- Asymptomatic means that patients don’t exhibit any symptoms for the virus
- Experts state that asymptomatic patients involve people from all age groups
- Asymptomatic can transmit the virus as much as the symptomatic patients
New Delhi: Amrik Sukhdev dhaba was founded way back in 1956 mainly to cater to the needs of truck drivers. Strategically located on the GT road, national highway 1, today it is a major landmark and is often tagged as one of the busiest dhabas. The biggest draw is its sumptuous Indian as well as Chinese offerings that can satiate the hunger of any traveller on the route. Located about 70 km away from Delhi, this eatery is also one of the major food destinations for all Delhiites looking to venture out for a long drive out of the city. But in these times of coronavirus, this very popular dhaba has become a spot for a recent outbreak of covid-19. Many of its employees have been tested positive for coronavirus infection.
According to the officials, all patients were asymptomatic and did not exhibit any sign of the highly contagious virus, such as, cough, fever, tiredness, breathlessness, loss of taste or smell among many other symptoms. This meant that these employees continued to work even after they contracted the virus. Apart from Sukhdev Dhaba, another famous restaurant located on the same highway – Garam Dharam workers have also now tested positive for coronavirus.
According to the official figures, during the time when all its 75 COVID infected workers were working in both the popular dhabas at least 10,000 people visited these restaurants, which have now been sealed. Currently, official guidelines have been passed and it people who recently visited the two popular eateries in Murthal have been asked to immediately self-isolate and get themselves tested after a couple of days.
According to the health experts, asymptomatic carriers are a huge challenge for any country for the simple reason that people infected with the virus don’t even know they have it and therefore unknowingly may infect many others. Moreover, according to Dr Raman R Gangakhedkar, a senior scientist at the Indian Council of Medical Research (ICMR), more than 80 per cent of the cases in india are asymptomatic.
There has been A continuous debate on whether the asymptomatic carriers are as vulnerable as symptomatic carriers or can they transfer as much virus as any other symptomatic patient? Over the last few months, scientists from across the world have collected a number of new insights.
Here are a few things that is now known about asymptomatic COVID-19 carriers:
1. Asymptomatic Cases Are Everywhere
Back in April, when India crossed the first milestone of 500 deaths due to the virus, experts raised a red flag saying that in India many COVID-19 cases are asymptomatic and it is a cause of worry as there may be many asymptomatic people who are yet to be detected but carrying the virus around. Nearly fourth months and few sero surveys later, this trend of asymptomatic coronavirus cases in India persists.
Recently, according to the analysis done by the health ministry it was concluded that 80 per cent of Indian COVID-19 patients in the country are asymptomatic or have shown very mild symptoms over the past few months. In Sero-survey studies done in Delhi, Mumbai, Pune, Ahmedabad and now Andhra Pradesh, the resultS shows that majority of the people who were surveyed had some antibodies in their system, highlighting that they had come in contact with the virus at some point of time.
2. Asymptomatic Carriers Include People Of All Ages
Recent studies and data of coronavirus shows that the asymptomatic patients include people of all ages. WHO Western Pacific regional director, Takeshi Kasai in a virtual press briefing for the month of August said,
The epidemic is changing. People in their 20s, 30s and 40s are increasingly driving the spread. Many are unaware they are infected. This increases the risk of spillovers to the more vulnerable people out there.
According to the recent studies, it is being concluded that children also seem to play a much bigger role in the silent spread of COVID-19 than originally thought.
As per the journal JAMA Pediatrics that followed 91 children at 22 hospitals throughout South Korea, infected with the novel coronavirus found that children — a group widely thought to develop mostly mild disease that quickly passes — can retain symptoms for weeks, and even asymptomatic children can continue to shed virus for a long time after initial testing, making them potential key in the transmission of the disease.
3. Asymptomatic Patients Carry A Lot Of Virus In Their Bodies
Recently, Indian scientists have observed a higher association between asymptomatic COVID-19 cases and viral load, or the amount of virus in an infected person’s bodily fluid, in a study of over 200 patients with SARS-CoV-2 virus in Telangana. The researchers, including those from the Centre for DNA Fingerprinting and Diagnostics (CDFD) in Hyderabad, advise testing asymptomatic primary and secondary contacts followed by surveillance as now an essential thing in India’s fight against coronavirus.
Apart from this study, even a recent study from South Korea found that asymptomatic and symptomatic people carry a similar viral load in their bodies, which is the amount of virus located in throats and noses that indicates asymptomatic people could potentially spread the coronavirus just as readily as those with symptoms.
4. Being Asymptomatic Doesn’t Mean You Will Not Have Lasting Damage
In past, being asymptomatic meant a person has good amount of immunity to fight against the disease, however, over the months, health experts have seen even asymptomatic patients, who had no obvious symptoms complaining of long-term illness. Talking about the same and sharing health advice on what sort of check-ups asymptomatic patients should get done, AIIMS Director Dr Randeep Guleria adds,
It was picked up in many studies that when the CT Scan of asymptomatic patients who exhibited no symptoms of coronavirus, was done, almost 30 per cent of the patients had some patches in their X-rays, which were part of COVID-19 infection. In some cases, these patches go away within few weeks, however in some we are finding that the patches may leave permanent residue. So, firstly, asymptomatic patients should get CT-Scans done instead of just tests of COVID, secondly, if the patches are few and their symptoms are normal then they can continue to home isolate themselves.
Lessons From China And Italy In Managing Asymptomatic Cases
What proved successful for China is some of its strict rules in dealing with asymptomatic coronavirus carriers. As per He Qinghua, an official with the National Health Commission in one of the press briefings said that the country since late January has taken asymptomatic carriers as one of the key targets to be monitored for their successful coronavirus fight. He also added that China has also put out a mandate for the medical institutions across the country and have ordered to report the infection within two hours of an asymptomatic case being found, and a case epidemiological investigation should be completed within 24 hours.
Moreover, asymptomatic carriers are put under concentrated medical observation for 14 days and can only be released from quarantine upon two consecutive negative test results, followed by an additional 14 days of medical observation and follow-up visits.
Whereas, a study published in medRxiv said that contact tracing and isolation of asymptomatic spreaders helped in successfully controling the COVID-19 epidemic among healthcare workers in Milan. The study was done in two large hospitals and 40 external healthcare services in Milan (Italy).
What Are The Lessons For India?
As the asymptomatic cases become a potential threat for the country, health experts say that what really is needed is tracking and isolating infected people who are exhibiting no symptoms of the virus and India should just not just focus on testing and isolating people who are clearly sick or are symptomatic but also on identifying asymptomatic patients.
Dr Randeep Guleria says the solution for the country is to pick more and more people and get them tested for coronavirus as the more tests will happen, more people will come to know if they have COVID-19 or not and subsequently the treatment steps can be taken by the authorities. He added,
ICMR has also revised its testing guidelines now, it is a big step as earlier, people had to go and get the prescription from their doctors to get the COVID-19 test but now ICMR has approved testing on demand, which means if people know that they have come in contact with COVID positive patient they can simply go and get the test done.
Dr Naresh Trehan also stressed on the importance of testing and said,
At this point, what becomes very crucial is to test and test more and more number of people out there, isolate them and treat them. There is no other way we can combat the situation.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.