When my brother, his fiancée and I went for rapid COVID-19 tests so we could safely see our parents, the testing center didn’t take their insurance. Instead of paying more than $300 out-of-pocket each, they pooled their resources together and assumed that if one of them tested negative, they both were in the clear. After all, we remembered friends who had given birth during the pandemic, and the hospital policy stated that if the mother tested negative for the coronavirus, her partner was thought to be fine too as long as they remained symptom-free.
If that was good enough for hospitals full of vulnerable patients, it had to be good enough for three otherwise healthy and asymptomatic thirtysomethings, right?
Unfortunately, the scientific and medical consensus is that it’s entirely possible for someone to test negative for COVID-19 when the person they sleep next to has the virus. More surprisingly, test error isn’t always to blame. “COVID is a very ‘sticky’ virus, which means it’s easily transmittable; so if partners live together, they will have come into contact with it,” U.K.-based physician Ravi Dasan explains. “However, we’re also seeing that people can test positive whilst the person they live with tests negative.”
Dasan speaks from personal experience. After contracting the virus several months ago and testing positive for antibodies ever since, COVID-19 has never at any stage been detectable in his partner, who’s been tested more than 10 times. Their two young children are similarly split — one has antibodies, the other has never tested positive for either antibodies or the virus.
More and more studies are showing that some people may have T-cells from other coronaviruses such as the common cold. Scientists suspect these T-cells can kill COVID-19 before antibodies are created, which could potentially explain why some individuals remain negative despite coming in close contact with the virus. The problem is, there’s currently no test for these T-cells and “a lot more research is required to fully understand how it works,” Dasan explains. Still, he’s certain about one thing: “It’s bad practice to assume that if one partner tests negative, the other will also be negative.”
Ramin Ahmadi, chief medical officer for Graduate Medical Education Global LLC, agrees. “We know with COVID that we aren’t all equally likely to get infected. Genetics play a role,” he says, noting the Princess Cruises case as an example. “They were all together and mixed with infected folks for two weeks and took no preventive measure, and yet, not everyone became positive.”
So why do hospitals use this arguably “bad practice” as their visitor policy?
“The family members aren’t the hospital’s patients,” explains Audrey Snyder, associate dean for experiential learning at the University of North Carolina Greensboro School of Nursing. In short, the COVID-19 test is a medical procedure people have to consent to, so for hospitals to legally test visitors, they’d have to admit them as patients first. Moreover, she adds, “There’s a [test] supply-and-demand issue even though in the media we hear differently.”
Obviously, admitting concerned family members to the hospital as a condition for visitation would be an extreme measure, and probably anger a lot of people who are already going through a lot emotionally. Since visitors are required to wear masks, and presumably wouldn’t want to put already at-risk family members in further danger, hospital administrators have landed on screening them and testing patients as a middle ground. This is in line with the CDC’s recommendations. Meanwhile, in hot spots where coronavirus numbers are high and this policy is too risky, it makes more sense to ban visitors altogether than burden staff and families with restrictive visitor policies that require testing.
“From an epidemiology perspective,” Snyder says, “everyone is trying to look at what the incidences are in the area, and trying to create policies that allow them to screen and take care of patients, but don’t upset families as much as possible.”
Again, a big issue here is that the health-care system isn’t equipped to accommodate a “peace of mind” test for everyone at the moment, even though it would be a safer way to go about testing. “Frequent cheap, fast tests are the key,” Ahmadi says. “The most effective test is one that can be done often, cheaply and with rapid turnover.”
Until there are more free tests available everywhere — with lab capacity to get results in a timely manner — it makes a sad amount of sense why couples like my brother and future sister-in-law would consolidate testing. Same for my parents. Because both my mom and dad remain coronavirus-free, too — or at least that’s what my mom’s negative test would seem to mean.