• Published on: Jul 07, 2020
  • 1 minute read
  • By: Dr Rajan Choudhary

Asymptomatic Carriers Of COVID

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Why Asymptomatic carriers of COVID are as dangerous as symptomatic patients

 

Many countries have now begun enforcing masks for everyone to wear when out in public, in enclosed spaces, or on public transport. There is good evidence to support these measures, but unfortunately, some still show resistance to the idea. Whilst some reasons put forward are non-sensical (masks do not cause any noticeable or measurable decrease in oxygen delivery to the body), other people feel like they shouldn’t wear a mask because they do not have symptoms of COVID. And thus would not spread anything. Here we look at a recent publication in Nature, one of the most esteemed peer-reviewed scientific journals in the world, and what it shows us about the transmission of COVID in a population.

This study by Lavezzo et al looked at the suppression of the SARS-CoV-2 outbreak in the Italian municipality of Vo’. This municipality is 50 kilometers west of Venice with a population of just 3,416 people. It experienced its first casualty of COVID on the 21st of February, after which it underwent lockdown for 14 days. During this time data was collected on the clinical presentation and hospitalization of COVID patients, as well as other citizens through the contact tracing network.

In total 2,812 residents were tested in late February, with another 2,343 tests performed two weeks later at the end of lockdown. Nasal and throat swabs were taken to identify infected individuals. The study found only 2.6% of people were positive for COVID at the start of lockdown, which reduced to 1.2% two weeks later.

Out of this infected population, 42.5% were asymptomatic. They had no symptoms at the time of swab testing nor did they develop symptoms afterwards. When the viral load was measured between symptomatic and asymptomatic patients, there was little difference.

Evidence has pointed to a large asymptomatic population, and previous studies have shown it to be as high as 50% in some cases. Many would assume if a patient has no symptoms then they must have fought the infection before it became an issue, or had a very low viral load and therefore were not likely to spread it. This study shows it is simply not true. Asymptomatic carriers of COVID are likely to contribute to the transmission and spread of COVID amongst the population.

If you are asymptomatic you have as high a viral load as someone who is symptomatic. But there is no way to tell without a swab. You have as much of a potential to spread the infection to the vulnerable. Even in people who became symptomatic the height of transmission was found to be before the patient showed any symptoms.

So what does this mean? If you have COVID you are likely to spread it before you show any symptoms or any symptoms at all. We know masks are effective at significantly reducing the spread of COVID, by catching the water droplets that carry the SARS-CoV-2 Virus. Now that shops and public places are re-opening, the risk of spread is high.

Wear a mask. Stop the spread.

https://www.nature.com/articles/s41586-020-2488-1_reference.pdf suppression of a SARS article

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Lower premiums

Lower Premiums for Health Score Achievers: How Preventive Wellness Rewards Healthy Choices

Healthcare costs are rising steadily across India, driven largely by lifestyle-related diseases and late-stage diagnosis. In response, organisations and insurers are shifting focus from reactive treatment to prevention. One of the most effective approaches emerging from this shift is offering lower premiums for health score achievers.

This model aligns personal health responsibility with financial incentives, creating a win–win situation for individuals, employers and insurers.

 

What Is a Health Score?

A health score is a composite indicator that reflects an individual’s overall health status.

It typically considers:

  • preventive health checkup results

  • lifestyle habits such as physical activity and sleep

  • key biomarkers like blood sugar, cholesterol and blood pressure

  • body composition indicators

The focus is on risk reduction, not perfection.

 

Why Health Score–Based Premiums Are Gaining Importance

According to NITI Aayog and EY-FICCI reports, preventive healthcare can reduce long-term medical costs by up to 30–40 percent.

Health score–linked premiums:

  • reward proactive behaviour

  • reduce claim frequency

  • encourage early detection

This shifts healthcare from illness management to health preservation.

 

The Preventive Healthcare Gap in India

NFHS-5 and ICMR data show:

  • many chronic diseases remain undiagnosed until advanced stages

  • preventive screenings are underutilised

  • lifestyle risks are increasing among working adults

Health score incentives help close this gap.

 

How Lower Premiums Motivate Behaviour Change

Financial Incentives Drive Consistency

When healthy habits are rewarded financially, individuals are more likely to:

  • attend regular screenings

  • improve diet and activity

  • monitor health metrics

Behaviour change becomes sustainable.

Focus on Improvement, Not Punishment

Modern health score models emphasise:

  • gradual improvement

  • personalised targets

  • achievable milestones

This avoids discouragement and promotes inclusion.

 

Benefits for Individuals

Reduced Insurance Costs

Lower premiums directly reduce out-of-pocket insurance expenses.

 

Better Health Awareness

Tracking health scores increases understanding of:

  • personal risk factors

  • lifestyle impact

  • preventive actions

Knowledge leads to better choices.

 

Early Disease Detection

Regular monitoring identifies:

  • prediabetes

  • early hypertension

  • lipid abnormalities

Early intervention prevents complications.

 

Benefits for Employers

Lower Healthcare Claims

Preventive health programs reduce:

  • hospitalisations

  • long-term treatment costs

This improves corporate insurance sustainability.

 

Improved Productivity

Healthier employees experience:

  • fewer sick days

  • better energy levels

  • improved focus

Wellbeing translates to performance.

 

Stronger Wellness Culture

Reward-based programs signal genuine employer commitment to health.

 

Benefits for Insurers

Health score–based premiums help insurers:

  • manage risk more accurately

  • reduce high-cost claims

  • promote preventive engagement

This supports long-term viability of insurance models.

 

Role of Preventive Health Checkups

Preventive screenings form the backbone of health scoring.

They help track:

  • metabolic health

  • cardiovascular risk

  • nutritional deficiencies

NITI Aayog identifies screening as the most cost-effective health intervention.

 

Addressing Privacy and Fairness Concerns

Responsible programs ensure:

  • data confidentiality

  • voluntary participation

  • non-discriminatory design

Transparency builds trust and engagement.

 

Making Health Scores Inclusive

Inclusive programs:

  • adjust for age and baseline health

  • reward progress

  • offer support for high-risk individuals

Equity is essential for success.

 

Integration with Digital Health Platforms

Digital tools enable:

  • real-time health tracking

  • personalised insights

  • long-term trend monitoring

This improves engagement and accuracy.

 

Long-Term Impact on Public Health

Widespread adoption of health score incentives can:

  • reduce lifestyle disease burden

  • shift focus to prevention

  • improve population health outcomes

WHO supports incentive-based preventive health strategies globally.

 

Challenges and How to Overcome Them

Common challenges include:

  • low initial engagement

  • lack of awareness

  • resistance to change

Solutions involve education, simplicity and continuous support.

 

Why Lower Premiums Are More Effective Than Penalties

Positive reinforcement:

  • motivates sustained behaviour change

  • reduces anxiety

  • builds trust

Punitive models often discourage participation.

 

Future of Health Score–Linked Premiums in India

As digital health infrastructure expands, health score–based models are expected to:

  • become more personalised

  • integrate AI-driven insights

  • support nationwide preventive strategies

This marks a shift toward value-based healthcare.

 

Conclusion

Lower premiums for health score achievers represent a powerful shift toward preventive, value-driven healthcare. By rewarding healthy behaviours, early screening and consistent wellness practices, these programs benefit individuals, employers and insurers alike. Financial incentives aligned with health outcomes encourage long-term behaviour change, reduce disease burden and create a sustainable healthcare ecosystem. In a country facing rising lifestyle diseases, health score–linked premiums are not just an incentive—they are a strategic investment in healthier futures.

 

References

  • World Health Organization (WHO) – Preventive Healthcare and Incentive Models
  • Indian Council of Medical Research (ICMR) – Lifestyle Disease and Prevention
  • National Family Health Survey (NFHS-5) – Adult Health Indicators
  • NITI Aayog – Preventive Healthcare and Insurance Reform Reports
  • EY-FICCI – Corporate Wellness and Healthcare Cost Studies

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