No NP swabs left! Why not do something easier like the new swab that patient’s can do themselves? As a physician, the fast tracked swabs that have been rifled thru the FDA are SCARY! It seems there is limited sensitivity information meaning that patients who get tested may show a negative test but actually have COVID-19. Some of these have been approved to sample just the front of the nose and are patient administered. If you are trying to find information regarding the sensitivities on this, good luck. The CDC has gone so far to allow oropharyngeal swabs to be accepted given the lack of NP swab production. Historically oropharyngeal swabs miss the diagnosis for viral pathogens greater than 50% of the time. Rather than panicking and jumping to the unknown, we should be performing a properly performed NP swab or NP aspirate.
What About A Serology Test?
The serology tests have a place in testing as does the molecular test. Certainly there are concerns with the serology tests not having long term or large number data. For those patients with active symptoms and suspicion of active infection the proper test is a PCR molecular test with NP swab or NP aspirate. Serology tests can give some peace of mind if you have had COVID-19 and have antibodies to it. The unknown is quantifying the antibodies. How much do you need to prevent you from having re-infection. Or furthermore, transmitting it to family members or co-workers. Bottom line is we don’t know.
Conclusion
So for active infection the best test you can perform is a NP aspirate giving the greatest sensitivities in a patient not on a ventilator. For those who suspect or need to know if they have had COVID-19, the serology test we hope will provide the reassurance we need to mingle.
Click HERE to see how to perform open-air drive-up testing using a nasopharyngeal aspirate.
