In the last months of the Corona pandemic and with the emergence of the Omicron variant, many people may have recently recorded a series of negative tests in a row, sometimes up to three tests. No one can yet say how common these early negatives are, or who is most at risk.
However, if the coronavirus is rewriting the rules of the game for early infection, that could make it scary! You cannot test and get a negative result and already know that you are negative. The truth about these false negatives can speed up the spread of the virus; they can even delay treatments based on a positive test result! It may even contradict the idea of the Coronavirus (Covid-19), which says: Test as soon as you feel sick! It is assumed that the few days approaching the onset of symptoms when the virus inside you will be more detectable and transmissible, especially since it has been adopted, as we all remember, with a complete idea of testing and isolation on this basis.
Here, we may ask ourselves, what is the reason for the late positives of the Coronavirus tests? Is it possible that population immunity, viral mutations and human behaviour have some role? Regardless, the virus could certainly behave differently from a symptom perspective.
Undoubtedly, there may be several phenomena that can lead to confusion in the testing schedule. Among them, the immunity hypothesis, as seen by many researchers, may precede the test-positive symptoms, less because the virus peaked late and more because the disease arrives early. Thanks to the quick reactions of people’s immune systems. Sometimes, the disease is direct damage by the virus. But a runny nose, muscle and joint aches, chills, fever and fatigue — common in many respiratory infections — can also be signs of an overactive immune system.
Interestingly, when the pandemic started, infection occurred exclusively in people who had never encountered the coronavirus before. The illness took several days to appear, as the virus turned into a frenzy and the immune system struggled to catch up. Most importantly, once people are vaccinated, their immune systems start working immediately, especially since previous infections also have an effect. However, some people who are not immunised may have experienced early negativity also in their tests and many people who have tested positive for corona still before they get sick.
On the other hand, symptoms and test accuracy are also subject to human bias. People can’t always remember when they started feeling sick. And user error can obfuscate the diagnosis. Hence, do people really do 15 seconds in each nostril and really clean every time? Even ultra-sensitive tests will lose the virus some time. So don’t you see with me that a large part of samples taken from patients in medical settings come back negative for everything?!
In the end, this takes us to say that you probably cannot fully trust a negative early-onset rapid test. Especially since negative results cannot rule out infection. So this means that our guidance and our perceptions about the virus may need to be adjusted soon — probably not for the last time, especially if the pandemic is still serving plot twists. Can a series of negative tests for Corona and its variants still portend positivity everyday?!
Dr Yousuf Ali al Mulla is a physician, medical innovator and a writer.