What a Negative Result Means on At-Home Covid Tests

When Dr. Jillian Horton, an internal medicine doctor in Winnipeg, started feeling ill, she was pretty sure she had Covid. Her husband had been exposed and had symptoms, too. She decided to conduct an experiment of one, testing herself several times over the course of a few days to track the dynamics of the virus. “With my husband testing positive and myself very symptomatic, I was sure I had Covid,” Dr. Horton said. “I was curious to see what I could pinpoint in terms of when I might flip positive.”

Dr. Horton’s husband became ill on a Friday night, and that evening she tested negative. On Saturday, she began to feel sick and tested herself three times throughout the day. All three results were negative.

By Sunday morning, she woke up and was feeling worse. At 6 a.m. she tested and saw a faint line on the test — what she called a “weak positive.” She took two more tests on Sunday and both were negative.

On Monday morning, she tested again, and the test rapidly turned positive.

What is notable about Dr. Horton’s experiment is that if she had tested at a different time on Sunday, she may never have discovered the weak positive. Her immune system was clearly battling the virus, as evidenced by her two negative test results later in the day.

Dr. Horton noted that testing at the right time to catch a high viral load was similar to putting a net in a stream. If the fish aren’t there, you won’t catch anything. But if you time it so that the fish are plentiful, you’ll catch your dinner.

Dr. Horton said she was concerned that too many people think the tests aren’t working when, in fact, they are a useful tool if you understand how to use them. They are ideal for “ruling in” Covid, but you have to consider more information when evaluating a negative test.

“So often I hear people say, ‘The test is useless,’” Dr. Horton said. “What my experience illustrated is that when you have symptoms, the tests are really ‘rule-in’ tests. I think of those two days when I was so symptomatic. I had one positive test and five negative tests. There was only one moment in there where I was more infectious.”