What if you had COVID-19 but didn’t even know it?  

Imagine yourself, right now. No cough, no shortness of breath or fever. Just life as usual, plus coronavirus.  

They call it asymptomatic transmission, and it is a big problem for public health officials trying to contain the spread of COVID-19. Because if even those feeling healthy can be quietly carrying the virus, just how do you snuff it out?  

As of the end of April, nearly one in every five cases detected in Malta was classified as asymptomatic. 465 cases had been detected at that time. That means that more than 90 people had no symptoms when they tested positive.

I kept thinking about those figures. Then I decided to get tested for COVID-19.

Booking a test  

I was concerned that I would be turned away. Testing was initially reserved for people exhibiting symptoms of COVID-19. Over the past weeks, criteria have been broadened to include more testing of at-risk groups and even an element of random testing. But would I – a perfectly asymptomatic citizen who is working from home - qualify for testing?  

I dialled the 111 helpline and cut to the chase.  

“My wife and I don’t have any symptoms, but we’re concerned we might be asymptomatic carriers,” I told her. “Could we get tested?”  

“Yes, of course,” she replied.  

Within minutes, I had an appointment at the Pembroke testing centre. It was that easy. 

“Bring your ID card and a packet of tissues,” I was told before hanging up.  

It was 10.45am and my test was booked for 12.15pm. A 90-minute wait. I used the time to reach out to a Health Ministry official and get official permission to record myself getting tested.  

Getting tested 

The Pembroke centre was empty when I arrived, save for the healthcare professionals suited up in personal protective equipment from head to toe.  

A nurse signalled for me to roll my car forward. A few metres, and then came the raised palm, gesturing me to stop. It felt like I was boarding a Gozo ferry in a parallel universe.   

A COVID-19 nasal swab test kit. Photo: Matthew Mirabelli

She asked for identification. I held my ID card up against the car window as she scrawled my details onto a clipboard.   

When a suited nurse approached with what looked like an extra-long cotton bud, I lowered my window and pressed my head against the headrest. 

She asked me to look up and close my eyes.   

Something went up my nose, and then kept going. For the next 15 seconds, I felt the slightest choke at the back of my throat, as though I were drowning in a drop of water.  

It was awkward, but not at all painful.  

And that was it. The nasal swab was done and I hadn’t even unfastened my seatbelt. By the time I exited the Luxol car park, the awkward feeling inside my sinuses was already a memory.  The packet of tissues remained unopened.

Test results  

A day passed. At 2.45 pm my phone vibrated. Once, then again.  

An SMS from ‘PUBL HEALTH’ sat in my notification drawer.  

“Result for BERTRAND BORG:  COVID19 virus NOT DETECTED. If you have symptoms, you must still remain home until 24 hours after the symptoms are gone. If you are in quarantine, remain isolated. If you need medical assistance, call your family doctor or a Primary Health Care doctor.”  

An unread email in my inbox said the same thing in a few more words.   

The test result did not come as a surprise or even a relief. I had no reason to suspect that I was positive. But then again, most asymptomatic patients don’t.  

Still, I was undoubtedly reassured. A niggling concern at the back of my mind had been addressed, albeit temporarily. 

A COVID-19 test can only tell you whether you have the virus at that moment in time. It is no guarantee that you will not get it in the future. I may have infected myself 30 minutes after getting swabbed. Unlikely, but still possible.  

My little test is also part of a bigger picture. Testing people like myself for the virus is hardly going to end the coronavirus pandemic, or allow life to return to normal. Community testing, though, including that of asymptomatic individuals, is one of the most effective weapons public health authorities have in their arsenal. The wider they cast their net, the more likely they are to catch those infections skulking in the shadows.  

Our lives will still be conditioned by the pandemic come 2021. The World Health Organisation’s chief scientist said on Wednesday that she fears it will be “four to five years” before the coronavirus is completely under control.  

That means most of us will probably be tested at some point. The tests will undoubtedly evolve and become less awkward to administer and faster to process. Research in the US suggests saliva tests are even more effective at detecting the virus.  

But even if things were to stay the same, I now know the nasal swab process is simple, painless and quick. All it takes is a phone call and a few spare minutes.