Asymptomatic and Pre-symptomatic spread: What’s the difference?

The novel coronavirus is bizarre for many reasons, making its spread unpredictable and hard to control.

One oddity is how easily people can get infected by someone without symptoms. But there’s a difference between asymptomatic spread and pre-symptomatic spread.

Here’s what you need to know:

Asymptomatic Spread

Asymptomatic spread is when the virus is transmitted to others by people who don’t show any signs of symptoms. They are still carriers of the virus and contribute to the expansion of a pandemic. This is much more common than you would infer. In a study done in China, it was estimated that every 4 of 5 patients were most likely infected by people they didn’t know were carriers.

Pre-symptomatic Spread

Pre-symptomatic spread is when the virus is transmitted to others by people who are infected but have not yet shown any signs of symptoms. Although the virus may not show its symptoms yet they still shed the virus and contribute to spreading it. It is hard to determine if you are a carrier since you will feel relatively normal until the symptoms start to show.

Symptomatic Spread

Symptomatic spread is when the virus is transmitted to others by people who are infected and show the symptoms. The virus can be transmitted through sneezing, coughing, talking, etc.

Differentiating between Pre-symptomatic and Asymptomatic

Distinguishing between a pre-symptomatic and asymptomatic patient is essential when it comes to surgeries because it may influence the outcome. For example, if they suffer the symptoms right after the surgery, the recovery process will be affected and may have major consequences for the patient. Although we can determine if someone is a carrier, there is no way to tell if a person is asymptomatic or pre-symptomatic until the symptoms develop if they are pre-symptomatic.

The Overlap

People with COVID-19 are either ‘symptomatic’ or ‘asymptomatic’ but there is also an overlap: confirmed cases who are initially classified as ‘asymptomatic’ but later develop symptoms of the disease, making them ‘pre-symptomatic’.

A Venn Diagram where the circles are the two types of cases while the sections (including the overlapping part) represent different phases of infection.

Why is this important?

It is hard to determine if you are pre-symptomatic or asymptomatic since there are no physical changes that will indicate you are a carrier. This reinforces the importance of social distancing since our main goal is to prevent the spread as we combat the virus. However, if you feel like you may have contracted the virus, the PCR COVID-19 test is highly sensitive so it will be able to detect the virus during asymptomatic or pre-symptomatic stages.

Additionally, it is theorized that people are highly contagious when in the pre-symptomatic stage and when the symptoms are generally mild. Since COVID-19 has a generally long pre-symptomatic stage, carriers are likely to spread it to many people since they don’t suspect anything until the first sign of symptoms.

We still have a lot to learn and discover. For right now, the most important thing we can do is focus on socially distancing regardless if we exhibit symptoms or not. The only way we can reduce the spread successfully is by wearing face masks and maintaining a physical distance from others for a safer, brighter future.

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