Dear Pandemic Problems,
I'm freaking out about possibly coming down with COVID, despite being vaccinated and boosted. I work as a nanny to two young children. Over the weekend, one of the kids came down with standard cold symptoms; so I was not surprised when I got a mild runny nose on Monday, which alone would not be a reason for concern.
(This article first appeared in Salon.)
Then, the parents of the children whom I nanny told me that the five-year-old was going to be quarantined because one of her classmates had tested positive for COVID. I started wondering if my runny nose was actually COVID. I went and got tested yesterday.
Then, this morning, the parents of the child called me and said their daughter had indeed tested positive for COVID.
But then I got my test result back — from the test I took yesterday — and it came back negative.
At this point I assumed I got COVID from the kid that tested positive — luckily with mild symptoms thanks to getting a booster a month ago. I spend a lot of time around this child, after all.
So I have trouble believing my test result, frankly. What are the chances that I get a persistent runny nose and very mild cough, and then it turns out that the little girl I nanny is COVID-positive and I'm not? It just seems weird.
I don't know what do to now. Do I believe what seems like an unlikely result? Do I get tested again? What are the chances that I have a false negative? Are there other types of tests I could get? (This test was a PCR).
Right now, my insurance will not authorize another test so soon but I feel strongly that I should get another test ASAP. How will I know when I can stop quarantining, if at all?
Not Positive I'm Negative
Dear Positive I'm Negative,
I'm so sorry this is happening to you. This certainly sounds like a confusing and stressful situation. It's frustrating that we are 19 months into this pandemic, and we still have to worry about being exposed to COVID-19 and the possibility of getting false negative tests. I'd be a bit disoriented, too, if I were you — particularly given that you are vaccinated, and got a booster. Ugh!
And yet, this is where many of us find ourselves in the pandemic right now. The good news is that the Biden administration recently purchased 65 million pediatric doses of the Pfizer/BioNTech vaccine, which is enough to vaccinate an estimated 28 million children between the ages 5 to 11— pending the Food and Drug Administration's approval, of course. This means the five-year-old you care for will finally be able to get vaccinated, providing even more protection for you at your job. I'm sorry it didn't happen earlier.
I have to be honest with you, Not Positive I'm Negative, that I haven't answered a pandemic problem in a few months. Partly because I haven't received any questions that I thought I could answer, and partly because whenever I write about vaccines, I receive a bunch of hate mail. But I was intrigued by your email because I think there is a lot of confusion around what vaccinated (and boostered) people are supposed to do when exposed to COVID-19— so let's dive in.
First, let's start with the facts. You, a vaccinated person, who was exposed to COVID-19. Here's what the Centers for Disease Control and Prevention (CDC) advises on that:
"If you've had close contact with someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don't have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative. You should isolate for 10 days if your test result is positive."
OK, so you did the right thing by getting a COVID-19 test, but it came back negative. I am wondering if the timing of the test has something to do with your result. When I asked Dr. Amesh Adalja, an emergency medicine physician, about your situation, he said: "The validity of the test result depends on how long post-exposure the test was performed."
"Post-exposure testing should be 3-5 days after the exposure," Adalja said. "If a person is not symptomatic and is vaccinated and tested negative 3-5 days post exposure, I would not recommend a retest. If the exposed person is not vaccinated and has no symptoms, a negative test at day 5 would be sufficient."
Adalja added that many exposures don't result in transmission of the coronavirus, which was the case "even in the pre-vaccine era," he said.
"Lastly, if the person who was exposed was vaccinated, transmission risk would be blunted as well," Adalja said.
OK, but you're having symptoms. Since I don't know the exact timing, it could be possible that you tested too early and it might be wise to retest — especially if your symptoms worsen. But as you asked, what are the chances that you get a persistent runny nose and very mild cough, after being exposed to a positive COVID-19 case?
It's estimated that adults have an average of 2-3 colds per year; children have even more. So it could be that you have a cold, or you tested too early. If it's the latter, perhaps consider retesting.
I know you said your insurance won't authorize another test, but is it possible that you can go to a nearby community testing site — where you don't need to provide insurance or pay for a test? The United States Department of Health and Human Services has a list here. You could also do an at-home Binaxnow test, which costs $23 (though it should be free).
I hope this helps, Not Positive I'm Negative. I know it's a frustrating time, but I'm positive that you will weather this storm.
"Pandemic Problems" is a periodic advice column that answers readers' pandemic questions — often with help from public health data, professors and therapists — who weigh in on readers' dilemmas. Do you have a pandemic problem? Email Nicole Karlis at email@example.com.