Need to iron your throat for a quick COVID test at home?

With gold standard tests for COVID-19 becoming increasingly difficult to find, the debate is swirling over whether to collect a throat swab sample next to a nose swab for quick tests at home – as opposed to some instructions on the package.

For most tests, the accuracy of a combined throat and nose graft has not yet been tested, and Canadian and US official health guidelines still advise people to follow the user manual for the kit they have on hand.

However, debate has arisen on social media and among some experts after anecdotal evidence from people who said they were only tested positive after stroking both the back of their neck and their nasal cavity, despite test instructions to wash only the nose .

“I finally took Twitter advice and wiped my throat as well as my nose,” wrote Jennifer Rohn, a British cell biologist in a tweet on December 27th. “If you think you may have COVID, consider adding the throat swab.”

That advice was repeated by Dr. Michael Mina, a notable epidemiologist in the United States, who wrote that Omicron infection could only be detected in the throat due to its shorter incubation time compared to other variants, and a throat and nose inoculation can improve the chances of contracting an infection.

Others have pointed to one pre-print study from South Africa, which found that nasal polymerase chain reaction (PCR) missed 14 percent of Omicron cases compared to saliva samples that successfully detected all cases.

Official guidance from Health Canada and Public Health Ontario, as well as a recent statement from the United States Food and Drug Administration (FDA), maintains that inoculation in the nasal cavity is the best standard to follow when it comes to testing for COVID-19 at home, if the package instructs it.

“The FDA has noted safety concerns regarding self-collection of pharyngeal grafts, as they are more complicated than nasal grafts – and if used incorrectly, they can cause harm to the patient.” a statement to the media of the FDA said. “That [U.S. Centers for Disease Control] recommends that throat swabs be collected by a trained nurse. “

Christine Bruce, senior director of the Laboratory Medicine Program at the University Health Network in Toronto, said laboratory workers continue to follow Health Canada’s guidelines for using a nasal swab only when performing a rapid antigen test, as there is no definitive research to suggest a neck inoculation along with a nasal inoculation would give a more accurate result.

“It will always be our position as laboratory experts to follow the manufacturer’s and Health Canada’s instructions,” Bruce said.

While the neck collection method is not used in the United States or Canada, it is officially approved in the United Kingdom, where certain rapid tests distributed by the national health service instruct collection of both throat and nose grafts. Others that are distributed, such as the FlowFlex or Orient Gene rapid tests, instruct users to take only one nasal swab.

For throat cleansing tests, the UK and test guidelines advise users not to eat or drink for at least 30 minutes before taking the test.

Dr. Tara Kiran, a primary care physician at Unity Health Toronto, said it is important to note that experts and physicians are still learning how to best use rapid home tests to detect Omicron. But she added that her advice is to wipe both nose and throat for higher sensitivity of test results.

Kiran also said she agrees with the FDA that there may be a risk of performing a neck graft incorrectly without package guidance, but resources and videos are easy to follow. how to perform a combined throat and nose inoculation at home safely.

Although not as accurate as the gold standard polymerase chain reaction (PCR) test due to a higher margin of error, rapid home tests have become most people’s best bet to determine if they are sick or not, as Ontario’s PCR test capacity has been limited due to an increase in cases associated with the Omicron variant.

However, if someone develops symptoms, Kiran recommends that they isolate themselves regardless of a negative or positive result, as rapid tests are not entirely accurate.

“A quick antigen test does not guarantee that you are not able to transmit the virus right now or that you do not have it, because it may be early and [infection] is not shown at this time, ”Kiran said.


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