Solve my Covid testing riddle
February 4, 2021 4:52 PM   Subscribe

My husband tested positive for Covid - asymptomatically - in December. We both tested positive - symptomatically - this week. It doesn't make any sense, can anyone come up with a plausible theory of what might have happened? Testing dates etc. inside.

I live with my husband and four children, we're a blended family and each have two bio kids.

12/26 - My husband tested positive after a random asymptomatic test, his two kids tested negative at the same time.

12/28 - All six of us, plus my husband's ex-wife (an in-the-bubble frequent contact) got tested. His ex-wife was positive, one of their children was positive, but everyone else (including my recently-positive husband) was negative.

1/12 - All six of us test, all six are negative

All tests above were PCR tests through our state. During isolation, then quarantine, we all stayed in the house together without making any particular effort to avoid transmission in the household. None of the three positive people (my husband, his ex-wife, their child) ever developed any symptoms. But we figured, hey, three positives, obviously it's a real infection that has spread in our household, at least we were lucky and caught it and stayed home.

Fast forward to this Tuesday. My husband started showing Covid symptoms (low fever, sniffles), but we weren't too worried because "he's had Covid" and I felt fine. We have access to antigen testing through work, so we both tested on Tuesday - his test was (very! immediately!) positive, mine was negative. His positive test wasn't necessarily relevant because people can test positive for weeks or even months after an infection, but given his symptoms I was a little concerned. My husband seemed a little sicker yesterday - he's okay, but if you saw him you'd know he wasn't feeling well.

Then today I woke up with a sore throat and stuffy nose, so I re-tested through work and it was positive. And shortly after that my husband completely lost his sense of smell and taste. It seems pretty clear to me that we both actively have Covid right now, despite my husband's earlier positive test.

So why or how did he test positive before? False positives are rare-but-possible, but we're not going to have three of them over two separate test dates, right? Either he DID NOT have Covid when he first tested positive in December (asymptomatically, but with two other household-ish positives), or he DOES NOT have Covid now (but he really, definitely does, as do I). I literally asked the Department of Health today and they agreed it was very curious but they had no idea. What could have happened? All plausible guesses welcome!

(He will isolate again for a full 10 days no matter what anyone says here, safety first.)
posted by zibra to Health & Fitness (14 answers total) 1 user marked this as a favorite
Are you in the US? The scary thing about the Brazil variant is that it can infect people who have already been infected - and the fact that the US is not doing much sequencing means we have no idea how much it has spread in the country, but we know it's here. So that's one possibility. Hope you feel better soon.
posted by coffeecat at 4:55 PM on February 4, 2021 [6 favorites]

12/26 your husband tested positive, two days later he tested negative. Sounds like it there is a possibility this was a false positive rather than he completely recovered in two days, a lucky coincidence that his kids were positive and he and you didn't get it from them.
posted by metahawk at 4:59 PM on February 4, 2021 [12 favorites]

I’m a little confused, are you under the impression he can’t have had covid twice? That’s not true. I had likely-covid in March, and when I was ill again in November my doctor said it was possible I had it again. I would assume that your husband had covid asymptomatically in December, and he caught it again recently, this time with a higher viral load, causing symptoms. I certainly don’t know anyone who’s had covid who has then assumed that they’re immune as a result. (See, for example, this article, there are plenty more if you google covid reinfection).

Or do you mean that you’ve all been 100% isolated for the whole of January so his current infection is a mystery? How much to you know about his ex-wife’s level of isolation? Even if the six people in your household have been isolating all this year, if she’s in your bubble you’ve been potentially exposed to everyone she’s been exposed to.
posted by penguin pie at 5:09 PM on February 4, 2021 [10 favorites]

Best answer: I agree with metahawk, reinfection with a variant seems the most likely, because 3 PCR tests are very unlikely to be false (though not completely impossible, someone wins the lottery eventually). If you look at how vaccinated people are responding to the variants, symptomatic infection is very possible, but there is greatly reduced risk of serious injury or death. I had a fever last night and have been quarantining in the garage, so I sympathize and hope you all recover quickly.
posted by wnissen at 5:15 PM on February 4, 2021

Response by poster: Yes, we’re in the US. Brazil variant is a great theory!

It’s my understanding that he’s very *unlikely* to be reinfected ~6 weeks after the first infection, not that reinfection is impossible.
posted by zibra at 5:16 PM on February 4, 2021

COVID is just a weird virus and the testing is weird. It wouldn't surprise me if it were some kind of flare-up of his initial "infection", as asymptomatic as it was. I work in healthcare and people do test positive, appear to get over it, then suddenly get much sicker for their second go-around. There is so, so much we don't know. There are also variants like other posters have said that could be responsible for his second illness. Or maybe he's someone who tests positive for a long time, then just so happened to get a cold. Who the hell knows. What we DO know is that this isn't very far outside of the realm of typical COVID behavior at all. It's not typical for sure, but it's also not unheard of.

I hope you both feel better soon.
posted by Amy93 at 5:32 PM on February 4, 2021 [6 favorites]

Anecdata - I know of two people personally (one of whom is a 2 year old) who have been infected twice over a period of <3 months. Echoing that Covid is weird. Hope you all feel better soon.
posted by tatiana wishbone at 6:05 PM on February 4, 2021

Maybe the negative test was the false one.
posted by AugustWest at 7:04 PM on February 4, 2021 [3 favorites]

I want to emphasize and reiterate what penguin pie said—you absolutely can get covid twice. Sometimes people are positive, and even get very sick, but don’t produce noticeable levels of antibodies naturally. Or they do produce antibodies, but they aren’t very effective, or don’t last very long. Or they do produce antibodies, but they aren’t effective against one of the new mutated strains.

One of the many terrible consequences of the Trump administration’s “herd immunity” strategy is that it resulted in a lot of just plain wrong messaging (even from reputable outlets) about what herd immunity is and how viruses work. It’s not only that waiting for infection to tear through our country would result in massive loss of life; it’s that even with that loss of life the strategy still can’t work. Herd immunity isn’t something that just happens during the lifecycle of a virus in a community; it is specifically and only something that happens when a vaccine is prevalent in a community. Vaccines produce an immune response that natural infection just cannot be relied upon to do.

If someone tests positive for covid twice, there’s really no riddle to be explained. They just had covid twice.
posted by CtrlAltDelete at 7:25 PM on February 4, 2021 [3 favorites]

Oh, and I also agree with AugustWest: the best explanation for your husband’s negative test on 12/28 is that it is probably the false result you’re looking for. False negatives are much, much more common than false positives (which is part of why you can’t rely on a negative test result as an excuse to skip mitigation measures like distancing, masks, and ventilation).
posted by CtrlAltDelete at 7:29 PM on February 4, 2021 [2 favorites]

Yes to getting it twice, or a false-positive, or a new variant. There is also some evidence (sorry, I read far too much, no idea where I saw it; but I do read science resources rather than popular media, etc :) ) that asymptomatic cases don't mount as strong an immune response, which lines up with getting it again 6 weeks later.

Wishing you both well, and sending hopes for a speedy and unremarkable recovery.
posted by lulu68 at 9:54 PM on February 4, 2021

I don't know how much data there really is on asymptomatic cases resulting in reinfection vs symptomatic ones (obviously, the latter is easier to notice). It could be that there's lots of people who would have tested positive (but didn't get tested) who then go on to get reinfected and have symptoms. Unless you're testing everyone every few days, it's going to be hard to actually measure the rate that this happens.

Immunology is, as I think we're all learning, unbelievably complicated. But we know reinfection is possible- and given the sheer number of cases, it must be happening to quite a few people even if it's unlikely.
posted by BungaDunga at 8:07 AM on February 5, 2021

Best answer: Epidemiologist here. There are a number of possibilities here that cover the spectrum of possibility-to-probability. The initial round of positive test results may have been cross-reactivity to another, non-COVID-19 coronavirus (especially since there are children and mixed households involved, as coronaviruses are extremely common and kids are perfect little vectors with sticky hands and runny noses), which I think is a genuine possibility given the timeframes involved. Otherwise, reinfection with a variant (not necessarily any specific one, i.e. it doesn't have to be the so-called Brazilian mutant--there are many, many mutants forming all the time that don't confer striking new features of virulence or transmissibility to the virus that are major enough to be noticed and named) seems possible. If none of the people who tested positive on 12/28 had symptoms, then it's possible that conditions allowed for subclinical infections (anything from the initial infective dose being just small enough to cause infection without leading to symptoms, to, yes, a variant associated with minimal sequelae) that didn't produce a strongly protective immune response quickly enough to confer protection before this round of infections.

The timeline of infection to immune protection is publicly talked about in pretty discrete terms, i.e. it takes 10-12 days to form antibodies after infection, but you should think of the actual biological processes underlying these figures as average, variable, bell-curve situations. I can sketch out the timing of these events on paper with enough room for error to assume that this was a straightforward instance of reinfection before immunity from an initial infection developed.

I had COVD-19 last February, before we had a name/test for it. I came up positive on antibody tests as late as August, but by September my antibody tests started coming back negative. Immunity is dependent on much more than our antibody responses, but let it be known that even people in my field recognize that COVID-19 is just plain weird. It's going to take some time to figure all this out.

Hang in there, and I hope y'all feel better ASAP!
posted by late afternoon dreaming hotel at 11:22 AM on February 5, 2021 [2 favorites]

Your husband may also be a perfect incubator for these viruses. It's possible he will be hosting the virus without symptoms (aka consequences that build to an immune response) again. My anecdata follows:

This lack of testing sucks. We don't know whether a superspreader is an obviously-pestilent coughing mess of coronavirus or an untroubled mild-cold type (or both). I get colds which stay sniffly in my sinuses and don't get into my lungs. So the thought terrifies me that my seasonal sniffles go unchecked and might be a coronavirus that could put other people in hospital. My counter action is to do what I can: I wash my hands wear a mask and minimise being outside.

P.S. Don't amplify this message with a like -- it's a hypothesis without a plan for what to measure that could show my idea is false. Amplify the message that we need population-level testing weekly to show which people are vectors if we're to understand what makes a super-spreader so effective.
posted by k3ninho at 11:15 PM on February 5, 2021

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