Covid PCR Test Results are wrong 20% or more of the time!?

Last week my daughter flew home from Florida, where she had been working for the summer, for a week with the family before she returns to Florida to start her junior year at Eckerd College. Despite diligently wearing a mask while traveling, she developed a runny nose and cough a few days after arriving. Though it seemed like a pretty mild cold, she scheduled a Covid PCR test at El Centro Hispano here in Durham, NC, just to be on the safe side.

My head started hurting the next day, and I couldn't seem to cough the frog out of my throat. I thought about getting tested too but then figured I'd know well enough if I had Covid if my daughter's test came back positive.

The next day, my daughter was feeling much better, but I was feeling worse - weak and tired with a runny nose full of sneezes. Though I knew my time with her was waning, I spent most of the day in bed.

The following morning, we were relieved when my daughter's Covid test results came back negative and confidently drove her to the airport for her return flight to Florida. But I still wasn't feeling any better. In fact, I was feeling worse. My stuffy head turned into an ice-pick headache that made sleeping nearly impossible, as every 30 seconds or so a stabbing pain just above my neck would wake me. I stayed in bed most the day, nonetheless, and, at my mother's prompting, drove to El Centro Hispano to get my own PCR Covid test. My husband didn't think this was necessary, because I clearly got whatever I had from my daughter, and she'd already tested negative. PCR is a very selective and sensitive analytical test, he argued; the results are generally very accurate and reliable. He would know - he's a Ph.D. chemist who has worked in the pharmaceutical industry for 20 years. If my daughter tested negative, then surely I would too. But I figured I may as well add to the collection of COVID data, and it would be good to have verification that I wasn't a COVID carrier.

I couldn't taste my food that night. I verified my loss of smell by taking a big whiff of our used cat litter container - I could smell nothing, though my nose and throat burned a little from the urea. Convinced I had contracted COVID, I worried that my daughter's confidence in her non-COVID status may be unfounded (she was waiting tables only hours after she landed in Florida). As I laid in bed, clammy with sweat, I searched the Internet for information regarding COVID PCR testing, which is reportedly the most accurate COVID testing available. What I found scared me.

"The rate of false negatives — a test that says you don’t have the virus when you actually do have the virus — varies depending on how long infection has been present: in one study, the false-negative rate was 20% when testing was performed five days after symptoms began, but much higher (up to 100%) earlier in infection." -Harvard Health Publishing

"In one recent study, Chinese researchers attempted to contact all close contacts of individuals who had tested positive for COVID-19, but who had tested negative themselves, and invited them to perform an antibody test. The results suggested that the PCR tests missed 48 (36%) out of 134 infected close contacts. “Even rigorous [PCR testing] protocols might miss a substantial proportion of SARS-CoV-2 infections, perhaps in part due to difficulties in determining the timing of testing in asymptomatic individuals for optimal sensitivity,” the authors wrote. Despite these limitations to testing, the authors also noted that the overall control programme (which included strict quarantine measures post-exposure) was successful in controlling the spread of the virus." -Gavi.org and The Lancet

"In an analysis of seven studies (including two unpublished reports) that evaluated RT-PCR performance by time since symptom onset or exposure, the estimated rates of false-negative results were 100 percent on the day of exposure, 38 percent on day 5 (estimated as the first day of symptoms), 20 percent at day 8, and 66 percent at day 21 [73].” -UpToDate.com and Annals of Internal Medicine

There are a plethora of other articles from reliable medical sources that support the information I have quoted above.

How can we base quarantines, travel, and returns to work/school on tests that report false negatives, at best, 20% of the time!?

I am writing this blog article to make others aware of this scary situation.

Please do NOT assume that you don't have COVID if you test negative but have symptoms of the illness.

Because of the specificity of the PCR test, the CDC advises, "If you have a positive test result, it is very likely that you have COVID-19. ...However, it is possible for this test to give a negative result that is incorrect (false negative)."

So you can trust a positive COVID PCR test result, but don't trust a negative one. Instead, follow the warnings of the CDC, Mayo Clinic, Healthline, and the president of the American Academy of Family Physicians regarding the propensity of false negatives in COVID-19 testing: "If You Have Symptoms, Assume You Have the Disease."

As expected, my test came back positive- I have COVID. My daughter got another COVID test (in Florida) today; and my husband and son, who are now presenting symptoms, got COVID PCR tests this morning. We will be quarantining for at least 10 days, regardless of the results.