Inconclusive COVID tests: what should I do?
LAST UPDATED: Sep 10, 2021
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What should I do if my COVID-19 test was inconclusive?
You went through all of the trouble of getting a COVID test and you were expecting a clear answer, but unfortunately, it’s not always that simple. If you had an inconclusive test result, you may be wondering what you should do next. So we’ve broken it down for you.
If you have symptoms of COVID-19, or if you’ve been exposed to a person who tested positive for COVID-19, the Centers for Disease Control and Prevention (CDC) recommends getting another test if your first one was inconclusive. This is particularly true if your first test was something called a rapid test or a rapid antigen test.
While these rapid tests are helpful when it comes to identifying a lot of cases of COVID-19, they’re not always quite as good as PCR (polymerase chain reaction) tests at detecting the virus. That’s why the CDC recommends getting a PCR test if your rapid antigen test was inconclusive, or even if it was negative but you have a known exposure or symptoms of COVID-19 (CDC, 2021a).
Why are some tests inconclusive?
There are a few things that can make a COVID-19 test come back inconclusive. Sometimes, the sample wasn’t collected properly. This is particularly true of at-home tests, where the process can be a little tricky, especially if you’re not a seasoned medical professional.
But even experienced professionals can make mistakes, so if your sample was sent to a lab for analysis or performed by a medical professional, you still might get inconclusive results. Each test has a few different steps, and each step can be an opportunity for error.
But inconclusive results aren’t always the result of an error. In fact, someone with COVID-19 might have an inconclusive test if they were tested very early in their infection—a time at which they might be most contagious.
That’s why if you received an inconclusive test result, the first thing you should do is isolate (CDC, 2021b). Inconclusive doesn’t mean you don’t have COVID-19, and if you have symptoms of COVID-19 or if you’ve been exposed to a person who has tested positive, your best bet is to stay home to avoid further spread of the virus.
Next, consult with a healthcare provider about whether you need an additional test. In some cases, a healthcare provider might decide to let you wait it out at home, if possible, and avoid infecting others by leaving the house for another test (CDC, 2020c).
What should I do if I took two tests with different results?
No test is 100% accurate all the time. If you took two tests in a single day and one was positive and one was negative, it’s more likely that the positive test was right. That’s because the various test options are pretty accurate when they say you’re positive and slightly less accurate when they say you’re negative (Watson, 2020).
While diagnostic tests like PCR and antigen tests can diagnose current COVID-19 infection, they can’t tell you if you’re still contagious. In general, people are most likely to transmit the virus to others in the three days before their own symptoms first appear and for about 5-14 days after. However, PCR tests can remain positive for as long as 90 days, meaning that a positive test is not always a sign that you’re currently contagious (CDC, 2021d).
Antigen tests, on the other hand, are usually less sensitive when it comes to identifying the virus but they tend to be positive during the window in which you’re most contagious (Yohe, n.d.).
If you took two different types of tests (a PCR/molecular test and an antigen test) and the PCR test was positive but the antigen test was negative, it’s a good bet that you currently have the coronavirus in your body, even if you might not currently be contagious.
If you have symptoms, the CDC recommends remaining isolated until (CDC, 2021e):
At least 10 days have passed since your symptoms first appeared and
At least 24 hours with no fever without fever-reducing medication and
Other symptoms of COVID-19 are improving
If you never had symptoms, you should isolate for 10 days after your first positive test.
If you had a severe case of COVID-19 that required hospitalization, your healthcare provider might recommend isolating for longer.
What if I have symptoms, but my test was negative?
Not all tests are created equal, and some people who actually have COVID-19 have consistently tested negative. If your first test was a rapid antigen test, the CDC recommends getting a PCR test to verify your results (CDC, 2021c).
If you have symptoms of COVID-19, you should isolate even if you’ve had a negative test. Contact your healthcare provider to decide if you need to venture out of the house for another test.
Also, if you’ve had negative test results, you might, in fact, not have COVID-19 at all. Many upper respiratory infections (like the common cold and the flu) can cause similar symptoms. Getting your seasonal flu shot is a good way to reduce the likelihood you’ll get the flu and make it easier to rule out the flu as the cause of your symptoms. And while many infections cause cough, fatigue, and muscle aches, COVID-19 causes a telltale loss of sense of smell and taste that isn’t as common with other infections.
If you have symptoms of an upper respiratory infection and you’ve tested negative, it’s a good idea to isolate anyway. Waiting it out at home can prevent the spread of whatever infection you’ve got and save others plenty of worry and confusion.
And of course, it's important to get vaccinated and continue to wear masks when you're out and about around people who might not be vaccinated. Masks have been proven to reduce the spread of COVID-19 and the more we adhere to guidelines, the sooner we can all get back to normal (Howard, 2020).
My test was positive, but I feel fine.
It’s fantastic that you feel fine, but a positive test, even in the absence of symptoms, is still a reason to stay home. Researchers estimate that a serious portion of people who catch COVID-19 are actually entirely asymptomatic.
Just because you aren’t coughing doesn’t mean you won’t infect someone else. In fact, one study found that presymptomatic transmission—that is, infecting a person before you yourself even start to feel sick—is a significant source of spread for the virus (Wei, 2020).
While it’s impossible to know just how many people have had COVID-19 and what percentage were asymptomatic, it didn’t stop the tiny country of Iceland from trying. In 2020, they implemented a broad testing strategy for random individuals and estimated, based on their findings, that about 50% of cases are asymptomatic (Gudbjartsson, 2020).
With that picture in mind, you can imagine just how important it is to get tested and just how important it is to stay home if you’ve tested positive. The CDC recommends quarantining for at least 10 days after your first positive test (CDC, 2021c).
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
CDC: Centers for Disease Control and Prevention. (2021a) Interim Guidance for Antigen Testing for SARS-CoV-2. Centers for Disease Control and Prevention. Retrieved September 9, 2021 from https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html
CDC: Quarantine and Isolation (2021b). The Centers for Disease Control and Prevention. Retrieved January 20, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/isolation.html
CDC: Test for current infection (viral test). (2021c). The Centers for Disease Control and Prevention. Retrieved September 9, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html
Centers for Disease Control and Prevention (CDC). Interim Guidance on Ending Isolation and Precautions for Adults with COVID-19. (2021d, March 14). Retrieved September 9, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html#:~:text=Thus%2C%20for%20persons%20recovered%20from,of%20viral%20RNA%20than%20reinfection
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Howard, J. (2020, Nov. 2). Pre-print: Face Masks Against COVID-19: An Evidence Based Review. Retrieved Feb. 2, 2021 from https://files.fast.ai/papers/masks_lit_review.pdf
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Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. (2020)Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:411–415. DOI: https://pubmed.ncbi.nlm.nih.gov/32271722/ http://dx.doi.org/10.15585/mmwr.mm6914e1
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