By Doug Barker

The Daily World

The first person to have tested positive for COVID-19 in Grays Harbor County was considered recovered after a second test came back negative and the patient was no longer having symptoms, but a third test has now come back positive, hospital officials said Friday. The patient has been at Grays Harbor Community Hospital the entire time and is is not showing symptoms, said Dr. Anne Marie Wong, the hospital’s chief medical officer.

The patient, who is a male in his 60s, seemed clearly to have COVID symptoms when he came to the hospital and was put in isolation even before the first test results were known, said Chris Majors, the hospital’s director of public relations. The first positive test was announced March 11. The patient was in isolation at the hospital for 20 days and had been without symptoms for three days before the second test was ordered, Majors said. It came back negative.

Majors said the man has underlying medical issues and was scheduled to be released to a long-term care facility. That’s why the third test was done, in order to establish two negative tests in a row before sending him to the facility. Majors said the hospital is now waiting for results of a fourth test being conducted by the University of Washington virology lab.

Dr. Wong said there is still not much known about how long the virus can stay in the body, and sample sizes for studies are small, but medical literature suggests a median of 20 days. One study in China showed the presence of the protein the tests are designed to identify still there for 37 days in one case, she said.

The University of Washington virology lab goes through as many as 40 cycles of detection looking for the protein in the sample. If, after the 40th cycle, the protein is not detected, it’s considered a negative test. If it’s detected in one of the early cycles, there is a presumption of a stronger presence of the virus, said Dr. Wong. In the Grays Harbor patient’s most recent positive test, it was detected in the 35th cycle, possibly indicating a lower level.

Majors said when the man remained in the hospital after coming out of isolation, hospital staff caring for him stopped using the same level of personal protective equipment it had when he was in isolation.

Hospital staff was notified and will be closely monitored and tested if symptoms are shown, he said.

Dr. Wong said she believes the risk of transmission during the time the patient was not in isolation is very low.

“The third test … came back positive, but very weakly positive and based on his clinical course, a long extended course with improvement and resolution of symptoms and a negative test, my sense would be that the likelihood of transmission is very low,” she said.

She said that given what is known about the incubation time for the virus, and when the patient was symptomatic and most likely to have transmitted it, if hospital staff were to have been infected, symptoms would likely have already started to show up, but that’s not been the case.