You have the telltale signs of COVID: fever, headache, dry cough, and exhaustion, but your rapid antigen test is coming back negative.
You are not alone.
So, if you’re testing negative for a RAT but still have symptoms, or if you need to record a positive RAT test result, here’s an update on what to do.
Can you have COVID-19 and test negative?
Yes. A negative test is not a guarantee that you do not have COVID-19, and there is still a chance that you are infectious.
Australian Medical Association vice-president Dr John Williams advises anyone with symptoms of COVID who returns a negative RAT to seek a polymerase chain reaction (PCR) test.
Although RAT tests can detect the virus, they are most accurate when people have symptoms and are generally best used within the first seven days of the onset of symptoms.
The TGA says poor sample collection and incorrect use of the test will affect accuracy. Therefore, it is important to follow the instructions for RAT test sample collection.
What to do if you are negative on a rapid antigen test and still have symptoms
In addition to the home RAT test, access a PCR test.
If you’ve tested negative for COVID-19 on both a RAT test and a PCR test, Dr. Williams says you likely don’t have COVID.
But there are other diseases, such as RSV and the flu, that have symptoms similar to COVID-19. He says COVID has highlighted the need to take precautions to restrict the spread of all viruses.
Multivirus tests (or multiplex tests) are combined tests that detect influenza and COVID-19 from one sample, and are available in most locations with a referral from your GP or from testing sites of PCR.
Regardless of test results, if you experience symptoms similar to COVID, Dr. Williams recommends following these guidelines until you get definitive test results.
“So if you’re testing negative while symptomatic, wear a mask, social distance, notify those around you that you have symptoms, and practice hygiene with soap and water and use alcohol-based hand sanitizers.”
What does it mean if a rapid antigen test is false negative for COVID-19?
This means that the test did not detect the virus, even though you are actually infected with it.
Dr. Sonya Bennett, deputy chief medical officer, says if a RAT has a clinical sensitivity of at least 80%, that basically means we can expect 80% of the tests to be accurate at detecting the infection.
So if we line up 100 people infected with COVID, 20 might get a “false negative” result.
In this case, it is advised that:
- try again; or
- seek a PCR test.
PCR testing is considered the gold standard when it comes to detecting COVID-19.
They detect the presence of nucleic acids, the genetic material of the virus, early in the infection, and sometimes even before a person feels sick.
Although a positive RAT result is likely to be accurate.
Dr. Bennett says that TGA establishes clinical specificity of at least 98 percent, and that means only 2 percent of RAT tests could incur a false positive.
So you can be pretty sure that if your RAT comes back positive, you probably have COVID-19.
How long can people test positive for COVID-19?
There is no hard and fast rule.
Some people continue to test positive for RAT beyond five days, and some even test positive after 10 days.
University of Sydney epidemiologist Associate Professor Meru Sheel said the virus could still be present inside your body after the infectious period.
“You may have bits of the virus in your lungs and that can be detected when you do a PCR,” he said.
Because of viral spread, some people may continue to test positive weeks or even months after their infection.
But testing is the best option to detect whether the virus is still in your system or not.
In terms of being infectious for the virus, people are generally considered to be infectious from 48 hours before symptoms start.
In high-risk environments, they can be considered infectious from 72 hours before symptoms begin.
Do I have to record a positive RAT test result?
Yes, anyone who tests positive for a RAT must register their result.
From self-isolation, you can access your local health advice and register your positive COVID-19 test result here:
Do I still need to isolate myself?
Yes. According to the Australian public health requirement, you must self-isolate for seven days.
Isolation is important to protect people around you who may not have COVID-19 and also to prevent it from spreading to others in the community, especially those who are vulnerable and may get sick if exposed.
Meanwhile, infectious disease experts have repeatedly stressed the importance of scaling up when eligible, ventilating indoor spaces, wearing masks indoors and researching your eligibility for antiviral drugs as keys to dealing with the latest waves of infection.
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