Has asymptomatic transmission of the virus been significant to this pandemic? The published research I have read indicates that asymptomatic transmission is not significant to the reproduction rate of the Covid virus and therefore not key to the pandemic.
Why does that matter? If not enough of us can get Covid from infected people with no symptoms to significantly affect the reproduction rate of the virus, then the orthodox policy agenda does not make sense. I’ll explain more about why in a moment. But first, some context.
It feels odd, personally risky, and somewhat reckless for me to write a blog on epidemiology. What a weird situation has arisen in society so that sharing tentative analysis on public challenges involves such intense emotions and potential consequences for relationships with friends, colleagues and even future employment or income. That is a situation which I do not want to acquiesce to, as open dialogue on public issues is an aspect of contemporary society that I value deeply.
I know how some people will react negatively to me sharing ideas that are contrary to the new medical orthodoxy, because previously I had the same views as them. For instance, during 2020 I had a strong negative reaction to people who were not wearing masks properly. I remember walking on a pavement and passing a woman who was walking her dog, and noticed that her mask did not cover her nostrils. I remember thinking what’s the point of doing that? I casually assumed she was either stupid or that she didn’t want to wear a mask and so was just pretending. I remember laughing at internet memes that made fun of the ‘stupid’ or ‘selfish’ people who didn’t wear their masks properly. I also remember thinking that mask wearing is an indicator of one’s character and how much one cares about other people’s health, or about showing that one takes public health challenges seriously.
I now recognise all those ideas, and the emotions I was experiencing because of those ideas, were produced within me by stories promoted by institutions to serve their own interests, often for profit. (No I am not talking about mask manufacturers but the pharmaceutical industry and those they influence. I will explain further in a moment). I like to think that I am a responsible human being who is responsibly working out right from wrong and then trying to be good. Most people I know express a similar motivation – unless enlightened or sociopathic. Therefore, it is not so easy to admit that our ideas are shaped by the stories we are told through mass media, or by the people we know who have received that media. Because to do that means that we have to admit that our values, or interpretation of what they mean in practice, might be entirely arbitrary and produced within us by systems of power with no inherent goodness to them. That is awkward for some people to consider. However, consider it we must, because it is beyond doubt that communications from our mass media are driven by the general aim of making us into good consumers and employees. Buy this, look at that, want this, and don’t think of that, etc. You don’t need to be a professor like me to notice this basic reality of living in society. I believe the implication of this situation is that a key personal responsibility is to live in a questioning way.
I don’t mean randomly questioning everything. I mean being attentive to how all forms of communication have an origin and an effect that might serve some people and institutions, not others. We can choose to do that because of valuing how all of us can explore what we know to be true and wish for in life, as a key step in our self-expression and self-actualisation. To live that way means we choose not to relinquish our sense-making to authority, nor to anti-authority commentators, and instead try to consider reality for ourselves. Living like that means we are instinctively curious about what the ‘facts’ might be in any situation, and consider what might be the powerful institutions producing such ‘facts’, and the stories being told, or not told, with and about such ‘facts’. It means inquiring into how power might be being protected or projected through particular narratives. In my specialism in sociology we call that deeper questioning ‘critical consciousness’ (Bendell and Carr 2021). It involves not only analysing what’s happening outside of us, but also becoming more aware of our inner landscape of assumptions and judgements, and welcoming any moments of revelation when we realise that we have been operating from assumptions and narratives that were fed to us by people with power. It means being relaxed about discovering we have been wrong or have even been duped. So it is a skill that requires our self-image not to be attached to being right or being seen to be right. That is a particular challenge for people who take on roles in society as the people who know better. Me included.
Many people choose not to be critical thinkers, and instead defer to authority or the current societal norms. Often that approach to life can appear to work out for them and for others, but not when authorities or norms in societies are harmful. Most of us choose not to critically question everything, as we do not have time for it. So how do we know when to be critical thinkers? The key is to be open to feedback from people around us, and our inner intuitions, that something might be misleading or unhelpful, and then to switch into a critical way of thinking. It means asking ourselves:
- Am I feeling resistance to certain information, or judgements against certain people or behaviours?
- What are the assumptions I am making in order for me to think and feel that way?
- What are the sources of those assumptions?
- What is allowed and disallowed by those assumptions?
- Who or what is being served by any subsequent ideas or behaviours that arise from those assumptions?
- What else could be true and how might I think, feel and act as a result?
I teach this stuff at University and for organisations, and know that it is far easier said than done. Even some of the most famous analysts of discourse can get things badly wrong, as we will see later with Noam Chomsky. In my case, despite conducting research over 25 years on the way institutional power shapes our thinking and emotions to serve that institutional power, there I was back in mid 2020 feeling angry at a woman in the open air walking her dog. I was even judging this wonky-mask wearer as less worthy both intellectually or morally. So I know how some of you reading this could be feeling about someone critiquing the orthodox policy agenda on the pandemic. The defensive part of me once again pushes me to think that I’m witnessing intellectually or morally inferior people. If that is you, then ouch, I’m sorry. I now know that in the short term it can seem easier for me to think and feel that way about you. But once again that would be giving into a story I have been told since childhood that coerces us to conform to authority. That story is that our personal self worth is ascribed by society, rather than being innate in every one of us. Instead, I want to reconnect with a different story of reality. The story of reality that it is OK to disagree. That it is OK to make mistakes. That it is OK for one’s views to be disliked. That it is not OK to denigrate and demonise people as a result. And that it is not OK to focus primarily on what stories of reality that might gain social acceptance or praise. It is in that spirit that I will now share some of what I have learned about one aspect of epidemiology over the past year and the conclusions I have made as a result.
The science on asymptomatic spread
Mass vaccination programmes, restricting the movement of healthy people and general mask wearing have all been supported by the view that asymptomatic transmission of Covid is a significant concern. That means people are meant to consider it insufficient to be vigilant about symptoms in oneself or others. Focusing on asymptomatic transmission as significant therefore undermines the focus on people taking responsibility for their own and others’ health. Can you imagine for a moment if we did not think that people without symptoms could spread the disease? We would focus on whether we or other people had symptoms, and take sensible precautions, such as isolating ourselves or asking other people to go home. We might even organise for infrared thermometers to be installed at the entrance to places where people gather in close proximity. It would be a different approach to the current orthodoxy.
That is why it is so important to know that the scientific basis for the view that asymptomatic transmission is significant to the pandemic, by being significant to the reproduction rate of the virus, is extremely weak. The first and largest-scale study on Covid transmission, which investigated nearly 10 million people, found that asymptomatic transmission did not occur at all: “There were no positive tests amongst 1,174 close contacts of asymptomatic cases” (Cao et al 2020). Since then, there have been studies which unhelpfully do not distinguish sufficiently between asymptomatic infection and asymptomatic transmission, often speculating that the former means that the latter must exist. That is not the case – asymptomatic infection does not mean that you pass it on to others, and they are separate phenomena to study.
One analysis that does not distinguish sufficiently between infection and transmission, nevertheless concludes that asymptomatic Covid infection exists in 1 in 6 people with a positive test result (Byambasuren et al 2020). One meta-analysis of transmission found that ‘Among five transmission studies, 18 of 96 (18.8%) close contacts exposed to asymptomatic index patients were COVID-19 positive’ (Yanes-Lane et al 2020). That means 1 in 5 asymptomatic people might infect close contacts, defined as co-inhabitants in most studies. So if 1 in 6 are asymptomatic and of those, 1 in 5 can transmit to close contacts only, the probability of asymptomatic transmission to close contacts is no more than 1 in 30. Other more recent studies find even lower pre-symptomatic and asymptomatic transmission of Covid at 1.12% and 0.06% (which is 1 in 1600 cases) respectively (Mahmood, et al 2021). These transmission rates are in the absence of an early stage and major public-education campaign on counter-measures relating to ventilation, nutrition and natural antivirals. If that massive study of nearly 10 million people is not enough to dismiss asymptomatic transmission as an important concern for health policy, then the possibility it might be somewhere between 1 in 30 to 1 in 1600 cases would not make it a factor in whether the reproduction rate of the virus increases to a level that affects the pandemic.
When I discuss this topic with other people who follow the science, some point to studies that find there is asymptomatic infection not transmission. This confusion between these two phenomena is also contained in the fact checker articles on the topic to incorrectly state asymptomatic transmission is significant (as I explained in an earlier blog). Even if there is some asymptomatic transmission it would not necessarily mean that such transmission is at a level to matter significantly to the spread of the virus. One of the studies that has recently been used to argue there is significant asymptomatic transmission is not yet peer reviewed and I found it to be particularly poor, thereby illustrating how we need to interrogate any claims. The preprint study concluded that “An inpatient was diagnosed with asymptomatic [Covid delta variant] infection on routine pre-discharge testing. Contact tracing detected infection in 6 of 38 patients (15.8%), 1 of 168 staff (0.6%), and 1 of 6 visitors (16.7%)” (Linsenmeyer et al, 2021). This was a study of just one person. It is immediately obvious that the directionality of infection is not clear, because all of those other people had contact with people other than the patient. Any one of the infected people could have been infected by someone else. The infection in the patient was detected before discharge, so the infection could have come from within the hospital from one of those other people.
It is clear that the majority of the science on asymptomatic transmission of Covid finds it currently to be insignificant to the spread of the virus. Therefore, there is no justification for pursuing intrusive (and often damaging) policy measures that affect everyone, whether or not they have symptoms. Once we let that idea sink it there are massive implications. Therefore there is resistance from people who want to maintain the new medical orthodoxy – as I will now discuss.
The misuse of the precautionary principle
One of the responses by people who seek to defend the medical orthodoxy is to cite the “precautionary principle”. That is a really important principle about assessing the risks of being wrong or delaying decisions based on limited evidence. Therefore some people ask what if the science is wrong and there is significant asymptomatic transmission? I consider that question – posed rhetorically – is a misuse of the precautionary principle for two reasons. First, it stretches the principle to an absurd degree. Because the science would have to be hugely wrong in order for asymptomatic transmission to have been significant to the spread of the pandemic.
The second reason it is a misuse of the precautionary principle is that it ignores the collateral damage of the belief that asymptomatic transmission is significant. That collateral damage is real both in terms of the specific health challenge of Covid as well as other important societal issues. That damage includes the counterproductive distraction from a focus on whether oneself or someone else has symptoms. I can illustrate this effect with a series of questions.
Can you see their runny nose behind their mask? Do you falsely think you are safe to other people despite your fever and other symptoms because you have a mask on? Do you think you have done enough by getting vaccinated and so if you have some symptoms it doesn’t matter to go out in public? Do you think you can expect your staff to come to work even if they have symptoms? Or deny them income when they stay at home due to symptoms? Do you politely challenge people who have symptoms in public places but who are vaccinated and wearing a mask? Why not? Where is the relevant social pressure to support such a sensible act?
The collateral damage extends far beyond the matter of distraction from sensible attention to symptoms. Lockdowns of healthy people would not have been justified. Therefore tens of thousands of businesses and livelihoods would not have been destroyed around the world. Public finances would not have been destroyed. Hundreds of millions of children would not have been forced into poverty, with associated malnutrition and likely health problems for life. Hundreds of millions of children around the world would not have had their schooling and childhoods massively disrupted. Laws would not have been passed that steal basic rights from people who choose not to be vaccinated. Horrible rows between friends and family would have been avoided. Constant citizen surveillance would not have been initiated. Bigtech platforms would not have been given an excuse to censor our public online communications. Young people’s health would not have been risked, even if in minor ways, with the use of experimental compounds prior to final multi-year safety testing for a disease that is not known to be a significant risk to them. And public confidence in science and medical authorities would not be collapsing in the way it is in many countries right now.
The existence of this collateral damage means that the burden of proof for asymptomatic transmission is with those who argue that it exists sufficiently to matter to the pandemic. It is a basic principle in medical ethics that the burden of proof is with the people proposing any medical intervention. The idea of significant asymptomatic transmission underpins so many medical interventions, whether pharmaceutical or non pharmaceutical measures. Therefore the burden of proof on significance of asymptomatic transmission is with anyone promoting any of those measures, and the science I have summarised in this article demonstrates they would fail to deliver on that burden of proof.
Avoiding complicity with medical aggression
It is a strange aspect of the situation that a large proportion of the general public do not believe in many of the measures and are ‘going along with them’ for an easier life . I have received pictures of people sitting around the Christmas dinner table with their masks under their chins. That reflects that mask wearing has now become a sign of half-hearted deference to social norms. Like wearing a tie at the office, it shows you wish to indicate your deference to social norms (I haven’t looked into it, but perhaps an alternative history of the necktie might be that the cravatte initially doubled up as a mask during a past period of health concerns).
Might I be taking such things too seriously? I do not think so. Around the world the most draconian measures are being introduced on the basis of a starting assumption of the importance of asymptomatic transmission. A new era of institutionalised medical aggression is being based on the falsehood of significant asymptomatic transmission. Some people are calling it bio-fascism. That might sound strong. But let’s look at what is being done. In some countries foreigners can be deported for not wearing a mask. Some countries are now preparing to fine and imprison people who choose not to be vaccinated. Some countries are requiring employers to fire staff who are not vaccinated. These rapid removals of basic rights from huge numbers of citizens can be regarded as ‘fascist’ because it uses a fake moral discourse and fear-based hysteria to gain public support for the fabrication of an enemy to blame and oppress. It is why asking those questions that enable our critical thinking is important as we assess what is happening in our societies. Otherwise it is easy to become an accidental fascist. Which reminds me of Noam Chomsky. He is an academic known for critical perspectives, and how corporations ‘manufacture consent’ in the general public. He has previously warned of the potential rise of fascism in the USA. In a recent interview he said that people not vaccinated against Covid should not be allowed to do anything outside their homes and that obtaining their basic necessities for life, such as food and medicine, should be of no concern for the state or any one else.
If Professor Chomsky could momentarily morph into a biofascist as he experienced some personal vulnerability, then it shows how difficult it will be for the rest of us to remain calm enough to be critical thinkers throughout the disruptions to come. But we must try. Because any one of us can change and realise that we were wrong. And that we were made to be wrong by corporate power and the state having manipulated our understanding. That is why I have decided to speak out: I want to share with people who are interested in my analysis on society how we can think again and thus remove our participation from attitudes and behaviours that harm both ourselves and others.
One important principle for critical thinking is never to dig ourselves into a position. So, before concluding, I want to note that my views might change in the future. Although asymptomatic transmission has been insignificant for the spread of the virus until now, that might change in the future. One cause of a change could be a future mutation. Another cause could be an accidental side effect of some of the vaccines. Unfortunately, there is now evidence that a vaccination in the arm for a disease that mainly enters the body through the nasal passage slightly misdirects the immune system so that the antibodies are lower in the nose for the vaccinated person and thus the viral load in the nose is higher when they become infected (Brown 2021 found that “the vaccinated had on average more virus in their nose than the unvaccinated who were infected.”) That may increase the likelihood of all forms of transmission – including pre-symptomatic and asymptomatic. We must hope that if that becomes the case, then the effect is not so bad as to change the situation of insignificant asymptomatic transmission. Also, we must hope that Covid evolves to a less virulent form and so all these concerns dissipate. But right now, we can state that over the first two years of the Covid pandemic, asymptomatic transmission was not significant.
I believe the absence of asymptomatic transmission as a significant factor in this pandemic means that we could have organised a response to the virus without the disruption, demonisation, divisiveness, draconian assault on rights, damage to people’s lives and decimation of public finances. Rather than such medical aggression, we could have taken a different approach. We could have focused on encouraging – and removing barriers to – responsible behaviour. I explained some aspects of this citizen-based response in a blog here. We still could try such an approach.
It is important we learn from this pandemic, as there will be more to come, because modern industrial societies have destabilised the ecology of the planet. Critical thinking about what we are told by the corporate media and authorities, as well as non-attachment to our current stories of reality, will be crucial in how we avoid participating in societal harm as our societies become more disrupted due to the increasing pressures from environmental degradation.
Thanks for reading. I hope that although the manipulations and aggressions will continue during 2022, that more of us will speak up, connect with each other, and sustain each other in the face of medical aggression from wherever it arises. It is with that in mind I wrote and released the song Love and Rage, with a video that invites attention to mask wearing. If you watched it and felt upset or angry, then congratulations, you have experienced the way our inner worlds are shaped by power. Noticing that is the first step towards consciously freeing yourself.
What to do?
If you conclude that the orthodox policy agenda on the pandemic needs to be rethought, what can you do? It can be daunting when there seems to be a tide of authority, media and public opinion headed in one direction.
I would like to ask you to do each of the following:
- First, choose an organisation or network that you are part of and care about, such as a trade union, charity or community group. Write to the coordinators of that organisation with a request that they read this article and offer you their own views on how their organisation can respond well to a polarising policy agenda on the pandemic. Explain that you would welcome a phone or video call to discuss the issues either alone or with a wider group if they prefer.
- Second, choose a dozen friends or colleagues and send them this article and ask if they would join a group video call about the issues arising. Explain that you are concerned about how polarising the current policy agenda has become and want to hear more views on it.
- Third, share this article within the social media groups connected to organisations or topics that you care about. Explain that you would like to hear what people who are interested in the topic of the group think is a sensible response to the polarising policy agenda on the pandemic. That might be Facebook, LinkedIn, Ning or another platform. I recommend not expressing your views but inviting people to read this article and share theirs. That will help you understand the sentiment in the community of interest that you engage with.
Yes I am asking you to talk to people within networks that involve shared agreements on how people engage each other within them. We need to start there. Apart from that, I recommend finding the non-party political groups in your country that are coordinating resistance to vaccine mandates for citizens or employees. In the UK that is the Together Declaration.
If I have changed your mind at all then you could play my video to Love and Rage and maybe enjoy it!
Good luck in 2022.
xJem
My previous writings on Covid
The Climate for Corona – our warming world is more vulnerable to pandemic – where I discuss how environmental degradation makes zoonotic disease more likely.
COVID and Climate Change – why XR must visit the WHO – where I discuss that even if the virus came from an experiment then the people who fund such dangerous experiments have tried to justify themselves due to anticipating an era of pandemics due to environmental change.
For Environmentalists, COVID is the Elephant in the Zoom – where I emphasize that either due to direct impacts on bats or indirect impacts on the recklessness of bat scientists that the suffering being caused by Covid and the policy responses are forms of suffering due to climate change and our maladaptations to it.
Lies Damn Lies and Hospitalisation Statistics – where I explain that medical corporations have been too involved in shaping our understanding of possible responses to the pandemic and that even concludes developing misleading statistical methods on vaccine effectiveness.
It’s time for more of a citizen’s response to the pandemic – for a real #PlanB – where I explain how a different agenda to the current orthodoxy could be pursued that allies with our fellow citizens to remove barriers to us all making responsible decisions and how the Left has failed to articulate this agenda due to having lost close connection with the low paid workforce.
Uniting in Love and Rage against Corporate Power – where I explain that the corporate media demonise activists in ways that limit solidarity across different topics in the struggle against the abuse of corporate power so we need to come together rather than accept the negative stories about other kinds of activists.
Finding my voice through a fever – where I explain that getting Covid myself made me stop work, rethink my priorities and start writing, performing and recording music for the first time in my life.
References
Bendell J, Carr K. Group Facilitation on Societal Disruption and Collapse: Insights from Deep Adaptation. Sustainability. 2021; 13(11):6280. https://doi.org/10.3390/su13116280
Brown et al (2021) Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings – Barnstable County, Massachusetts, July 2021 MMWR Morb Mortal Wkly Rep. 2021 Aug 6;70(31):1059-1062. doi: http://doi.org/10.15585/mmwr.mm7031e2
Linsenmeyer et al (2021) Cryptic Transmission of the Delta Variant AY.3 Sublineage of SARS-CoV-2 among Fully Vaccinated Patients on an Inpatient Ward
Katherine Linsenmeyer, Kalpana Gupta, Rebecca Madjarov, Michael E. Charness
medRxiv 2021.08.05.21261562; doi: https://doi.org/10.1101/2021.08.05.21261562
tMahmood, M., Ilyas, Nua., Khan, M.F. et al. Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases. Virol J 18, 138 (2021). https://doi.org/10.1186/s12985-021-01609-w https://virologyj.biomedcentral.com/articles/10.1186/s12985-021-01609-w
Mercedes Yanes-Lane, Nicholas Winters, Federica Fregonese et al, ‘Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: a systematic review and meta-analysis’, PLoS One (National Library of Medicine: National Center for Biotechnology Information), 15 (11), 3 November 2020: e0241536; DOI: 10.1371/journal.pone.0241536. Available at https://pubmed.ncbi.nlm.nih.gov/33141862/
Oyungerel Byambasuren, Magnolia Cardona, Katy Bell et al, ‘Estimating the extent of asymptomatic COVID-19 and its potential for community transmission: systematic review and metaanalysis’, Official Journal of the Association of Medical Microbiology and Infectious Disease Canada, 5 (4), 11 December 2020: 223–34; DOI: https://doi.org/10.3138/jammi-2020-0030. Available at https://jammi.utpjournals.press/doi/full/10.3138/jammi-2020-0030
Shiyi Cao, Yong Gan, Chao Wang, Max Bachmann et al, ‘Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China’, Nature Communications, 11, 5917, 20 November 2020; DOI: https://doi.org/10.1038/s41467-020-19802-w. Available at https://www.nature.com/articles/s41467-020-19802-w
Professor Jem Bendell 