The W.H.O. so far has found few truly asymptomatic cases, in which a patient tests positive and has zero symptoms for the entire course of the disease.
However, there are many cases where people are “pre-symptomatic,” where they have no symptoms at the time when they test positive but go on to develop symptoms later.
“In some sense, symptomatic versus asymptomatic isn’t really the appropriate dividing line” for us to be focusing on, said Jeffrey Shaman, a professor of environmental health sciences at Columbia University’s Mailman School of Public Health. “The appropriate dividing line is documented versus undocumented infection.”
What he means by “documented” is people who are identified as being infected, either because they were sick enough to go seek care or were tested through contact tracing, which is when public health officials track down all the contacts of someone who tested positive.
The “undocumented” could be people who have symptoms but didn’t get tested, or worse, people who had no symptoms or such mild symptoms that they decided to just carry on with their daily lives.
“Maybe they pop some ibuprofen, but still go to work, still get on public transportation, still do all the things we normally do, and the consequence of that is those people with mild infections — as well as if they’re truly asymptomatic — are taking the virus out into the community, and they’re spreading it far and wide,” Shaman said.
Substantial undocumented infection facilitates the rapid dissemination of COVID-19.
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