Discussion
We reported on a clinician in Bangladesh who had a persistent COVID-19
negative report while living in close proximity to known COVID-19 cases
and visiting one of the countries with the highest death rates. The most
prevalent method for severe acute respiratory syndrome‒coronavirus-2
(SARS-CoV-2) testing is based on reverse transcriptase‒polymerase chain
reaction (RT-PCR) for the presence of viral RNA. The virus extraction or
positive response of polymerase chain reaction (PCR) from phlegm, nasal
sample, or throat swab is used to provide a clear diagnosis of corona
virus disease 2019 (COVID-19)(9). Because the consequences of swab
testing are affected by a variety of factors, along with the period of
swab acquisition after the onset of symptoms, the location of the
specimen, the shipping of the swab, and the procedures used in swab
collection, physicians should not rule out COVID-19 in a widely
speculated patient who has traveled to an epidemic zone(10). Thorough
viral screening for SARS-CoV-2 infections could help ensure safe
aircraft flight during the COVID-19 pandemic and slow the virus’s wide
adoption. Unfortunately, the efficiency of these test-and-travel
procedures in reducing traveler risk of SARS-CoV-2 transmission of the
disease at the community level is uncertain(11). Proven test-and-travel
methods for SARS-CoV-2 infection, which include periodic viral
diagnostics surrounding airline travel, can lower both passenger chance
of infection and population-level SARS-CoV-2 transmission risk when
traveling. The clinician performed 13 Covid19 tests (Figure 1) in order
to detect for virus infection while traveling across nations. A negative
RT-PCR nasopharyngeal swab test does not rule out COVID-19. As a result,
putting too much faith in test results could be harmful, and the demand
for widespread testing could be exaggerated. Furthermore, avoiding
attempting to test the many numbers, if not millions, of mild COVID-19
instances could save a significant quantity of personal protective
equipment. Barrier protection and preemptive behavior, such as acquiring
travel or having vaccinated before traveling overseas, is influenced by
personal healthcare and well-being perspectives(12, 13). Masking, social
dispersion, handwashing, cleansing of commonly handled items, better
ventilation, self-isolation, and confinement are among the
nonpharmaceutical measures advised to minimize SARS-CoV-2 transfer.
Vaccines are the most effective way to avoid the SARS-CoV-2 outbreak.
Numerous vaccinations are being developed in many countries using
various approaches. The cornerstone of attempts to control the
propagation of SARS-CoV-2 has been preventing transmission to the virus
and, more recently, immunization against the virus(14). The percentage
of false-negative SARS-CoV-2 results from patient respiratory samples
varies between 1 and 30%(15). There is no screening test that offers
100% sensitivity and specificity. Despite the fact that the RT-PCR test
seems to have become the best model for detecting SARS-CoV-2 virus,
false-negative incidences have been observed. These false-negative
results can occur for a variety of causes, including detecting either
early or too late in the virus’s pathogenic process, inefficient or
defective sample collecting techniques, incorrect specimen aspects, low
analytic sensitivity, low viral load, or viral shedding mutability.
These false-negative findings could have major ramifications, opening
the path for positive case aggregations to lead to adverse outcomes and
increased transmission rates throughout the population. Because false
negative RT-PCR results in cases of COVID-19 are not rare, researchers
advocate collecting upper respiratory tract samples in the acute stage
and lower respiratory samples or stool samples in the non-acute
period(16). Doctors in India who are intensively examining the second
wave state that bronchoalveolar lavage done on RT-PCR negative patients
with COVID-19 symptoms produced COVID-19 positive results. According to
a doctor quoted in the same source, 15 to 20% of COVID-19 patients come
with the aforementioned issue, which is posing a problem for
doctors(17). In another study, a scientist said that alterations in the
SARS-CoV-2 virus may have enabled it to evade RT-PCR testing, and that
the reagents must be re-configured immediately(18). Furthermore,
epidemiology, background of exposure, and clinical signs such as fever
or pulmonary disease should all be examined when establishing COVID-19.
As a result, combining serum IgM/IgG antibody identification, nucleic
acid testing, CT scan, and clinical characteristics increases COVID-19
accuracy rate. By falsely claiming that an infected individual does not
have a disease, a false-negative test puts the entire society at danger.
As a result, this individual may spread infection throughout the
population. False negatives in group testing are far more dangerous than
false positives in solo testing.