One of the great mysteries of the coronavirus is how quickly it rocketed around the world.
It first flared in central China and, within three months, was on every continent but Antarctica, shutting down daily life for millions. Behind the rapid spread was something that initially caught scientists off guard, baffled health authorities and undermined early containment efforts — the virus could be spread by seemingly healthy people.
“It’s a silent stalker in multiple ways. Firstly, that the person doesn’t even know they have symptoms. Now, this is different from someone who doesn’t have symptoms, but then later develops symptoms. That’s the pre-symptomatic. What we are talking about here is people that never display symptoms.” says Dr. Eric Topol, head of Scripps Research Translational Institute.
Researchers have exposed the frightening likelihood of silent spread of the virus by asymptomatic and presymptomatic carriers. But how major a role seemingly healthy people play in swelling the ranks of those infected remains unanswered — and at the top of the scientific agenda.
The small but mighty coronavirus can unlock a human cell, set up shop and mass produce tens of thousands of copies of itself in a single day.
Virus levels skyrocket before the first cough, if one ever arrives. And astonishing to scientists, an estimated 4 in 10 infected people don’t ever have symptoms.
Several studies around the world are trying to find people who don’t show COVID-19 symptoms.
At Scripps Research in San Diego, Topol leads a team that gleans information from wearable devices such as a smartwatch or Fitbit.
The DETECT study monitors a person’s heart rate and allows participants to record symptoms like fever or coughing through their device to share with scientists.
Previous research suggests changes in a person’s resting heart rate and sleep patterns can improve real-time predictions of flu-like illnesses at a population level. So researchers are trying to see if they can spot COVID-19.
“We are likely going to be able to help be able to find people who don’t even know they have this, no less an outbreak that we don’t even know are in the early stages. So we can get our arms around it and suppress it.” he explains.
In early July, Fitbits were distributed among some key workers in hopes of recruiting some of them for the study.
Monica Valencia is a mother of an infant and toddler. She agreed to participate because COVID-19 affected her personally.
“I’m participating in this study, because myself, I have family members that are affected by COVID. And I would love to help someone else, so their family doesn’t have to go through what my family has to go through,” says Valencia.
At the University of California, Berkeley, scientists are collecting volunteers’ spit in hopes of finding asymptomatic people to stop them from unknowingly spreading the virus.
“Saliva testing is a lot simpler. It allows people to literally spit into a tube, and we think it will take five or six minutes as we pass into our testing center here. So we hope to make this painless, simple and easy for people to come by and get tested,” says Jennifer Doudna, who founded the Innovative Genomics Institute at UC Berkeley.
Doudna, who is also known for her work on the CRISPR gene-editing tool, says saliva testing is a simple way to detect the genetic material of the virus.
“And how fast our testing time is depends on our turnaround times in the testing lab. But we’re certainly aiming to be reporting test results within five days or less,” says Doudna.
The nose and mouth are convenient entryways for the coronavirus.
Once inside, the virus commandeers the cell’s machinery to copy itself, while fending off the body’s immune defenses.
Virus levels skyrocket in the upper airway, all without symptoms in the early days of an infection.
Many scientists believe that during these days, people can spread virus by talking, breathing, singing or touching surfaces.
In the truly asymptomatic, the immune system wins the battle before they ever feel sick.
As it became clearer that healthy people could spread the virus, U.S. health authorities opted not to wait for scientific certainty. In early April, the CDC recommended people cover their nose and mouth in public with masks, bandannas, even T-shirts.
Days later, Chinese researchers published a paper saying patients are most infectious two to three days before developing symptoms.
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