South Sudan’s First COVID-19 Patient Could Have Been Asymptomatic, Presymptomatic Or Symptomatic Risk

South Sudan is no longer a coronavirus-free territory. Today, April 5, 2020, the world’s youngest nation announced its first case of COVID-19 virus since it broke out 5 months ago.

However, this first case is carried by a person who entered South Sudan from the Netherlands 5 weeks ago. How possible could the 29 year-old lady have carried the virus from or before February 28, 2020? 

Since the incubation period of COVID-19 is between 1 and 14 days, with the patient going symptomatic within the average of 5 days, the case in question here could have spread the disease presymptomatically, asymptomatically, or symptomatically.

Before looking into what the above-mentioned terms mean, first, the breaking news quotes:

Press Statements


“On behalf of the president and the Chairman of the High-Level Task-Force, I would like to inform the public that on Saturday 4th April 2020, the Public Health Laboratory tested and confirmed a case of COVID-19 in an individual. 

The suspect presented to the UN Clinic on the 2nd April 2020 with fever, cough, headache and shortness of breath. The Ministry of Health Rapid Response Team (RRT) went to the clinic and collected the sample the same day. The initial test came positive. The second run of the same test also returned positive.

The patient is a 29-year-old female who arrived at the country from the Netherlands via Addis Ababa on the 28th of February 2020. She has no history of underlying or pre-existing illness. She is currently under isolation and is in good health.”


“The United Nations in South Sudan has confirmed a case of coronavirus disease (COVID-19) among its staff. The Ministry of Health and the World Health Organization (WHO) are leading the investigation by epidemiologists to test people recently in contact with the patient in accordance with agreed protocols.

The patient has been resident in South Sudan for five weeks. She started working from home immediately after the onset of the symptoms and voluntarily requested to be tested to check her status with regard to COVID-19. The patient is recovering well.”

Public Reactions

Upon receiving the news, the South Sudanese populations, both inside and outside of the country, reacted with vehemence. 

First, the question of how long the patient has carried the disease around unknowingly beyond the normal symptomization and incubation periods. Secondly, why it had taken long for the Government and UN agencies to detect such a case. 

However, since I revealed yesterday on this platform (as linked at the end of this page) the possible reasons why South Sudan had not detected a coronavirus case since it’s outbreak, the second question today is why the lady had not developed or shown any symptoms since her arrival on February 28? Is there any error or foul play in the reporting by the patient, herself, or by the authorities, or is there a new anomaly in the development of the insidious virus?

While members of the public have also gone ahead to suggest that this Covid-19 carrier could have contracted the virus from within Juba after her arrival from the Netherlands, it is prudent to look into the disease, itself, vis-a-vis the victim. And the following could be the possible scenarios.


 According to Science Alert report, 1 out of 4 Covid-19 cases could be ‘asymptomatic’. This means a person is carrying the virus without feeling the symptoms or without necessarily falling sick of the virus. It is like a discordant carrier in the case of HIV.

“There’s significant transmission by people not showing symptoms,” Stephen Morse, an epidemiologist at Columbia University, told Business Insider.

According to Robert Redfield, the director of the Centres for Disease Control and Prevention, 25 percent of people infected with the new coronavirus don’t present any symptoms or fall ill but can still transmit the illness to others.

Redfield on Tuesday told NPR that “we have pretty much confirmed” that “a significant number of individuals that are infected actually remain asymptomatic.”

Therefore, a possibility that the Dutch citizen, who is a UN worker in South Sudan, could have been in such a situation. 

Anyhow, from these analyses, the prevalence of asymptomatic transmission doesn’t bode well for global containment efforts, as Bill Gates recently wrote in an article published in the New England Journal of Medicine.

“That means COVID-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people,” Gates said.


So what is this? Simply by grammatical rule, it is the opposite of the above. It is carrier whose symptoms are conspicuous and testable. Therefore, in our case of South Sudan here, an asymptomic can give rise to a symptomatic, but the reverse is not automatic or true.

In the WHO study, 75 percent of people in China who were first classified as asymptomatic later developed symptoms, ProPublica reported. That means, technically, “presymptomatic transmission” is what’s probably common.


Simply in the same linguistic vein, the affix (prefix) ‘pre-‘ means ‘before’, and the ‘symptomatic’ is explained above. So it is the infecting of the unsuspecting victims by a virus carrier before feeling and reporting the symptoms. This can possibly occur during the first 48 hours or days of the 14-day gestation period of the virus. 

In the case of our South Sudan’s ‘Patient Zero’ (debut or novel case), the UN’s press release has indicated that “she started working from home immediately after the onset of the symptoms…” Take note of the adverbial qualifier of time, ‘after’!

Here, no intention or cause for an alarm, though, but to be on the safer side, investigators of the patient’s trails should consider the Presymptomatic analysis in this case. I mean, those with whom she interacted immediately before she felt the symptoms that prompted her to seek self quarantine and voluntary testing. 

In conclusion, let me use the CDC authority again. Redfield, “It appears that we’re shedding significant virus” about 48 hours before symptoms appear.

So, the South Sudan Task Force should take this note from the scientist. “This helps explain how rapidly this virus continues to spread across the country, because we have asymptomatic transmitters and we have individuals who are transmitting 48 hours before they become symptomatic,” he added.

A handful of recent studies and reports suggest that presymptomatic and asymptomatic transmission are not unusual.

The most important takeaway from this new development is that children are very potential asymptomatics in that the virus does not overcome their immune system so easily. That means they can spread the disease to the older members of the house.

So, with them, stay at home, watch your hands even without having greeted anyone or touched anything. You never know!



First story by the same author: (link:

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