Each third person infected with COVID-19 shows no symptoms – what is the real number of the virus’ invisible spreaders? (infographic)

So far, out of 2 000 registered people infected with COVID-19 in North Macedonia, 32.3% have no symptoms at all, but can transmit the sickness. According to the Institute of Public Health’s daily report, two-thirds of the asymptomatic cases (75%) “had contact with already confirmed case in the country”.

The question is if each third person of the registered infected population has no symptoms at all, then what is the real number of the persons that are positive to COVID-19 and have been spreading the virus unknowingly? The tip of the iceberg may be small, but no one can know for certain how big is the iceberg below the water.

If we knew the number of these people, would the health authorities receive more precise directions and  know what sort of measures they can take? To answer these questions, we spoke with the microbiologist professor Nikola Panovski PhD and th epidemiologist professor  Dragan Danilovski, PhD.

According to Dr. Panovski’s estimation, around 25.000 persons in Macedonia should have had contact with the virus, with over 20.000 people already recovered.

“According to my evaluations, there are around 25.000 COVID-19 cases in Macedonia” said Panovski who also says that he knows personally 15 people who got infected but didn’t pass the testing algorithm and were not tested at all.

Д-р Никола Пановски | Фото: Од гостувањето во емисијата

“Basically, we know only those who had symptoms and were tested. There are many who recovered and there are those who had mild symptoms”, said Panovski. “When those would be tested now with the standard tests that are detecting the virus’ presence (PCR tests), they would be negative. With the tests for the presence of antibodies (IGG) it can be seen how many had the virus, “but when the percentage of infected is smaller as it is in Macedonia then the number of falsely positive will be greater than the truly positive”, said Panovski.

His prognosis is that the virus will not disappear and that it will be present throughout the summer.

“The virus will still be here. These measures cannot last indefinitely. The schools and the kindergartens will be working, the sickness will spread and it will be transmitted by the children” said Dr. Panovski.

He expects the daily tally to be from 5 to 15 newly infected during the summer. “In July and August, the numbers can be below 5, but it will certainly be present” said the professor.

Фото: Јутјуб, скриншот

Epidemiologist Danilovski thinks that the proportions of those without any symptoms, but who are actively spredint the virus, are far from known.

“In a German study published two weeks ago, an evaluation was conducted on the basis for testing the general population. They estimate that the number of positively registered people is only 9% of the total number of people positive to the virus” said Danilovski.

He stressed that the testing should encompass the general population nothwithstanding if  the target should be people from the so-called risk groups or a selection of representative specimen.

“Another acceptable variant that is used is to determine spots for testing and all passersby to be tested” said Danilovski who pointed at a testing conducted in California.

According to him, another way of testing people is through their primary care physicians who would take samples from one of the family members that they treat.

This way, with the first results, the quantity of distribution of positive cases will become known and we shall know the size of the iceberg that is lurking above the water.

According to him, if this research is conducted during certain periods, for eg. every two or three months, the health authorities will constantly have an insight into the epidemiological situation.

“Then we wouldn’t be any need for blindly calling for restrictive measures, but the measures would be dimensioned proportionally to the epidemiological risks. If we have a clear picture of what the epidemiological map of positive cases is and if we send teams to isolate the positive cases that were targeted then everything will be different” said Dr. Danilovski.