Since coronavirus testing became widely available, health experts have encouraged us to test when we develop COVID-like symptoms. But increasingly, people are speaking up about being sick, almost certainly with COVID, and repeatedly testing negative. Experts point to a variety of factors, including vaccines, our immune system, and the virus itself.
Last month in the New York Times, science journalist Melinda Wenner Moyer explored this topic after it happened in her family. Moyer and her husband were vaccinated and boosted, and their children were fully vaccinated. Their 7-year-old daughter became ill after being exposed at school and quickly tested positive on a rapid-antigen test. Moyer’s husband and their 11-year-old son soon became sick with classic coronavirus symptoms. But they tested negative for seven days straight; Moyer never became ill and continually tested negative. She turned to experts to understand what had occurred.
Vaccination status is important in this scenario, immunologist Dr. Gigi Gronvall told Moyer. Once we are vaccinated, our immune systems start working much faster after an exposure. This activity slows viral reproduction and spread, and it may make us less likely to test positive.
Despite testing negative, people–such as Moyer’s son and husband–may still feel sick. That’s because COVID symptoms, including fever, fatigue and runny nose, are caused by our immune systems fighting off the virus, and not by the virus itself, Moyer wrote. One expert told Moyer that it’s possible her husband and son tested negative repeatedly because COVID was replicating outside of the tests’ reach, possibly in their brains, hearts, kidneys or other organs.
A big difference exists between never testing positive and not yet testing positive, Moyer stressed. Most people exposed to the virus and experiencing COVID symptoms will test positive eventually. However, many people may stop testing too early, likely creating further spread of the illness in the process. Dr. Gronvall recommends that people with two to three doses of vaccine should test with symptom onset and continue through day four or five of symptoms. Free tests continue to be available. Washington residents may request tests through Washington state at sayyescovidhometest.org and the federal government at COVID.gov.
Public health officials urge people who have been exposed to COVID-19 but test negative to follow guidelines from the Centers for Disease Control and Prevention. Those guidelines include wearing a well-fitting, high-quality mask around other people for 10 days. To read Moyer’s account of her family’s experience in full, see tinyurl.com/moyer-story.