Is Asymptomatic Spread of COVID-19 Very Rare? Depends How You Define ‘Asymptomatic’

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New confusion over asymptomatic transmission of COVID-19. We’ve been told by public health experts for weeks that COVID-19 is being spread in part by masses of sick people who show no symptoms. Now, World Health Organization (WHO) epidemiologist Maria Van Kerkhove says spread by asymptomatic people is “very rare.” What?

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Former Food and Drug Administration head Scott Gottlieb said WHO is making premature conclusions. “Clearly there is some asymptomatic spread—the magnitude of it is going to take time to determine…and it’s going to take a lot better data than what WHO is basing this conclusion on quite frankly,” he said.

Still, some are already interpreting this as “another early scare about coronavirus [that] has been tamped down.” But Bloomberg News points out that WHO “had said as far back as February that it did not see asymptomatic cases as a major cause of viral spread.”

But the whole thing may be a miscommunication. Here’s more of Van Kerkhove’s comments on asymptomatic spread of COVID-19:

“When we actually go back and say, ‘How many of them were truly asymptomatic?’ we find out that many have really mild disease…They’re not quote-unquote COVID symptoms, meaning they may not have developed fever yet, they may not have had a significant cough, or they many not have shortness of breath. But some may have mild disease.”

As Slate‘s Will Saletan sums up: “Van Kerkhove said many people thought to be asymptomatic were actually mildly symptomatic. So we might just be reclassifying the undetected spread.”

Overall, people seem to be mixed up about what asymptomatic means.

“Some of the confusion lies in the distinction between the roles played by truly asymptomatic people and those who are merely pre-symptomatic—and later go on to become ill—in spreading the disease,” writes Bloomberg‘s Jeff Sutherland. “Pre-symptomatic individuals, who develop a higher viral load just before the onset of symptoms, may be infectious, the WHO said.”

A lot of our talk about asymptomatic carriers of COVID-19 has included a) people who don’t yet have traditional symptoms (fever, cough, etc.) but will soon develop them and b) people who may never develop traditional COVID-19 symptoms but still show other signs of illness. However, the WHO does not seem to be including these people in its definition of asymptomatic. Its group of asymptomatic coronavirus carriers—those for whom passing on the disease is “very rare”—includes only people with the disease who never develop any symptoms.


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