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1/ Given my interactions with @ASlavitt and @jeremyfaust yesterday, I decided to make a compiled list of data on asymptomatic transmission. This is not complete, but the most striking data I have seen on #COVID19 and #SARSCoV2 worldwide.
2/ A nice summary published in @TIME yesterday:

Covert coronavirus infections could be seeding new outbreaks
nature.com/articles/d4158…
3/ USA (NY) #usaCoronavirus #NewYork

Universal Screening for #SARSCoV2 in Women Admitted for Delivery @ColumbiaWomens @NB83
- 33 positive cases, 29 (87%) asymptomatic
- nejm.org/doi/full/10.10…
4/ USA (MA) #usaCoronavirus

#SARSCoV2 titers in wastewater are higher than expected from clinically confirmed cases
- #viral titer in feces to be about 3000 times higher than that in sampled raw sewage
- medrxiv.org/content/10.110…
5/ #CHINA:

Covid-19: 4/5 of cases are #asymptomatic, #China figures
- Found 43 000 cases of asymptomatic infection through contact tracing
- 166 new infections, 130 (78%) asymptomatic identified in the 24 hours to the afternoon of Wednesday 1 April
- bmj.com/content/369/bm…
6/ #CHINA:

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (#SARSCoV2 )
undocumented infections was 55% of documented infections
science.sciencemag.org/content/early/…
7/ #CHINA:

A familial cluster of pneumonia associated with the 2019 novel #coronavirus indicating person-to-person transmission: a study of a family cluster
- Reports of #asymptomatic infected children
- thelancet.com/journals/lance…
8/ #DIAMONDPRINCESS (#JAPAN):

Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
- 634 confirmed cases, 328 (51.7%) were reported to be asymptomatic.
- eurosurveillance.org/content/10.280…
9/ #ICELAND:

- Iceland countrywide data
- 0.3%-0.8% of Iceland's population is infected with the respiratory illness, about 50% of those who test positive for the virus are #asymptomatic when they are tested
- covid.is/data
- marketwatch.com/story/iceland-…
10/ #JAPAN

Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)
- Among the Japanese patients evacuated from Wuhan, the center of the coronavirus outbreak, 30.8% were asymptomatic.
- ijidonline.com/article/S1201-…
11/ #SOUTHKOREA:

- “Korea currently has a significantly higher rate of asymptomatic cases than other countries, perhaps due to our extensive testing," said Jeong Eun-kyeong, director of KCDC, at a press briefing on 03/16/2020.
- dw.com/en/up-to-30-of…
12/ OTHER HELPFUL ARTICLES:

Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
- nejm.org/doi/full/10.10…

Coronavirus: Why it’s so deadly in Italy
- Demographics and why they are a warning to other countries
- medium.com/@andreasbackha…
13/ Of additional concern is prolonged asymptomatic viral shedding:

A special case of COVID-19 with long duration of viral shedding for 49 days (CHINA)
medrxiv.org/content/10.110…
14/ PROLONGED VIRAL SHEDDING

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study (CHINA)
- Viral shedding of survivors can occur on average for 20 days, at max 37 days.
thelancet.com/journals/lance…
15/ I hope no one believes that I am an expert on #SARSCoV2 or believes that *I* think I am an expert on #COVID19

My role has been asking questions, synthesizing ideas, and hoping to catalyze discussion amongst colleagues.

More thinking, more questions…
@ScottGottliebMD
16/ If you are also curious or interested in my late night medical #COVID19 and #SARSCOV2 queries please check out my other 3 threads:

THREAD 1: Hypercoagulable State in COVID19
threadreaderapp.com/thread/1248512…
17/ THREAD 2: COVID19 as a Biphasic Disease of Hypercoagulable State and Endothelial Damage Followed by Immune Response
threadreaderapp.com/thread/1249236…

THREAD 3: Eyes, ENT, Neuro, and #SARSCoV2
threadreaderapp.com/thread/1249790…
#USA #usaCoronavirus

4800 sailors on aircraft carrier
>600 sailors (12.5%) tested positive for #SARSCoV2
~360 sailors (~60%) who tested positive have no symptoms

reuters.com/article/us-hea…
Yet another data point to add to the amassing pile of ASYMPTOMATIC TRANSMISSION:

#Boston #homeless shelter #USA #usaCoronavirus
397 people tested
146 people (36.7%) tested positive for #SARSCoV2
146 people (100%) who tested positive have no symptoms

boston25news.com/news/cdc-revie…
#SantaClara County
- 3,330 individuals tested
- 50 tested positive (1.5%)

Seroprevalence of antibodies to #SARSCoV2 is 2.49%-4.16%, with uncertainty bounds ranging from 1.80%-5.70%.

#COVID19 cases likely 40-84 fold higher than currently reported

medrxiv.org/content/10.110…
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