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

Asymptomatic COVID Infections – Are You Safe?

Asymptomatic COVID infections – are you safe?

Patients with COVID usually exhibit signs of coughing, fever, and fatigue. This can develop into further respiratory problems including difficulty breathing, pneumonia in both lungs, and in severe cases the need to ventilate a patient in an intensive care setting. But what if you are asymptomatic? Do you need to worry? Surely you get the benefits of immunity without the dangers of life-threatening symptoms.

In our previous blog, we discussed how a study showed 41% of people with COVID were asymptomatic. However, they had the same viral load as their symptomatic counterparts. This paper published in Nature Medicine suggests that even the asymptomatic patients developed signs of lung inflammation without showing any outward symptoms. Could asymptomatic patients still be damaged by COVID? It's not easy to study this subset of patients, as they do not get tested routinely or present to hospital for examination or investigation.

This study looked at 37 individuals in the Wanzhou District who were diagnosed with COVID via swab test but did not show any symptoms before the test or during hospitalization. These patients were found through the extensive contact tracing program set up in Central China. Whilst in hospital 57% showed abnormalities in the lung fields on a CT scan, including the “ground glass” appearance classic for COVID pneumonia. These changes could be due to fluid or blood in the area or due to inflammation caused directly by the infection.

What does this mean for the individual in the long term? This is difficult to say, especially since COVID has only been around for a few months so long term follow up is simply impossible to state accurately. Depending on the size and severity of the inflammation it may resolve spontaneously with no lasting damage, or the inflammation could cause scarring of the lung tissue that only becomes evident several years or decades down the line. It's difficult to tell.

The study also looked at two other factors in these patients. Compared to their symptomatic counterparts, asymptomatic patients were found to shed viral particles for several more days. It is unclear the significance of this, or whether this makes them more infective or prone to transmitting the infection for a longer period of time. It does add support to the theory asymptomatic people should not believe themselves exempt from spreading the infection.

Secondly, the study looked at the prevalence of antibodies present in the patient's blood. These antibodies can be used as a surrogate for immunity. In theory, after infection occurs our body has the ability to rapidly produce these antibodies against the virus in the event of a second infection. This would neutralize the infection before it could develop into a serious disease.

Looking at these antibodies the researchers found antibody levels against the SARS and MERS virus to last over 2 years. However, against SARS-CoV-2, the antibody levels fall within 2-3 months, providing only a short duration of immunity. This is worrisome for individuals and countries hoping to achieve herd immunity or at least immunity to the virus after a mild or asymptomatic infection.

So what should we take away from this? Perhaps an asymptomatic infection is not the perfect scenario. Damage does occur to your lungs, albeit temporary damage. You are still able to spread it to vulnerable people. And your immunity may not last as long as other infections.

Therefore be safe. Maintain social distancing, follow government advice on wearing a mask. And if you can, avoid excessive socializing or close contact with lots of other people. The virus hasn’t gone away, and it is still dangerous.

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Difference Between Sadness and Depression: Understanding Normal Emotions vs Mental Illness

Feeling low or unhappy is a part of being human. However, not all low moods are the same. Many people confuse sadness with depression, which can delay proper support and treatment. Understanding the difference between sadness and depression is crucial for mental health awareness, early intervention and reducing stigma.

In India, mental health conditions are often misunderstood, with emotional distress frequently dismissed as temporary sadness.

What Is Sadness?

Sadness is a normal human emotion.

It usually occurs due to:

loss or disappointment
relationship issues
failure or stress
temporary life challenges

Sadness serves a psychological purpose, allowing individuals to process emotions and adapt.

Key Characteristics of Sadness

Sadness is:

situational
temporary
emotionally painful but manageable
responsive to support and positive events

A person experiencing sadness can still function, enjoy moments and feel hopeful.

What Is Depression?

Depression is a medical condition classified as a mood disorder.

It affects:

emotions
thinking patterns
behaviour
physical health

According to WHO, depression is one of the leading causes of disability worldwide.

Core Symptoms of Depression

Depression involves a combination of symptoms such as:

persistent low mood
loss of interest or pleasure
fatigue
sleep disturbances
appetite changes
feelings of worthlessness
difficulty concentrating

These symptoms last at least two weeks or longer.

Duration: A Key Difference

One major difference lies in duration.

Sadness:

lasts hours or days
improves with time

Depression:

lasts weeks or months
persists despite positive events

Duration helps distinguish emotional response from illness.

Impact on Daily Functioning

Sadness:

allows continuation of work and relationships
may reduce motivation temporarily

Depression:

interferes with work, studies and relationships
reduces self-care and productivity

Functional impairment is a defining feature of depression.

Emotional Experience: Sadness vs Depression

Sadness:

allows emotional range
moments of joy still occur

Depression:

creates emotional numbness
joy and interest disappear

People with depression often describe feeling empty rather than sad.

Physical Symptoms in Depression

Depression is not only emotional.

Physical symptoms include:

chronic fatigue
body aches
headaches
digestive issues

ICMR mental health studies highlight the physical burden of depression.

Thought Patterns and Self-Perception

Sadness:

thoughts remain realistic
self-worth is preserved

Depression:

negative self-talk dominates
feelings of guilt and worthlessness increase

These cognitive changes deepen emotional suffering.

Risk Factors for Depression

Factors increasing depression risk include:

chronic stress
trauma
family history
medical illnesses
hormonal changes

NFHS-5 data indicates rising mental health concerns among young adults.

Can Sadness Turn Into Depression?

Yes, prolonged or unresolved sadness can progress into depression.

This is more likely when:

stressors are ongoing
support systems are weak
coping mechanisms are limited

Early emotional support can prevent progression.

When to Seek Professional Help

Seek help if:

low mood lasts more than two weeks
daily functioning is affected
sleep and appetite are disturbed
thoughts of self-harm occur

Early care leads to better outcomes.

Treatment Differences

Sadness:

improves with rest, support and time

Depression:

requires psychotherapy
may need medication
benefits from structured care

WHO emphasises early treatment to reduce disability.

Role of Social Support

Support systems help both conditions but are essential for recovery.

Depression recovery improves with:

understanding family
supportive workplaces
accessible mental healthcare

Stigma reduction is key.

Mental Health Awareness in India

Mental health remains underdiagnosed in India.

NITI Aayog reports:

limited access to mental health services
low awareness
high stigma

Education helps bridge this gap.

Importance of Early Recognition

Recognising depression early:

prevents worsening
reduces suicide risk
improves quality of life

Delay increases suffering and complications.

Supporting Someone With Depression

Helpful actions include:

listening without judgement
encouraging professional help
avoiding minimising feelings

Compassion is more effective than advice.

Conclusion

Understanding the difference between sadness and depression is essential for emotional wellbeing and mental health care. Sadness is a natural, temporary response to life events, while depression is a serious medical condition that affects thoughts, emotions and daily functioning. Recognising the signs early and seeking appropriate help can prevent long-term suffering and promote recovery. Mental health deserves the same attention and care as physical health.

References

World Health Organization (WHO) – Depression and Mental Health Disorders
Indian Council of Medical Research (ICMR) – Mental Health Research and Burden
National Family Health Survey (NFHS-5) – Mental Health Indicators
Lancet – Depression, Disability and Public Health
NITI Aayog – National Mental Health Policy and Awareness Reports
Statista – Global and Indian Mental Health Trends

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