Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control COVID-19
Monica Gandhi, Deborah S. Yokoe, Diane V. Havlir
Abstract
Traditional infection-control and public health strategies rely heavily on early detection of disease to contain spread. When COVID-19 burst onto the global scene, public health officials initially deployed interventions that were used to control severe acute respiratory syndrome (SARS) in 2003, including symptom-based case detection and subsequent testing to guide isolation and quarantine. Asymptomatic transmission of SARS-CoV-2 is the Achilles’ heel of COVID-19 pandemic control through the public health strategies we have currently deployed. Ultimately, the rapid spread of COVID-19 across the United States and the globe, the clear evidence of SARS-CoV-2 transmission from asymptomatic persons5, and the eventual need to relax current social distancing practices argue for broadened SARS-CoV-2 testing to include asymptomatic persons in prioritized settings.