Quarantine Journal: Doubt Creeps In

Last night I returned home from walking the dog — yes, the Health Dept. and Kaiser not only condone but encourage going out for walks while masked and social distancing! — I returned to my backyard entrance to see that my family was eating dinner.

Our dining table is flanked by a large window. It was just starting to get dark out, so the scene was illuminated from within. They were laughing and talking, eating the raviolis and pasta sauce I had purchased in what now feels like another lifetime. You can bet it felt poignant to stand outside, looking in.

When I tapped the window, at first they were startled, but then they all smiled and waved.

“The Little Match Girl!” Nutmeg yelled through the window.

Too true.

In the evenings, after my walks, I sometimes wonder if I am starting to feel a headache or sinus pressure. Far from worrying me, this feeling gives me a strange burst of hope. I assess the rest of my body. Is that a hint of soreness in my throat? I inhale. Is there a cough coming?

I find myself perversely wishing for these symptoms — even though it feels like a betrayal to the millions of people worldwide who have suffered and died of Covid-19 — because symptoms would prove that I am isolating for a reason.

On day four of my 10-day time out, I am desperate for confirmation that this is for real.

My search for symptoms so far has come up dry. I can taste both the bitter highlights and the mellow undertones of my morning coffee. What I thought might be the start of a headache or sinus pressure turned out to be soreness from the metal-banded KN95 mask I wear while walking the dog.

I didn’t have this doubt when I started my quarantine Wednesday night. At that time, my obsession was figuring out how I’d contracted Covid-19. Was it from picking up a discarded receipt from the grocery store parking lot? From the one person outside my household I met with maskless in the past week?* From my Costco run?

When I posted on social media that I had tested positive, multiple friends immediately hypothesized that it could be a “false negative.” Everyone, it seems, knows someone who had supposedly gotten a false negative.

At first, I was incredulous and annoyed by this theorizing. I had read that the technology behind the PCR test I’d gotten was very accurate, and that false negatives were much more likely than false positives.

“If you are tested for COVID-19, and the test comes back positive, you can be very sure that you are infected with this virus,” reads a FAQ from MIT Medical.

Part of what frustrated me about this conversation is that I couldn’t see how anyone could confirm a previous positive test was “false.” Sure, you might get a positive result, test again, and get a negative result. But how would you know that the first one was wrong and the second one right? Seemed like wishful thinking to me.

But then a friend who works in healthcare shared a scholarly article including a protocol for retesting, considering context such as exposure and symptoms, and determining which test was correct.

Source: False Positive Results With SARS-CoV-2 RT-PCR Tests and How to Evaluate a RT-PCR-Positive Test for the Possibility of a False Positive Result
Glenn D. Braunstein, MD, Lori Schwartz, MD, FACOEM, Pamela Hymel, MD, MPH, FACOEM, and Jonathan Fielding, MD, MPH, MBA

Using this protocol, a Disney TV production crew found that the positive tests they got were 22 percent false positives! Other studies confirmed my understanding that false positives are more prevalent than I thought.

I also learned that PCR tests can come up positive weeks after an infection. This had been my first test in four months. So what are the chances that I have a contagious case of Covid right now? Maybe I had it in September.

Then my family and some other people I’d encountered in the past week received their test results. All negative. This fanned the flames of doubt to bonfire levels. I mean, if I am supposedly so infectious, how did I not infect my husband, who I slept next to, and whose food I prepared?

Of course, all these people who tested negative are fully vaccinated. But so am I!

Unfortunately, I don’t have anything to do with this doubt. Getting a re-do on the gold standard, the PCR test, isn’t practical, since my health care provider won’t retest after a positive test. Besides, I wouldn’t want to endanger any healthcare workers by making them swab me, in case I really am infectious right now. And unlike actors on a film set or Olympic athletes, continuing to quarantine for me is a low-stakes situation. It’s really no big deal to keep living in my guest suite for the next week.

Still. I am the kind of person who abhors uncertainty. When I was pregnant, I never wanted to wait until birth to find out if I was having a boy or a girl. Going forward, I would like to know if I really had Covid or not!

So, even though it won’t change anything, I asked my husband to see if he can find an OTC test kit for me. If both tests in the kit come up negative, it won’t change much. I’ll still finish my quarantine, and I’ll be even more tortured by doubt.

Best case scenario is that the tests come up positive. Then I can feel secure that isolation was absolutely necessary. Missing the trip and feeling like the Little Match Girl wouldn’t feel so bad if I just knew that I was doing what I had to do in order to protect other people. I’d rather feel like a hero than a chump!

* I have no reason to believe this person had Covid. We talked for about 10 minutes. I have regret.

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