Mild symptoms don’t mean you’re less infectious: S’pore doctor debunks lingering Covid-19 myths

Covid-19 might seem like a thing of the past. After all, the pandemic was a good few years ago.

However, just because you or your friends and family haven’t been infected by the virus in a while, it doesn’t mean that the risk of another Covid wave is non-existent.

After all, Singapore saw a spike in cases in May earlier this year.

Furthermore, in a May 2024 update, the Ministry of Health (MOH) shared that 20 per cent of Singapore’s population had yet to receive a vaccination dose within the last year.

“This indicates that immunity in the population is likely to have waned,” MOH stated.

Findings from an independent, ongoing survey conducted by Ipsos (Covid-19 Diagnostics and Therapeutic Consumer Study), also points to a decrease in the use of diagnostic testing in this region.

Wave 10 of the study was conducted from May 6 to 13, and, in addition to respondents from across the globe, polled 2,002 people from Singapore.

The study found a decrease in the proportion of respondents who confirmed through testing that they currently have or previously had Covid-19 within the 12 months before they participated in the study.

From wave 9 of the study in February 2024, to wave 10 in May 2024, this number dropped from 33 per cent to 24 per cent.

Additionally, there were “significant changes in at-home testing behaviours” in the start of 2024, with an increase in respondents testing at least once a month, and a decrease in testing daily or when feeling ill, symptomatic, or after exposure.

Risks to reduced testing

We spoke to infectious disease expert Leong Hoe Nam to find out more about the reasons behind this decline, and the risks it could pose.

Leong explained that this could be due to Singapore transitioning into living with Covid-19 as an “endemic” disease.

“Many people no longer see the virus as a threat,” Leong said, explaining that many had already contracted Covid-19 before and recovered from it.

“This sense of indifference or ‘pandemic fatigue’ is a key reason for the reduction in Covid-19 testing.”

Additionally, Covid-19 treatment is no longer fully subsidised, and has not been so since April 2023, which could lead to an increased reluctance for patients to test themselves, Leong said.

Reduced testing could lead to a higher number of undetected Covid-19 cases and increased transmission rates.

This could make it more challenging to track and understand the spread and impact of the disease, which could hinder the implementation of effective public health measures needed to control the spread.

Testing is also key in detecting new variants of the virus, and early detection can help control the transmissibility of these new variants.

Leong added that a decrease in testing could delay identification of these variants, which may be more transmissible or resistant to current treatments.

“The world gleaned much in the first two years primarily because we were tracking and monitoring the Covid spread like a hawk,” Leong said.

Mild symptoms ≠ absence of Covid

Another reason that could contribute to reduced testing is the conception that if one’s symptoms are mild, there is less reason to get tested and seek treatment.

Only around one in five Singaporeans who had a positive diagnosis of Covid-19 in the past 12 months contacted a healthcare professional as they were concerned about the severity of their symptoms.

Meanwhile, 12 per cent of respondents who suspected they had Covid-19 but had no confirmed diagnostic test, did not test as they were not concerned about it or getting ill.

This should not be the case, Leong said.

“Firstly, mild symptoms do not exclude Covid,” Leong highlighted. “In fact, Covid may occur with very mild or no symptoms. Asymptomatic individuals may still develop complications such as the dreaded long Covid.”

Additionally, mild symptoms do not mean that the virus is any less infectious. After all, even those with Covid-19 who are asymptomatic can still spread the virus.

This misconception can thus lead to increased transmission, and Leong emphasised the need for testing regardless of the severity of symptoms.

This is crucial for containing the spread of the virus, among other benefits.

“Covid-19 testing enables individuals to make informed decisions on next steps. For example, getting treatment to reduce the risk of severe illness and taking proactive steps to lower the chances of spreading the virus to others, particularly the vulnerable populations and individuals with underlying medical conditions.

This at-risk individual could be your loved one living in the same household as you are whom you attend to every day.”

Risk of contracting Covid

Aside from the potential emergence of new variants and the possible uncontrolled spread of the virus if people do not regularly test themselves for Covid-19, Leong posited that another long-term risk is that of an overburdened healthcare system.

“If individuals are not seeking treatment until their symptoms become severe, this could lead to a sudden influx of severe cases that could pose greater strain on our healthcare system.”

According to the Ipsos study, 78 per cent of high-risk persons surveyed in Singapore are actually at risk of contracting severe Covid-19, but do not believe they are or aren’t sure if they are.

People considered “high risk” are those who have pre-existing conditions such as chronic respiratory diseases, asthma and diabetes, if they smoke, or are above the age of 60.

Other factors that could determine an individual’s risk of getting Covid-19, Leong mentioned, include age and the state of one’s immune system.

“Many individuals underestimate their own risks for severe disease, citing their healthy lifestyle or their supplements. These latter interventions are important, but often still insufficient in our protection against Covid,” Leong stated.

Covid-19 is not an illness to take lightly, even if it seems like the pandemic might be long over.

So take this as a timely reminder to test yourself if you’re experiencing symptoms, even if the symptoms are mild, or if you have been exposed to someone who has tested positive, or is exhibiting symptoms.

This is especially so if you’re at a higher risk of contracting the virus and developing severe symptoms.

According to MOH, the groups most likely to develop severe disease are:

• Persons aged 60 years or older;
• Pregnant women;
• Persons who are immunocompromised or have underlying medical conditions such as obesity, diabetes, heart, lung or renal disease.

Leong also advises people to stay updated regarding the latest developments about Covid-19, via reliable sources such as the World Health Organisation (WHO) and MOH.

Find out here if you could be at high risk of severe Covid-19 today.

This branded article is brought to you by Pfizer Singapore.

The opinions expressed in this article are solely those of the expert(s), speaker(s) or participant(s) featured herein. This material is intended for educational and/or disease awareness purposes only and should not be used as a substitute for consulting a healthcare professional. For more information, speak to a healthcare professional. References are available upon request.

PP-C1D-SGP-0198/13DEC2024

Top photo from Canva and MIMS website