It’s an issue that has been argued about for months, both by experts and by people strolling through parks all over the world: Can people who don’t feel sick spread the coronavirus? And if so, should we all be wearing masks to stop it?
Even the World Health Organization can’t seem to get it straight. On Tuesday, the U.N. health agency scrambled to explain seemingly contradictory comments it has made in recent days about the two related issues.
The confusion and mixed messages only make controlling the pandemic that much more difficult, experts say.
“If you are giving them confusing messages or they’re not convinced about why they should do something, like wear masks, they will just ignore you,” said Ivo Vlaev, a professor of behavioral sciences at the University of Warwick.
The communications debacle highlighted the WHO’s change to its longstanding mask advice—a revision that was made months after many other organizations and countries already recommended people don masks.
On Friday, WHO changed that guidance, recommending that people wear fabric masks if they cannot maintain social distancing, if they were over age 60 or had underlying medical conditions. Part of the reasoning, WHO officials said, was to account for the possibility that transmission could occur from people who had the disease but weren’t yet symptomatic.
But when Maria Van Kerkhove, the WHO’s technical lead on COVID-19, was asked about the frequency of this kind of transmission this week, she said “It still appears to be rare that asymptomatic individuals actually transmit onward.”
On Tuesday, Van Kerkhove said she was referring to a few studies, not the complete picture.
Still, many other scientists were stunned by the description of asymptomatic spread as “rare,” saying plenty of evidence exists that people can spread the disease before suffering symptoms.
“I was surprised by the conviction of that statement because there have clearly been people who have transmitted the infection before they go on to develop symptoms,” said Keith Neal, an infectious diseases expert at the University of Nottingham who has advised the U.K. government on outbreak control.
The details on how well the coronavirus spreads in different circumstances is not well understood and is still being studied. But here is what scientists say and experts recommend based on what is known:
Q: Can people who don’t feel sick spread the disease?
A: We don’t know. WHO has maintained for months that the vast majority of COVID-19 spread is from people with symptoms such as a fever or cough and that transmission from people who don’t feel sick is not thought to be a major driver of the disease.
At a hastily arranged social media event Tuesday to try to clear up confusion, the WHO’s emergencies chief, Dr. Michael Ryan, said “both symptomatic and asymptomatic individuals are part of the transmission cycle” but that it was unclear how much each contributed to disease spread.
Q: Does wearing a mask help?
A: Probably. Wearing a mask might not protect you from getting sick— your eyes are likely still exposed—but health experts think it might prevent you from spreading the disease unknowingly by acting as a physical barrier.
COVID-19 is spread via respiratory droplets, so wearing a mask will stop those droplets from reaching others. While most spread is thought to happen by coughing and sneezing, Ryan said there is some evidence that even such acts as singing or shouting could spread the virus from people who don’t yet show symptoms.
Q: Why don’t we know for sure?
A: It’s complicated, especially since the virus was only identified in late December. Some scientists said the WHO’s distinction between people who are truly asymptomatic—those who are infected by the new coronavirus but never show COVID-19 symptoms—and those who are presymptomatic and develop symptoms later is part of the problem.
While truly asymptomatic people are likely not responsible for significant virus spread, several studies have documented people spreading the disease before they get sick—and some experts say recognizing and stopping this kind of transmission is critical to controlling the pandemic.
Detailed studies and testing of people who test positive for the coronavirus but don’t show symptoms to determine if they spread the disease are needed—and few have been done so far.
Q: Why can’t the scientists agree?
A: Although numerous studies have suggested people can spread the virus before they show symptoms, the WHO has largely dismissed those as anecdotal or pointed out they were based on modeling.
Babak Javid, an infectious diseases doctor at Cambridge University Hospital, says many scientists are persuaded by the studies published so far and think WHO should publish the data it is citing to explain why it believes transmission of the disease in people without symptoms is “rare.”
“If you’re going to make a really important statement like that, it would be good to back it up,” Javid said. “I think WHO is an important organization, but they’ve made a lot of statements that have been misleading.”
WHO’s Ryan said the agency was committed to being honest and transparent and welcomed the scientific debate it has prompted.
More than 130 students might have to change elementary schools under a new school boundaries plan the Milton School Board approved May 26, parents were told at a listening session Tuesday.
Marcia Schwengels, principal of Milton West Elementary School, responded to an audience question by saying 132 students attended Milton schools this year that were outside the new boundaries.
One of the estimated 75 audience members in the high school auditorium asked how many students have child care providers located outside the new boundaries.
“I don’t know every child’s day care provider,” Schwengels replied.
“That’s the problem,” another audience member said.
Tuesday’s three-hour listening session was the second time in as many days that parents have voiced their opposition to the new boundaries, which dictate that students attend the elementary school in their attendance area. In the past, families could request that their children attend a school outside their area.
Parent Scott Weberpal said the relationships of all children will be affected by the new boundaries.
“Certainly there is a better time than during a pandemic,” he said.
He said it might sound like parents don’t want the inconvenience of a new school, but it’s much more than that.
Superintendent Rich Dahman said the plan, going forward, will factor in comments made at the listening session, Monday’s school board meeting, emails and phone calls from residents.
He said the plan must also address existing problems.
When parents were allowed to choose which elementary school their students would attend, they also could “buy a seat” on a bus if one was available. By having students attend elementary schools within their boundaries, Dahman said two to four bus routes could be eliminated at a cost of $45,000 per route.
Sarah Stuckey, principal of Consolidated and Harmony elementary schools, outlined safety and equity issues and transportation inefficiencies the school district aimed to address by enforcing the new boundaries. They include:
Schwengels said many factors brought the district to this juncture.
“We have, as a district, wanted to be very accommodating,” she said. “We have allowed bus requests to any eligible bus rider.”
To improve the system, she said, “We have looked at lots of different solutions.”
Among them was increasing the number of common stops.
Jen Cramer, principal of Milton East Elementary School, said the new boundaries will enable students to take one bus home without transferring.
Paul Markgraff, one of 78 people attending the session by video conference, said it doesn’t help parents if buses drop children off at home when no one is home. He asked how transportation to day care providers will be addressed.
Dahman replied, “That’s something we are continuing to look at.”
Isaac Johnson had one of those smiles you don’t forget.
His joy for life inspired others, including hundreds if not thousands of people in Janesville and around the world.
The loving boy suffered from an aggressive cancer that took his life Saturday.
Isaac battled stage 4 neuroblastoma for more than three years. He celebrated his sixth birthday four days before he died.
He loved superheroes. An image showing him in a cape was part of his fundraising campaign.
His obituary calls Isaac “Janesville’s fiercest superhero.”
His hugs,” the obituary said, “were good for your soul.”
His family, including father Pat, mother Debbie and their sons Tyler, 12, and Aiden, 9, benefited from those hugs and also fought for him.
Debbie quit her job to become his nurse and traveling companion as she took him for treatments in Madison, Chicago, New York and Michigan.
Pat, a salesman for DeVere Co., was the breadwinner. The company let him work from home.
Friends, family and soon a big part of Janesville got involved in raising money and supporting the family.
Van Buren Elementary School started a food train, and others joined in, Pat said.
Janesville police Detective Justin Stubbendick learned about Isaac through Isaac’s aunt Callie Schouten, a high school friend.
Stubbendick raised money to cover medical expenses, getting Craig High School students and others to help.
Stubbendick and others created an Isaac workout at a local CrossFit gym, where a CrossFit for a Cure benefit was held.
That event made its way through social media to a police officer in Austria and a CrossFit gym there, leading to more support for the Johnsons.
“Just everybody” got involved, Pat said. A GoFundMe effort raised more than $13,000.
Pat spoke to The Gazette on Tuesday and said he wanted to thank everyone who helped.
Isaac’s pain was not great, but it was almost always there. Medication helped when the tumor in his cheek or stomach problems hurt him, Pat said.
“He was just such a good little boy and didn’t complain too much, even though I think he was always in a little bit of pain,” Pat said.
Isaac’s short, inspiring life has produced results that outlive him.
“I made him a promise that I was with him as long as it took,” Stubbendick said, and that commitment doesn’t end with Isaac’s death.
Stubbendick noted that only 4% of federal spending on cancer focuses on childhood cancer, and he wants to do what he can for other children who suffer.
Cancer is the No. 1 cause of death by disease among children, according to the National Pediatric Foundation.
“We need to do something now because there’s just nothing worse than seeing a kid go through that,” Stubbendick said.
Stubbendick said he is not very religious, but getting to know Isaac changed his outlook.
“It really convinced me that there’s got to be something bigger out there,” he said. “And I really believe there has to be a heaven because that’s really the only place that’s good enough for him.”