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At the outset of the COVID-19 pandemic, the presumed telltale signs of infection were obvious: fever, respiratory distress, chills. Then more subtle symptoms like diminished senses of loss and smell became more apparent. Eventually, we understood that some people developed few (or even no) symptomsโ€”but that they could still infect others and be โ€œsickโ€ for months themselves. Unfortunately, the learning curve continues as an article just published by JAMA Network reveals that the proportion of people whoโ€™ve been infected with COVID-19 but are asymptomatic is much higher than previously thought. Researchers conducted a meta-analysis of 95 studies reflecting 29.8 million individuals who had undergone testing for the virus. While only 0.25% of the whole tested population were found to have the virus, over 40% of those known to have COVID-19 were asymptomatic. And this was in February 2021, well before the emergence of the Delta and Omicron variants. The message for urgent care providers is clear: Merely considering presenting symptoms as a basis for testing patients for COVID-19 is woefully insufficient. Broader testing of patients across the board, resources permitting, with recommendations to quarantine as needed may be the most effective means of containing the latest surgeโ€”especially with so many people gathering in large numbers during this holiday season.

Asymptomatic COVID-19 Cases Are Higher Than Previously Known. We Need to Test More
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