State health officer talks asymptomatic transmission of COVID-19

The Cullman Tribune, June 9, 2020 https://www.cullmant ... -covid-19/

CULLMAN, Ala. – The state’s top health official said Tuesday he was surprised when the World Health Organization’s (WHO) Dr. Maria Van Kerkhove said Monday that transmission of the coronavirus by asymptomatic people is “very rare.” The WHO walked that statement back Tuesday, after it drew skepticism from doctors and other health care professionals.

CNBC reported Tuesday: “Studies show that about 16% of the population may be asymptomatic, she (Van Kerkhove) said. Some models developed by other scientists suggest as much as 40% of global transmission may be due to asymptomatic individuals, she said, clarifying her comments.”

Alabama State Health Officer Dr. Scott Harris spoke to The Tribune Tuesday afternoon about the WHO’s claim.

“I think we were all kind of surprised by that statement yesterday that didn’t seem to be consistent with what everybody else had been saying,” said Harris. “When I saw that yesterday, I was kind of surprised because there clearly is evidence of asymptomatic transmission that’s been reported many different times.”

He continued, “I think it’s probably no question that people who have symptoms are more likely to transmit it, because if you’re coughing or sneezing or have a runny nose or watery eyes, clearly, that’s going to increase the risk for transmission as opposed to someone who is simply breathing. They’re not otherwise having symptoms of otherwise making droplets or aerosols. I think everybody would agree that it’s easier to transmit it if you have symptoms, but to say that asymptomatic transmission is rare, that’s kind of a quantitative statement in a way, and I think we know of plenty of examples of asymptomatic transmission, and I think we also know that nobody’s really testing enough, at least nationally-speaking, to know quite how many asymptomatic infected people there are out there. There certainly could be more going on than we realize because we just don’t always know who’s asymptomatically infected.”

When asked how many people in Alabama he thinks might be asymptomatic and not know they are infected, Harris said there is no way to know that right now.

“I would say we don’t know that. There’s definitely studies that people are trying to design to figure out how to answer that question, but there’s not really good testing capacity right now, not enough testing capacity, to go check everybody, even if they don’t have symptoms,” he said. “We are starting to see some testing in asymptomatic populations in say, nursing homes, for example, or health care workers. I know certain medical centers that are bringing people in for outpatient surgeries are starting to screen the patients coming in, even though they don’t have symptoms. So, I think we’re going to get more information on that at some point, but I would say there’s just no way to know right now. We know that about 80% of people don’t have serious symptoms, about 80% have a mild illness or less, so there certainly could be a lot of them.”

Cullman County’s numbers have risen significantly over the last two weeks. As of Tuesday afternoon, the Alabama Department of Public Health (ADPH) COVID-19 Data and Surveillance Dashboard reported a total of 203 cases of COVID-19 in Cullman County since tracking began in March, with 119 of those in the last 14 days.  Harris said the reason for that uptick is unknown.

“I don’t know for certain,” he said. “I know we certainly have seen some outbreaks in that part of the state that have been associated either with workplaces, like poultry processing, or in some cases, long-term care facilities, but I don’t know that specifically about Cullman County.”

Harris also addressed the upcoming school year, and whether students can expect to return to the classroom this fall.

“I know that the (Alabama) State Department of Education is working on a plan for that. (State Superintendent) Dr. (Eric) Mackey has a task force that’s developing guidance for that, and public health has representation on that group that are working on that,” he said. “Ultimately, schools going back is going to be an individual decision for local school boards and superintendents. They’ll get to decide that for themselves. We’re trying to give everybody the best information we can about what the health situation is in the community, and then, ultimately, they’ll be the ones making that decision.”

Harris noted that in planning for the school year, it’s not necessarily children that education and health officials are worried about, but more so the people they go home to when they leave the school building.

“Kids by and large have, not every case, but by and large have mild illness, so it’s not the kids we’re most concerned about at all,” he said. “It’s everyone else.”

Harris concluded by saying just because the state has opened back up, that doesn’t mean the threat is over.

“Now, more than ever, it’s important to remember the guidance around face coverings and hand washing and social distancing,” he said. “You know, when we were all sheltered in place, we still had that kind of guidance, but if you weren’t going out, you weren’t at risk anyway. Now that the economy has opened back up, I think certain people have taken that as a message that, ‘Hey, everything’s normal again and I don’t have to take any precautions,” so unfortunately they’re putting themselves at risk and even if they’re young and healthy, they’re putting at risk their loved ones who are older or have chronic health problems.”