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Presumed Asymptomatic Carrier Transmission of COVID-19

A novel coronavirus has resulted in an ongoing outbreak of viral pneumonia in China. Person-to-person transmission has been demonstrated, but, to our knowledge, transmission of the novel coronavirus that causes coronavirus disease 2019 (COVID-19) from an asymptomatic carrier with normal chest computed tomography (CT) findings has not been reported.

Covered in the lay press here.


Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020

An outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, Hubei Province, China has spread quickly nationwide. Here, we report results of a descriptive, exploratory analysis of all cases diagnosed as of February 11, 2020.

Table 1 and Table 2 shown below.








CDC confirms 34 coronavirus cases in US, prepares for ‘very possible, even likely’ pandemic

The CDC has warned that transmission of the deadly COVID-19 virus in the US is “very possible, even likely” and said its current goal is not to prevent but to slow down its spread and “buy more time” for US communities to prepare.

Added to the 13 already confirmed, the 21 new cases in the US were announced by the CDC on Friday in a media briefing, all of whom returned to the country aboard emergency repatriation flights arranged by the State Department for citizens stranded abroad. Health officials said they expect additional cases to arise from those still in quarantine.

“This new virus represents a tremendous public health threat,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, told reporters, adding that it is “very possible” and even “likely” the illness would continue to spread in the US.

The new patients are among more than 300 Americans evacuated from a quarantined cruise ship docked off the coast of Japan, where some 3,700 passengers were stranded for over two weeks in isolation. Ten additional passengers have tested positive in Japan, but will only be added to the official tally after confirmation by the CDC.

US health officials said they will now classify cases into two categories: those diagnosed inside the US, and those that were confirmed abroad and repatriated. Eighteen patients returned from the stranded cruise ship, while three others were brought home from Wuhan, China, where the illness was first observed.

The total number of infections worldwide has soared to around 77,000, with 2,360 fatalities, the majority of them in mainland China.


A Person Can Carry And Transmit COVID-19 Without Showing Symptoms, Scientists Confirm

Chinese researchers have confirmed a case of asymptomatic transmission of the new coronavirus: A 20-year-old woman from Wuhan passed it to five of her family members but never got physically sick herself


TABLE 1.  Patients, deaths, and case fatality rates, as well as observed time and mortality for n=44,672 confirmed COVID-19 cases in Mainland China as of February 11, 2020.

Baseline characteristicsConfirmed cases,
N (%)
Deaths,
N (%)
Case fatality
rate, %
Observed time,
PD
Mortality,
per 10 PD
Overall 44,6721,023 2.3661,6090.015
Age, years
 0–9416 (0.9) 4,383
 10–19549 (1.2)1 (0.1) 0.2 6,6250.002
 20–293,619 (8.1)7 (0.7) 0.2 53,9530.001
 30–397,600 (17.0)18 (1.8) 0.2114,5500.002
 40–498,571 (19.2)38 (3.7) 0.4128,4480.003
 50–5910,008 (22.4)130 (12.7) 1.3151,0590.009
 60–698,583 (19.2)309 (30.2) 3.6128,0880.024
 70–793,918 (8.8)312 (30.5) 8.0 55,8320.056
 ≥801,408 (3.2)208 (20.3)14.8 18,6710.111
Sex
 Male22,981 (51.4)653 (63.8) 2.8342,0630.019
 Female21,691 (48.6)370 (36.2) 1.7319,5460.012
Occupation
 Service industry3,449 (7.7)23 (2.2) 0.7 54,4840.004
 Farmer/laborer9,811 (22.0)139 (13.6) 1.4137,9920.010
 Health worker 1,716 (3.8)5 (0.5) 0.3 28,0690.002
 Retiree9,193 (20.6)472 (46.1) 5.1137,1180.034
 Other/none20,503 (45.9)384 (37.5) 1.9303,9460.013
Province
 Hubei33,367 (74.7)979 (95.7) 2.9496,5230.020
 Other11,305 (25.3)44 (4.3) 0.4165,0860.003
Wuhan-related exposure*
 Yes31,974 (85.8)853 (92.8) 2.7486,6120.018
 No5,295 (14.2)66 (7.2) 1.2 71,2010.009
 Missing 7,403104 2.8103,7960.010
Comorbid condition
 Hypertension2,683 (12.8)161 (39.7) 6.0 42,6030.038
 Diabetes1,102 (5.3)80 (19.7) 7.3 17,9400.045
 Cardiovascular disease873 (4.2)92 (22.7)10.5 13,5330.068
 Chronic respiratory disease511 (2.4)32 (7.9) 6.3 8,0830.040
 Cancer (any)107 (0.5)6 (1.5) 5.6 1,6900.036
 None15,536 (74.0)133 (32.8) 0.9242,9480.005
 Missing23,690 (53.0)617 (60.3) 2.6331,8430.019
Case severity§
 Mild36,160 (80.9)
 Severe6,168 (13.8)
 Critical2,087 (4.7)1,023 (100)49.0 31,4560.325
 Missing257 (0.6)
Period (by date of onset)
 Before Dec 31, 2019104 (0.2)15 (1.5)14.4 5,1420.029
 Jan 1–10, 2020653 (1.5)102 (10.0)15.6 21,6870.047
 Jan 11–20, 20205,417 (12.1)310 (30.3) 5.7130,9720.024
 Jan 21–31, 202026,468 (59.2)494 (48.3) 1.9416,0090.012
 After Feb 1, 202012,030 (26.9)102 (10.0) 0.8 87,7990.012
Abreviation: PD, person-days. -, not applicable.
* The Wuhan-related exposure variable, only includes a total of 37,269 patients and 919 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.
The comorbid condition variable, only includes a total of 20,812 patients and 504 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.
§ The case severity variable, only includes a total of 44,415 patients and 1,023 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.





TABLE 2.  Confirmed cases, case severity, and case fatality rates among health workers in different areas of China by time period.

Period
(by date of onset)
WuhanHubei (outside Wuhan)China (outside Hubei)China (overall)
Confirmed cases,
N
Severe + critical,
N (%)
Deaths, N (CFR*, %)Confirmed cases,
N
Severe + critical,
N (%)
Deaths, N (CFR*, %)Confirmed cases,
N
Severe + critical,
N (%)
Deaths, N (CFR*, %)Confirmed cases,
N
Severe + critical,
N (%)
Deaths, N (CFR*, %)
Before Dec 31, 2019 000 000 000 000
Jan 1–10, 2020 187 (38.9)1 (5.6) 11 (100)0 11 (100)0 209 (45.0)1 (5.0)
Jan 11–20, 2020 23352 (22.3)1 (0.4) 488 (16.7)0 291 (3.4)0 31061 (19.7)1 (0.3)
Jan 21–31, 2020 656110 (16.8)0 25029 (11.6)2 (0.8) 13010 (7.7)01,036149 (14.4)2 (0.2)
After Feb 1, 2020 17322 (12.7)1 (0.6) 953 (3.2)0 543 (5.6)0 32228 (8.7)1 (0.3)
Total1,080191 (17.7)3 (0.3) 39441 (10.4)2 (0.5) 21415 (7.0)01,688247 (14.6)5 (0.3)
Abreviation: CFR, case-fatality rate.
* CFR presented here was calculated as number of deaths (numerator) divided by total number of confirmed cases in the row (denominator), expressed as a percent.







asymptomatic: Presumed Asymptomatic Carrier Transmission of COVID-19
https://jamanetwork.com/journals/jama/fullarticle/2762028


stats: Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020
http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51


2360-77000: CDC confirms 34 coronavirus cases in US, prepares for ‘very possible, even likely’ pandemic
https://www.rt.com/usa/481436-coronavirus-us-cdc-warning/


no symptoms: A Person Can Carry And Transmit COVID-19 Without Showing Symptoms, Scientists Confirm
https://www.sciencealert.com/researchers-confirmed-patients-can-transmit-the-coronavirus-without-showing-symptoms