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I Had COVID-19 But Tested Negative 5 Times. Here’s What You Should Know About Testing."
“As an emergency physician, I’m often asked about the coronavirus. When I was exposed and my tests kept coming back negative, even I wasn’t sure what to think.”
CORONAVIRUS
08/25/2020 09:00 am ET Updated Aug 25, 2020
I Had COVID-19 But Tested Negative 5 Times. Here’s What You Should Know About Testing.
“As an emergency physician, I’m often asked about the coronavirus. When I was exposed and my tests kept coming back negative, even I wasn’t sure what to think.”
"I was working an overnight shift the evening that he developed a fever and fatigue and tested positive for the coronavirus. Even though I had no symptoms, because I had potentially been exposed to the virus via my husband, my hospital immediately required me to be tested as well. My test came back negative.
My husband immediately isolated himself at a hotel that was being used as a haven for infected health care providers and I was sent home. We were worried about his testing positive, that he may have transmitted the disease to me, and what might happen if either of us became very ill, but at that early stage of the disease, all we could do was wait to see what might happen.
Two days later, I was tested again using the rapid antigen assay. This test also came back negative. This was not completely surprising since I still had not developed symptoms. To more accurately verify whether I was infected, I was also tested using the PCR viral test. Unlike the rapid antigen test, this test detects actual viral RNA, but results usually are not returned quickly and mine were not going to be available for another two days.
This dual testing protocol is often initiated when there is a high suspicion that an individual has COVID-19 and the initial rapid antigen test is negative. Though I seemed fine, I was worried that I could be asymptomatic and I didn’t want to pass the disease to my 11-year-old son, whom I had to take care of by myself because my husband was isolating at the hotel.
I wanted to keep our son as safe as possible but I also knew that he still needed my love, attention and general care. So I manically cleaned surfaces around our house, wore a mask when I had to come in close contact with him and relegated him to playing video games in a room I did not enter. I knew he was healthy and, especially as a physician, I knew that the likelihood of him becoming significantly ill was low if he did contract COVID-19. I still couldn’t stop myself from fearing that he might be one of the kids who got seriously sick ― or worse ― from the disease.
The next day, I developed a minor cough and chills. I knew something was not right, but I did not have a fever and I was unimpressed with my symptoms. I obtained a fourth COVID-19 test and, once again, it came back negative.My husband thought I might have a different virus because I had been caring for many patients with many different illnesses the prior week. Maybe it was just a cold. Maybe it was the flu. I had no idea what to think. I wasn’t sure if I should feel reassured by my three negative COVID-19 tests (I was still waiting on the PCR results) and I was wary about not wearing a mask around my son. I knew tests can return false negatives and I knew that COVID-19 symptoms can continue to appear and worsen over time, so all I could do was continue to monitor how I felt.
While I waited to see if I would experience new or worse symptoms, I began to do more research about the accuracy of COVID-19 testing. Viral and antigen tests commonly used in hospital emergency departments detect active infection, whereas antibody tests are used to detect previous exposure or infection. However, if viral and antigen tests have weak sensitivity or are administered too soon, patients may receive false-negative results.
This concern was described by the Mayo Clinic Proceedings in June.
Internal and Emergency Medicine published a case report of a 30-year-old man in China who had seven negative PCR tests before testing positive on day eight of his illness. Researchers from Johns Hopkins determined that testing for COVID-19 too early in the course of infection increases the possibility of a false-negative result. According to their study, published in the Annals of Internal Medicine, there was a 67% chance of patients receiving a false-negative if they were tested within four days of contracting the virus. The study found that when the test was administered on the day of symptom onset, typically four days after becoming infected, the probability of receiving a false-negative dropped to 38%. Researchers noted that testing was more accurate when administered three to four days after symptom onset, but even then, the probability of receiving a false-negative was 20%. The New England Journal of Medicine further described issues with COVID-19 testing and false negatives, ultimately concluding that
“clinicians should not trust unexpected negative results (i.e., assume a negative result is a ‘false negative’ in a person with typical symptoms and known exposure).”
An argument could be made that in some situations, testing might be unnecessary and even dangerous because it could provide false reassurance, would not change how the disease was managed in that individual and could use up limited testing supplies.
more
https://www.huffpost.com/entry/coronavirus-testing-symptoms-doctor_n_5f43da82c5b6c00d03b1ffd9Even if the test produces a false negative in 1 out of 100 tests, if you were sick and elderly or in a high-risk group, would you want your treatment delayed because of a negative test that would risk your COVID infection advancing into stage two and a possible cytokine storm?
https://www.covid-19forum.org/index.php?topic=2.0 
