When someone gets tested for the virus, we know that they either receive a positive or negative result. The tests are not always 100% accurate, and this can result in false-positive or false-negative tests. Inaccurate test results can increase the virus's spread, which works against our fight for safer communities.
Why Might False Results Occur?
In terms of operational false-positives, swab tests are contaminated, which would confuse reagents. It is estimated that there are between 0.8-4.0% false-positives in the UK population.
There is a definite need for quality control and external/internal quality assessments, as this attributes to the mass of false-positive diagnoses. This would prevent both false-positives and false-negatives.
The Risks of False Test Results
As far as COVID-19 testing goes, false-negatives are a priority concern. This is because the undetected cases will lead to more spread, especially when those infected are either asymptomatic or carry mild symptoms. They are the most pressing variant of false results, but their counterpart is arguably more complicated.
Some risks for false-positives focus more on the individual rather than the community at large. A false COVID-19 diagnosis could cause the delay/cancellation of needed medical procedures, regardless of urgency. If the false-positive-citizen does receive treatment for a separate condition in a hospital, they are put at a high risk of exposure to COVID-19 due to said false diagnosis. This could also lead to financial consequences due to loss of income (from the inability to attend work legally). While psychologically, consequences could appear stigmatized for the diagnosis, fearful of infecting others, and amplified feelings of isolation.
The damage that false-positives can do on a global scale centers around finances, epidemiological logistics, and society in its entirety. Between human and capital resources, government funds used for contact tracing are being misspent. Where, as we have all seen, money is one of the key players in this pandemic, our funds are being dispensed inaccurately. Secondly, by overestimating the number of active cases, the number of asymptomatic cases will take a hit. Lastly, societal impacts of false-positives include improperly enacted lockdowns and school and business closures. Additionally, those in toxic and/or abusive environments are forced to remain as they are, with little to no external contact or assistance.
False-positive results are more significant in low prevalence areas of COVID-19, proportionally compared to high prevalence areas. Adverse consequences are therefore more significant in low prevalence areas. Risks in low prevalence settings include overestimating the extent of COVID-19 within the region. Risks in high prevalence settings cover it being unavoidable that COVID-positive patients get grouped due to overcrowding of hospitals and healthcare centers; this means that people initially not infected will become infected due to the false-positive result.
Educating oneself on the existence of these happenings is essential to stopping the spread. Though the answer to ending the pandemic is- in theory- simple yet there are many more complex factors in addition to those discussed above that must be considered when working toward a safer environment for all.
References
Surkova, E., Nikolayevskyy, V., & Drobniewski, F. (2020, December). False-positive COVID-19 results: Hidden problems and costs. ScienceDirect.com | Science, health and medical journals, full text articles and books. https://www.sciencedirect.com/science/article/pii/S2213260020304537
Mark H. Ebell|Henry C. Barry. (2020, July 1). Beware of false-positive results with SARS-Cov-2 antibody tests. AAFP American Academy of Family Physicians. https://www.aafp.org/afp/2020/0701/p5a.htmlfbclid=IwAR35SJgErIHDMmsqBOTPhN3UqyM75ge0ujuZ9u7cW5N1eKYJDACkFEilT3c
Healy, B., Khan, A., Metezai, H., Blyth, I., & Asad, H. (2020, November 26). The impact of false positive COVID-19 results in an area of low prevalence. RCP Journals. https://www.rcpjournals.org/content/clinmedicine/early/2020/11/26/clinmed.2020-0839.full.pdf
Article Authors: Mina Chong, Stephanie Sahadeo
Article Editor: Olivia Ye