomatic throughout the 14 days infectious period?

Away With The Fairies · 22-08-2020 1:42pm

Do people feel better with the word asymptomatic? That's trying to put a positive spin on things again, isn't it.

Yet, there was a link provided here about a doctor in Kildare being asymptomatic and now having heart issues.

Where's the positivity in being asymptomatic?

Pablo Escobar · 22-08-2020 1:55pm

[Deleted User] wrote: »

I seem to have got Covid early in March, but was never tested. Got the extreme breathlessness, low oxygen, fever etc, had travelled. Recovered in 5-6 weeks, although I got a superimposed bacterial infection which responded well to antibiotics. However, I have have subsequent episodes of cardiac arrhythmia, some of it severe and once or twice almost causing me to pass out. I did already have a history of Atrial Fibrillation, but this became more significant during and after my viral infection.

I had similar 1st week of February. GP and lung specialist think it was Covid. I haven’t taken an antibody test or been tested for covid full stop. 6 month on, I still have minor effects. I can’t run for any length of time anymore despite being 34 and quite fit. I manage about 3km when I used to be able to get off to couch and do a 10km run without a second thought. It has majorly improved since the beginning but it’s lingering and seems to have settled at this point. It’s very very frustrating.

FintanMcluskey · 22-08-2020 9:03pm

Away With The Fairies wrote: »

Do people feel better with the word asymptomatic? That's trying to put a positive spin on things again, isn't it.

Yet, there was a link provided here about a doctor in Kildare being asymptomatic and now having heart issues.

Where's the positivity in being asymptomatic?

Bizzare post.

It means your not sick.

Thats a positive. There is a miniscule number of outliers like above.

Would you rather every person that had Covid needed a ventillator

ShineOn7 · 23-08-2020 12:49am

What was the figure on Asymptomatic people in one of the meat packing places again? I remember it was huge

ShineOn7 · 23-08-2020 12:55am

lainey_d_123 wrote: »

But also, mental health is a thing. I've spent 6 months cooped up in a tiny bedroom (bar one awful, stressful trip home to visit my dysfunctional family) and I just can't cope with it anymore. The depression, anxiety and loneliness are starting to outweigh the risk for me now.

Sorry to hear Lainey. You're in London if I'm remembering right?

I've been extremely cautious and limited my social contacts to about 10 people max for 6 months now. In the last week though, like yourself, I've realised I can't maintain this for another 6 months and I'll need to bring my guard ever so slightly down

lainey_d_123 · 23-08-2020 7:45pm

ShineOn7 wrote: »

Sorry to hear Lainey. You're in London if I'm remembering right?

I've been extremely cautious and limited my social contacts to about 10 people max for 6 months now. In the last week though, like yourself, I've realised I can't maintain this for another 6 months and I'll need to bring my guard ever so slightly down

Yep, in London. From March until early August I had pretty much seen nobody but my flatmates. They went home to their families during the summer so had about 8 weeks of literally seeing nobody at all, which on one hand was more relaxing, but on the other I felt like I was starting to go mad from loneliness.

I decided to hold off any meetups when the pubs reopened, and see how things went and give them a chance to implement their distancing and whatnot and do a bit of trial and error. This weekend was the first time I felt confident enough to head out. I met a small group of friends yesterday at a restaurant (outside table, distanced from other groups, only went inside twice for toilet and to pay at the end) and today I met 4 friends at a pub for a few pints, again outside, only going in to get a round and to go to the toilet. Places were very, very quiet inside and well ventilated.

I have to say, my mental health is a LOT better for having met up with people and enjoyed a few drinks and some food. I knew I was suffering from being stuck on my own but didn't realise just how much. This is the first weekend since March that I feel like I've had a proper weekend and actually done stuff. Yes, there is a risk, but I did everything I could - hand gel, washing hands, distancing as much as possible, choosing quiet places to go. I actually do wish I'd relaxed a little sooner - looks like we've missed the best of the weather now but hot weather = crowds and that made me nervous!

TonyMaloney · 24-08-2020 12:03pm

ShineOn7 wrote: »

What was the figure on Asymptomatic people in one of the meat packing places again? I remember it was huge

It was 70 or 80, but if you read the first post in this thread you'll see they most were likely pre-symptomatic.

If there was a large outbreak here and they were all genuinely asymptomatic, then the eyes of the world would be upon us and there'd be all sorts of studies underway.

Uriel. · 24-08-2020 3:04pm

FintanMcluskey wrote: »

Bizzare post.

It means your not sick.

Thats a positive. There is a miniscule number of outliers like above.

Would you rather every person that had Covid needed a ventillator

That's not what asymptomatic means. It means you don't have visible symptoms. It doesn't mean you're not "sick"

FintanMcluskey · 24-08-2020 4:06pm

Uriel. wrote: »

That's not what asymptomatic means. It means you don't have visible symptoms. It doesn't mean you're not "sick"

No thats pre symptomatic, which is no symptoms at testing but leading to illness , asymptomatic means your not ill, you can spread it but you are not Ill

Uriel. · 24-08-2020 5:24pm

FintanMcluskey wrote: »

No thats pre symptomatic, which is no symptoms at testing but leading to illness , asymptomatic means your not ill, you can spread it but you are not Ill

No, pre-symptomatic is the period from infection to onset of symptoms.

Asymptomatic is showing no symptoms during the course of your illness. Neither means you do not have an illness. In both cases you have an illness but during the course of an/the illness, in one you go on to display (overt?) symptoms. The other you don't.

TonyMaloney · 24-08-2020 5:38pm

Uriel. wrote: »

No, pre-symptomatic is the period from infection to onset of symptoms.

Asymptomatic is showing no symptoms during the course of your illness. Neither means you do not have an illness. In both cases you have an illness but during the course of an/the illness, in one you go on to display (overt?) symptoms. The other you don't.

Prexactly!

And in the case of covid, some asymptomatic people can have organ damage

Asymptomatic vs pre-symptomatic

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