I have several layers of security, including an infosec mindset that comes naturally, but at the end of the day I don't really know. I have faith that if I were to be infected statistically it would be by some malware that would give itself away by mining crypto or doing something else very loud and disruptive. Fun story but my laptop was actually hacked remotely once, without me knowing. It was almost 20 years ago,…
So you really have to boot from trusted media with a trusted kernel and no untrusted modules to be sure what you are seeing. Generally this involves rebooting onto trusted readonly media, doing a scan, then rebooting back into production. The HOWTO mentioned finding an unused kernel module like floppy.ko and replacing it with a malicious payload and ensuring it loaded on boot.
Also keep in mind that attackers are well aware of tripwire and some attack kits I saw specifically looked for tripwire like approaches and would hook into the update the checksums process after patching so their exploited binaries would look just like valid binaries.