HONOLULU (KHON2) — Recently the Centers for Disease Control added four new symptoms of COVID-19, making the list 11.

The wide range of congestion, runny nose, nausea, and diarrhea, added to fever, chills, muscle pain, headache, sore throat, and loss of taste or smell has made the virus difficult to pin down. It is also challenging because of the lack of symptoms that the CDC estimates accounts for 40% of the cases.

The CDC also estimates that half of transmission happens before a person that has been infected develops symptoms, a problem Hawaii Department of Health Director Dr. Bruce Anderson addressed Monday.

“Often individuals are asymptomatic and don’t know that they’re infected,” Anderson said. “This is a classic situation which I think emphasizes treating yourself and everyone else around you as if they were infected and ensuring you’re social distancing, staying away from others, wearing your mask.”

CDC Director Dr. Robert Redfield agrees that eliminating the virus really is that simple.

“If everyone could wear a face covering now for the next four weeks to six weeks we could drive this epidemic to the ground,” Dr. Redfield told reporters Monday.

If that doesn’t happen, clusters can appear out of thin air. Recently on Oahu a Hawaiian Airlines flight attendant training class exploded to spawn 24 cases, one of which infected two different gym classes, totaling additional 20 cases.

“One case apparently attended both the gym classes just showing how problematic it can be for a single individual to be in a closed environment,” Dr. Anderson said.

He added that tight spaces that are indoors without being well ventilated are risky.

“Being in a small room with people sweating and breathing hard is not a good place to be,” added Anderson.

Other situations can present the same danger.

“That’s how it is being spread,” said Anderson. “By people at the beach, attending parties, being too close to others, work related parties, social events, as well as business related meetings are spreading the disease from one person to another.”

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