Why Some People Have Never Gotten COVID

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Young woman undergoing a corona antigen test with a cotton swab entering her nose

There have been nearly 80 million total cases of COVID-19 in the US, and almost 975,000 deaths, according to stats from the “New York Times.” Over the past two years, there have been times when it felt like everyone I knew was contracting the highly contagious virus, especially during the initial spike in cases, as well as during the surges caused by the delta and omicron variants. And yet somehow, a handful of people — my family included — never tested positive for COVID.

Of course, I feel so grateful that my husband, children, parents, and myself have never tested positive for the oftentimes fatal virus. But I also wonder how we avoided it. We did our best to follow the official recommendations about social distancing, sheltering in place, handwashing, and masking. But even so, members of my family have been exposed several times and have still never experienced symptoms or received a positive test. And we’ve all heard of similar incidents: of entire households testing positive for COVID except for one family member, for instance, even though everyone was vaccinated and boosted or had been exposed at the same time and in the same way.

POPSUGAR asked Mohamad Assoum, PhD, an infectious disease epidemiologist at The University of Queensland, about why some people haven’t tested positive for COVID-19. He says that ultimately, there’s no one reason, but a variety of factors that could help explain why someone may have avoided testing positive over the past two years. These are the top five.

Reasons Someone Hasn’t Tested Positive For COVID

Reason 1: They Avoided High-Risk Environments

When discussing why people haven’t tested positive for COVID, it’s important to know how people become infected. Most people become infected with SARS-CoV-2 (the virus that causes COVID) when they breathe in respiratory droplets that contain the virus, or when those droplets land on their eyes, nose, or mouth. “The key avenues that an infected person can contaminate an environment directly around them, and increase the risk of transmission, is through coughing, sneezing, yelling, screaming, loud singing, etc. — basically anything that forces a large amount of exertion from the respiratory tract,” Dr. Assoum explains. (While CNN reports that some research shows that variants like omicron may last longer on surfaces, earlier evidence found that it was more likely for people to contract the virus from respiratory droplets than contaminated surfaces.)

We know that poorly ventilated spaces that don’t allow you to remain at least six feet away from other people increases the risk of transmission. We also know that mask-wearing, frequent handwashing, “safe sneezing” (ie, coughing and sneezing into one’s elbow), and avoiding touching one’s face can decrease the risk of getting COVID. Of course, at some point in the past two years, most of us have had to go into public spaces, to go grocery shopping, go to work, visit family members, or run essential errands. Or maybe our kids had to go school. And while we can control some of our risk factors (like one-way masking), we can’t control all of them. If we must take public transport to work, for instance, we can’t guarantee that the vehicle we’re on will be uncrowded, or that our fellow passengers will be practicing COVID precautions.

Some people who never tested positive, however, simply may have been able to avoid being in high-risk environments more than others, either because they just got lucky or because they had the privilege of having the option to, say, work remotely or drive their own car rather than take public transport. As a result, they may never have been exposed in a way that would lead to infection.

Reason 2: They Were Asymptomatic

As many as 40.5 percent of COVID cases are asymptomatic, according to a recent review of the available data from Beijing. So it’s possible that a portion of the people who have never tested positive did have COVID at some point, but simply didn’t know it because they had no symptoms and never got tested during a time when they would have tested positive. People with asymptomatic cases are also more likely to receive a negative result on antigen tests, according to the CDC, so even if they did get screened for COVID, they may have received a false negative. This could also explain why someone wouldn’t have a positive test after subsequent exposures to the virus — which brings us to the next reason . . .

Reason 3: They Have Built-up Immunity

“A person who had an undetected very mild or asymptomatic infection will have some level of immunity against infection, especially if exposed to the same variant,” Dr. Assoum points out. Meaning: If you had an asymptomatic case of COVID that you never tested positive for, then later were exposed to COVID, you might have enough immunity to avoid contracting the virus again. That said, experts don’t know how long natural immunity lasts or how effective it is at protecting against subsequent variants, so they still strongly recommend that everyone who can get vaccinated against COVID.

Reason 4: They Are Vaccinated

The importance of getting vaccinated and boosted cannot be overstated. If a vaccinated person is exposed to the virus, they have a very good chance of avoiding contracting COVID altogether, Dr. Assoum explains. We know vaccination doesn’t guarantee you won’t get COVID, especially with new variants like omicron, but it does lower your risk, and can also help prevent serious illness and death, according to the CDC. Many vaccinated individuals who tested positive for COVID reported much milder symptoms.

Reason 5: They Received A False Negative

The available COVID tests are very accurate, but they’re not perfect. Some rapid at-home tests are less sensitive to COVID variants like omicron or BA.2, for instance. Others may not pick up very mild or asymptomatic cases, or if there is a lower viral load in the body. That’s why if you are symptomatic and received a negative result on a rapid at-home test, Dr. Assoum suggests getting a PCR test as well. If that’s also negative, it’s possible that your symptoms are due to a different infection, not COVID. But it’s also possible that a low viral load or an improperly taken sample may have led to a false negative PCR. So it’s a good idea to talk to your doctor about the best next steps — they may suggest quarantining, just to be safe. (For what it’s worth: false positives seem to be relatively uncommon.)

Are Some People Naturally Immune to COVID-19?

These five reasons can help explain why some people have never had a positive COVID-19 test. But is it possible for someone to be naturally resistant to the infection — to have some kind of innate immunity? Researchers have asked that very question, and are seeking to study the genes of people who are genetically resistant to COVID infection. By studying their protective genes, the scientists hope it can get them closer to developing virus-blocking drugs.

Having this kind of resistance is very rare; so much so, that it can be difficult to find people to study. And the scientists aren’t sure what kind of resistance mechanisms they’ll find. One idea is that “some people don’t have a functioning ACE2 receptor, which SARS-CoV-2 uses to enter cells,” an article in the journal Nature states. Another thought is that “people resistant to SARS-CoV-2 might have very powerful immune responses, especially in the cells lining the insides of their noses.” It’s also likely that several factors play into resistance, STAT reports. The idea of learning from those who seem to be immune to COVID is exciting, but the only issue is to be able to find such individuals to study; those who’ve been exposed to COVID over a long period of time, without protection, who regularly tested negative, and had no symptoms.

If I Haven’t Had COVID Yet, Will I Never Get It?

There’s no guarantee that you won’t ever get infected, especially with new variants emerging globally. That’s why it’s always best to take all possible precautions, including getting vaccinated and boosted, wearing a mask in indoor settings (even if no one else is) and when feeling unwell, practicing social distancing and safe hand hygiene, and getting tested if you have any symptoms or after being exposed, in accordance with CDC guidelines.

Image Source: Getty / Luis Alvarez

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