Coronavirus: Have symptoms but still testing negative? Here's why you could get a false negative report

COVID-19 cases are rapidly surging across the nation, with the number of fresh cases crossing the 3-lac mark recently. However, despite having symptoms, some people are getting misdiagnosed and testing negative for the virus.

With numbers only expected to rise further, testing mishaps and delays are being witnessed in huge numbers. The delayed diagnosis and false negatives could not only lead to poor management of the disease during the much-scary second wave of coronavirus but forcing many to suffer from complications and only get accurate detection with follow-up tests.

Given that RT-PCR test right now are considered to be gold standard test, why is this happening?

While RT-PCR tests are highly sensitive and carry good effectiveness rates, it is important to know that no test is 100% accurate and there are a lot of reasons why a person could get a false negative report.

As per research, while RT-PCR tests work well to detect viral presence in the body, the accuracy of the tests can vary depending on a lot many factors.

Doctors also mention that the tests only carry a sensitivity rate of around 60%, and dole out accurate results only when swabbed right. Hence, there could be a lot of chances for false negatives, as well as false positives to occur.

Getting false negatives at this point of time during the second wave of coronavirus could be extremely hazardous. Not only could it potentially cause delayed diagnosis, present false outcomes and increase transmission and spread of infection, it could also increase the risk of COVID severity and complications.

At a time when hospitals are choking up and patients scouring long miles to secure life-saving resources, a faulty diagnosis could complicate matters much more and burden healthcare resources.

A false-negative on a COVID report could also delay treatments and make a person's condition go from mild to worse, in the lack of knowledge.

According to experts, human error is one of the top reasons which can lead to a false-negative COVID RT-PCR report. During the second wave, when high surges are being witnessed, the pressure to release tests, long queues and incessant error could create mishaps.

RT-PCR tests also greatly depend on the time the swab sample is collected, how the test is administered and the time of detection and analysis. For example, it's crucial that the swab sample is inserted well, which is able to detect necessary viral load in the body. Wrong results could also come up if the collected sample or test isn't transported or stored well (since it needs specific temperatures).

Low viral load in the body could also return back negative results if there are not enough virus particles present for detection in the body.

Getting tested too early could give tests a bleak chance to return back false reports. Some people also make the mistake of immediately getting tested upon exposure to a positive case. The incubation period for the virus, i.e., the time taken for symptom onset from exposure could be anywhere between 2-7 days. Therefore, for the most accurate results, it is best to first self-isolate and get tested 3-4 days post exposure.

The newer variants and mutations of the virus are wreaking havoc across the country, with their super-infectious behaviour and infectivity rates. It is also being suspected that since newer mutations could easily surpass defences and diagnostic tools(since tests only detect specific genes), people infected by the newer strains may get falsely undetected right now. However, authorities haven't found enough clinical matter to support the evidence yet.

Retesting is one of the best measures to confirm your doubts and get an accurate result. However, patients who continue to exhibit symptoms with a negative RT-PCR report should not be complacent and continue to self-isolate, quarantine themselves until they start feeling better.

Isolate yourself and keep health trackers handy. keep checking on your symptoms and notice any changes. If you do go for retesting, it is advisable to do so after 3-4 days post the first test.

If need be, upon a doctor's recommendation, additional blood work and chest scans may be ordered, which could also be helpful ways to detect viral load in the body. Only then could proper treatment be started.

Remember to follow good hygiene practices and keep all preventive rules handy- keep wearing masks, wash hands frequently, maintain social distancing and most importantly, remain isolated. Do not step out or spread the infection.

While you remain under isolation or wait for results, it's also crucial that you be on the lookout for warning signs of novel coronavirus which could signal severity. During the second wave of coronavirus, even the young and healthy are falling sick to severe symptoms and landing up in hospitals. Lung infection could and other pulmonary symptoms could also progress quickly.

Keep an oximeter, thermometer handy and keep checking your symptoms. If your blood oxygen levels (SpO2) fall below 91%, consider immediate hospitalization.