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A ‘Negative’ COVID-19 Test Should Not Give You Too Much Peace Of Mind

by Karen Johnson
Updated: 
Originally Published: 
A cotton swab used in a nasal passage as health care professionals test for COVID-19 at the ProHEALT...
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One of the hardest parts of this ongoing pandemic is accepting that A) we’re going to hear things we don’t want to hear, and B) there is still a lot we don’t know. That’s just the reality of continuously evolving medical science—medical science that saves lives every day. Most recently, we have learned about a new piece of this confusing coronavirus puzzle, and it’s about testing. Negative testing results, to be precise. And this is one of those informational pieces you may not want to hear, but you need to. And honestly, once you really think about it, this is actually common sense.

Testing has been one of the biggest hurdles in this COVID-19 war, a hurdle that we seem to be overcoming, even if slowly, as tests are increasingly more available when compared to previous weeks. That doesn’t mean anyone can get one, however, and patients are still prioritized according to the following criteria per the CDC:

High Priority

  • Hospitalized patients with symptoms
  • Healthcare facility workers, workers in congregate living settings, and first responders with symptoms
  • Residents in long-term care facilities or other congregate living settings, including prisons and shelters, with symptoms

Priority

  • Persons with symptoms of potential COVID-19 infection, including: fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat.
  • Persons without symptoms who are prioritized by health departments or clinicians, for any reason, including but not limited to: public health monitoring, sentinel surveillance, or screening of other asymptomatic individuals according to state and local plans.

However, as tests become more readily available, it’s vital that we understand a few basic facts.

First of all, we need to understand the difference between the two types of COVID-19 tests being offered—viral tests and antibody tests. A viral test tells you if you have a current infection, whereas an antibody test tells you if you had a previous infection, the CDC says. And also, “an antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. We do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.”

Also, we need to accept that COVID-19 information is fluid. We will continue to learn new facts, with new research, and we must listen, learn, and accept that there might be something we previously thought to be true that has since been disproven. That’s how science works. Medical professionals and researchers literally spend their lives committed to saving people, so when they speak, we must pay attention. When they provide the newest, most up-to-date guidelines that will protect us and our families, we must follow them, even if those guidelines differ from what we were previously told.

A registered nurse puts a nasal swab into a tube held by another nurse, both wearing gloves and protective gowns, after doing a nasal swab on a patient in their car at Penn State Health St. Joseph where they are conducting drive through coronavirus / COVID-19 testing and have taken extra precautions regarding entry to the hospital, in Bern Township, PA Friday afternoon March 27, 2020. MediaNews Group/Reading Eagle/Getty

One new piece of information medical professionals need us to understand is that a negative test is not a free pass to go party it up at a crowded bar later that night or visit your 92-year-old grandma in a nursing home. Testing negative for COVID-19 does not mean you’re all clear and safe from ever getting it. And, furthermore, experts are saying that a negative test isn’t even 100% conclusive that you haven’t been exposed and aren’t currently carrying it at the time of the test.

“We don’t know how good these tests are in individuals who don’t have symptoms,” Dr. Emily Landon, a hospital epidemiologist and infectious diseases specialist at University of Chicago Medicine, tells NPR. “We know they’re pretty good at picking up COVID when it’s present in people who have symptoms. But we have no idea what a negative test means in an individual that doesn’t have symptoms.”

That’s right—an infectious disease specialist is openly admitting that there are things we don’t know, and we need to accept that reality as part of evolving medical science.

And they’re asking us to adhere to guidelines based on things we do know. Like the need for masks, physical distancing, and frequent hand-washing for example, even if you just tested negative. Why? Because you can still be carrying the coronavirus virus. Or you could still pick it up at any given time, so you need to still continue to take measures to protect yourself and others.

“We are certain that there are people who test negative even though they are definitely contagious,” Dr. Landon goes on to say, further explaining that because it takes three to five days after exposure to test positive, a negative test could mean the patient was tested too early in the disease process or that the swab didn’t pick up the infection.

Confirming this point, a study reported by the American College of Cardiology found that “the false-negative rate for SARS-CoV-2 RT-PCR is shockingly high, even at its lowest on day 8 post-exposure, or 3 days after symptoms.” And, the study says, “At its best, one out of five people suspected of COVID-19 will test negative.”

Coronavirus testing continues at the ProHealth testing centers in Jericho, New York on April 22, 2020.

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Therefore, medical experts are imploring us to still take COVID-19 symptoms seriously, even if we test negative. “If clinical suspicion is high, infection should not be ruled out on the basis of RT-PCR alone,” ACC says, recognizing that again, because this virus is a new worldwide development, more research is needed to improve testing procedures. And the health industry is committed to doing just that. “Major initiatives by the National Institutes of Health and industry are underway to accelerate the development and availability of new diagnostic tests for COVID-19.”

But for now, we’ve got to work with what we have, and the current testing results show that people could test negative and then test positive a few days later. Imagine if within those few days, that person who’s actually carrying the very contagious COVID-19 virus goes into groups of people, doesn’t wear a mask, doesn’t wear gloves, touches surfaces wherever they go, and hugs friends and relatives.

So here’s what the medical worlds needs from us as they continue to learn more about COVID-19: for everyone to wear masks, gloves, physically distance, and frequently wash their hands. But also, for all symptomatic people to behave as though they tested positive. That means if you feel sick with symptoms of COVID-19 (listed below, as per the CDC), even if you test negative, you should quarantine away from others and contact your doctor.

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Listen, we all want some hope to latch onto. We all want to see coronavirus numbers go down and life to return to normal. We all want to take our kids to the pool and the park and take that dream Disney trip, but we need it to be safe.

That only happens if we all do our part. And that doesn’t happen if we view negative COVID-19 tests as free passes to act selfishly and potentially infect others.

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