The COVID-19 test. In theory, it’s a simple solution. You go and get one—preferably a PCR test (the nasal swab ones you get at the doctor’s office/urgent care), which is most accurate. It comes back negative. Your friends do the same, and poof!all your COVID-19 worries disappear. Now you can feel free to socialize and party amongst that group. Great.
Except that’s not how it works.
Being COVID-19 negative comes with several caveats. Think of a single COVID-19 test as an outdated “snapshot” explains Charles Bailey, MD, medical director at St. Joseph Hospital and Mission Hospital in Orange County, CA. Basically, he says, it reflects “whether or not you had COVID-19 several days or more prior to the test date.” So, in theory, you could test negative on Tuesday or Wednesday—after having been unknowingly exposed the prior Friday— and be contagious by the Friday or Saturday later, he says. You could even “harbor the virus and become sick within hours” of receiving a negative test result, says Shruti Gohil, MD, MPH, an associate medical director of epidemiology and infection prevention, infectious diseases at the University of California, Irvine School of Medicine. This means if you’re planning to party and violate recommendations to mask and socially distance, there is still a chance you could be infecting people and people could be infecting you.
And, the fact remains, we never know when someone is going to turn positive, adds Karen Jubanyik, MD, an associate professor in the department of emergency medicine at Yale University, pointing out that on the day someone first tests positive, by definition, they were negative the day before.
Other tricky things about testing
You need to get the timing right
When it comes to testing, Julita Mir, MD, a practicing internist and infectious diseases physician and Chief Medical Officer of Community Care Cooperative in Boston, MA, says there is an optimal timeframe for one if you think you’ve been exposed: Day 7 or 8. Here’s why: “The first few days after exposure, there may not be enough of the virus in the nasopharyngeal area, so the test could be negative if you test too early,” she says. “Day 7 or 8 allows you to get the maximum chances of really securing that the test will be positive or negative.”
There’s more to consider when it comes to timing. “The viral kinetics [how the viral load changes] shows that the virus can go from being undetectable to 10000000 or greater in a matter of hours,” explains Supriya Narasimhan, MD, a division chief in infectious diseases, a hospital epidemiologist, and medical director of infection prevention at Santa Clara Valley Medical Center. “If such a person who has been exposed to COVID-19, who is brewing COVID-19, has a negative test a day prior and goes partying, they can spread it to a lot of susceptible people.”
A negative test doesn’t mean you can’t spread the virus
Once again, a negative test does not mean someone is absolutely not infected and contagious. Short of quarantining for 14 days, which data shows can clear the virus whether you have symptoms or not, says Dr. Mir, there will always be a window of uncertainty.
Tests are still useful
This by no means is a signal to stop getting tested. Tests are an important part of the cycle, especially during a health crisis. Dr. Mir explains that the COVID-19 test should be considered an additional measure you take to help keep yourself safe, especially if you insist on gathering in groups.
“The test is part of how you prepare for social interactions,” she says, emphasizing that testing doesn’t mean you don’t have COVID-19 this week or this month. It just means you didn’t have COVID-19 Thursday morning at 10 o’clock.
She says a negative test also does not replace the tried-and-true precautions we’ve been taking for the last eight months, which include wearing a mask, washing hands often, and social distancing. It’s not a permission slip to party. Proceed with caution, friends.
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