Covid-19: Pay more attention to patients without symptoms

Mr Mukasa (not real name) is one of the essential employees that are supposed to deliver services despite the whole country being under a lockdown.

While executing his duties, he makes a lot of inland movements using public transport and comes in contact with people from various places. By virtue of his job, he is sometimes in custody of people’s items such as clothes and bags, which he keeps in his office.

During a random survey by the Ministry of Health to ascertain the existence of community cases, Mr Mukasa was one of the few people who tested positive for Covid-19. This was quite surprising and terrifying news to Mukasa and his loved ones because he was seemingly healthy, performing his routine duties so well without any complaint of Covid-19-related symptoms.

Many concerns arose in the community in regard to where he could have contracted the infection and how many people he could have infected. This was also very striking to the health authorities because such cases could silently spread the disease leading to uncontrolled outbreaks.

This is particularly important because such cases are normally not isolating, they continue to interact freely with other people in the communities even when they are infectious.

By May 29, Uganda had reported 317 confirmed cases of Covid-19 and 57 per cent of these did not present with the virus-related symptoms such as cough, flu, fever or difficulty in breathing.

As new information about coronavirus keeps rolling in, we now know that for every 100 people with Covid-19, at least 80 of them are asymptomatic (do not show any visible signs and symptoms and are unaware).
When one gets infected, it takes between two and 14 days before developing signs and symptoms .

Throughout this global pandemic, public health experts have focused on self-isolation for people who have symptoms, with little or no attention for the asymptomatic case–patients.
However, there is evidence that a person infected with Covid-19 can start transmitting the virus 24 to 48 hours (that is; 1-2 days) before they start showing symptoms.

Studies have also indicated that Covid-19 infection that cannot be identified clinically (asymptomatic) can transmit the virus to other people.
The question now is who among the people you are working with is likely to be incubating Covid-19? We certainly do not know.

There are many people in the communities who could be infected but they have not developed any symptoms yet. They are silently and unknowingly spreading the disease. Therefore, as we look forward to the lifting of the lockdown and prepare to resume our routine activities, whenever and wherever we may be, let us remain vigilant. Let’s not take things for granted, Covid-19 is real and is with us anytime, anywhere.

If we are to control the spread of Covid-19, we should continue observing the recommended Ministry of Health guidelines, which include; regular hand washing, social distancing, wearing face masks and using alcohol-based sanitisers, among others.

The writer is a field Epidemiology Fellow at the Uganda Public Health Fellowship Programme, Ministry of health