Symptom-free Covid-19 patients must be reported within two hours, China says

Kinling Lo

Symptom-free Covid-19 patients are contagious and must be reported within two hours of confirmed diagnosis, the Chinese government has said.

In a document published on Wednesday night, the State Council, the country’s cabinet, issued official guidelines for managing asymptomatic patients, those who tested positive for coronavirus but have yet to develop symptoms such as cough, fever and pneumonia.

The move came as official Covid-19 numbers have shown a daily increase in the number of asymptomatic patients from within China and from overseas.

On Wednesday, another 56 asymptomatic patients were found in the country, with 28 being imported cases, bringing the total asymptomatic cases under medical surveillance in the country to 1,104. The 56 patients without symptoms reported is not far short of the 63 new infections with symptoms on the same day.

“Asymptomatic patients are infectious, and have risk of infecting others,” the guidelines said, adding that some of the cases were pre-symptomatic, meaning they would show symptoms later in the course of the infection.

“[We should] strengthen the scope of testing and surveillance for asymptomatic patients …[and] standardise the reporting system of asymptomatic patients.”

The guidelines recommended that local health institutions should report these cases within two hours of receiving positive test results. Then, within 24 hours, county-level health authorities needed to report through the central communicable disease report system.

The issuing of the guidelines highlighted the increasing importance for Chinese authorities to manage and assess the risks posed by asymptomatic patients. Asymptomatic cases threaten Beijing’s efforts to contain the virus despite having drastically brought numbers of symptomatic patients down since January.

Scientific research into asymptomatic patients and their transmission rates around the world has been controversial.

Chinese authorities insist that patients without symptoms are not likely to trigger another major outbreak of the coronavirus and that their transmission rates are low.

Yet, after citing the need to “address public concerns”, the National Health Commission began releasing the number of symptom-free cases last Wednesday, starting with figures for March 31. The national total of 81,865 confirmed cases in China is therefore an underestimate of Covid-19 infections as it only records those showing symptoms.

To assess the impact of asymptomatic patients, the government will back scientific research related to the topic, according to the State Council’s guidelines.

Meanwhile, identified asymptomatic patients can only leave specified health facilities after testing negative for the virus twice after 14 days. They also must return for tests in the second and fourth week after being sent home, much like symptomatic patients discharged from hospitals.

Once they displayed symptoms they would immediately be sent for medical treatment.

All close contacts of asymptomatic patients must also be isolated and observed.

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