This article discusses how failing to observe principles of evidence-based clinical reasoning when interpreting COVID-19 test results can have direct implications for public health, particularly for negative tests.
Given that early data from China suggest relatively poor sensitivity of initial RT-PCR tests, the risk from false-negative test results could be substantial as testing becomes more widespread and the prevalence of COVID-19 infection rises.
The authors recommend the following given this concern:
- Strict adherence to physical distancing, hand-washing, surface disinfection, and other preventive measures regardless of risk level, symptoms, or COVID-19 test result. This includes providing adequate personal protective equipment (PPE) for healthcare workers.
- Improved RT-PCR tests and serological assays to minimize the risk of false-negative results and ongoing transmission based on a false sense of security.
- Careful assessment of risk prior to testing and interpreting negative test results for individuals with higher-risk with caution.
- Development and communication of clear risk-stratified protocols for management of negative COVID-19 test results.