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CSTE COVID-19 Response Resource Repository

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Posted by Lisa McHugh ·

Onset Dates

We have several cases who were tested in late March but who had unresolved symptoms or symptoms with limited resolution that began in mid- to late-February. Anyone encountering similar issues and if so how are you dealing with assigning onset dates? Given what we know – I think – it’s possible they had COVID back in February and we are just finding it in late March – it’s also possible they had something else and got infected with COVID on top of that. We have looked at trying to identifying a "worsening of symptoms" if that information is available or are specimen collection as a proxy but we are wondering if there is a better way to classify.
 

Comments & Events

Sarah Park, State Epidemiologist at HI Sarah Park, State Epidemiologist
We've seen similar cases and struggled as well.  If really no symptoms, we default to the test date.  Not ideal but all we have.  Who knows where in the course of infection they are...  Others are asymptomatic at the time they're tested but have a history of illness maybe a couple weeks or more previous to being tested.  Suspect that may be onset date and likely not infectious and only shedding, but given no data to support this assumption and no way to know, again stuck with putting them in isolation....  Then there are those that had cough starting weeks previously and still have cough and that's it.  We really need a test that identifies whether someone is infectious or not, and we need data on what to expect with regard to those who are asymptomatic.  Am wondering if if a reasonable serological assay is developed, we perform both the PCR and serological assay, if the the serological assay is positive for antibodies while the PCR is positive, maybe we can assume the person is likely no longer infectious...
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