Mandatory Testing Can Halt Coronavirus Outbreak
An Italian academic has claimed striking evidence that most people infected with COVID-19 disease show no symptoms, but are still able to infect others.
Which, he says, has huge implications for coronavirus testing policies, particularly in hospitals.
Published in The BMJ on March 23, 2020, Sergio Romagnani, Professor and Head of Clinical Immunology Department of Internal Medicine, at the University of Florence, has reported how blanket-testing in a completely isolated village in northern Italy saw the number of people with COVID-19 symptoms fall by over 90 percent within 10 days.
Local health authorities repeated RNA testing of the entire 3,000 residents of Vo’Euganeo, located 50 km west of Venice, during mid-February 2020.
Anyone with positive test results was then quarantined.
Within 10 days, the number of people sick from COVID-19 fell from 88 to 7, Romagnani reported.
In an open letter to the authorities in Italy’s Tuscany region, Romagnani wrote that the great majority of people infected with COVID-19, between 50-75%, were asymptomatic, but represented “a formidable source” of contagion.
“The percentage of people infected, even if asymptomatic, in the population is very high and represents the majority of cases, particularly, but not only, among young people.”
“Isolation of asymptomatics is essential for controlling the spread of the virus and the seriousness of the epidemic,” he said.
He concluded that employing large scale testing to find and isolate asymptomatic cases, particularly among health workers who might unwittingly pass the virus to colleagues or patients, was a vital strategy in containing the spread of the disease.
He told La Repubblica, “We’re deciding not to test doctors and nurses if they’re not developing symptoms.”
“But in the light of the results, this decision could be dangerous.”
“Hospitals risk becoming zones with high infection rates in which infected people are not isolated.”
Tom Jefferson, a doctor, and epidemiologist at the Nordic Cochrane Centre based in Italy’s Veneto region said the Vo’Eugeano study results would have major implications for testing policy.
He noted that Romagnani’s findings appeared to contradict a WHO report based on COVID-19 in China.
This suggested that “the proportion of truly asymptomatic infections is unclear, but appears to be relatively rare, and does not appear to be a major driver of transmission.”
Other reports suggested that testing on the Diamond Princess cruise ship did find a significant number of symptomless cases.
Dr. Jefferson told The BMJ, “There are clearly some contradictions here.”
Nonetheless, he said it should be mandatory to do blanket testing.
Jonathan Ball, professor of molecular virology at the University of Nottingham, said that the “prevalence of asymptomatic or mild disease and its role in virus transmission and the potential role of children in driving this pandemic” are among the “key matters that need to be resolved.”
SARS-CoV-2 outbreak news published by Coronavirus Today.