Latest on COVID-19
NEJM 3/5/20: Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
A 33-year-old otherwise healthy German businessman (Patient 1) became ill with a sore throat, chills, and myalgias on January 24, 2020. The following day, a fever of 39.1°C (102.4°F) developed, along with a productive cough. By the evening of the next day, he started feeling better and went back to work on January 27. He had attended meetings with a Chinese business partner on January 20 and 21. The business partner had been well with no signs or symptoms of infection but had become ill on her flight back to China, where she tested positive for 2019-nCoV on January 26. Patient 1 tested positive at the end of his symptomatic period on January 27. 3 others at the company including 2 who only had contact with patient 1 during his asymptomatic period became symptomatic and tested positive.
Possible Implications: There may be risk to health care workers and others from exposure to people who are asymptomatic/ presymptomatic raising questions if simply masking febrile or coughing patients is adequate protection for health care workers and highlighting the importance of social distancing and the need to screen asymptomatic persons. To me this is very reminiscent of when we switched from symptom-based HIV testing to routine testing and from screening patients to UNIVERSAL PRECAUTIONS.
