Clare Bostock is Consultant Geriatrician and BGS member.
Relief should have been my dominant reaction to remaining fully asymptomatic following a positive PCR result for SARS-CoV-2. Instead, my recent ten days of self-isolation have been plagued with surprise, uncertainty, guilt and anxiety. Nothing could erase my positive PCR status, unless I were a professional rugby player.
It is estimated that 20% of people with SARS-CoV-2 remain asymptomatic throughout the course of infection, yet data from the Office for National Statistics (ONS) suggest that the false-positive rate of PCR tests is under 0.005%. So why did Owen Farrell and another international rugby player have a false-positive PCR result around the same time, but I had ‘asymptomatic infection’?
I'd attended the hospital drive-through test centre in response to a ‘Test and Trace’ alert. Although around 1 in 50 people had COVID-19 at the time, my positive result was an utter surprise. I’d taken a private PCR result two days prior which had returned a negative result. I'd had my booster vaccine nearly a month prior. I had managed to escape COVID-19 thus far, despite looking after many people with COVID and living with an infected 10 year old during the summer.
My result felt unbelievable. In a very unscientific attempt to gain some certainty, I took daily lateral flow tests for 10 consecutive days - all of which were negative. If I felt uncertain about the validity of the PCR result, then it’s not surprising that I felt unclear about the benefits of isolating myself from my family.
A remaining area of uncertainty is the extent to which people without symptoms transmit SARS-CoV-2. PCR tests do not distinguish live virus and are not a test of infectivity, but I certainly wouldn't want to become the ward super-spreader. I needed to reconcile myself to the idea that my absence from the hospital was keeping others safe. Despite being able to perform some work duties from home, I felt guilty for burdening my colleagues. And even though I hadn’t broken any rules, I still felt guilty for having been on an aeroplane - the presumed source of my ‘ping’.
With uncertainty came anxiety. Would I remain well, or was this a pre-symptomatic phase? How long before I became unwell and how unwell would I become? Was it safe for me to run around the garden? I was grateful to colleagues who reached out and supported me.
Healthcare delivery requires good teamwork, much like rugby - we support each other on and off the pitch. But unlike rugby players, healthcare professionals can't be absolved of a positive PCR result.