To curb the COVID-19 pandemic, public health officials strive to recommend the most effective and efficient ways to contain the virus. Arguably, one key method for communities to restrain spread of the infection is to apply widespread testing, followed by contact tracing and selective quarantine. The early medical response in the United States (U.S.) was hampered, in part, by the lack of available materials and infrastructure to perform tests – a problem that is resurging as numbers of cases rise in the U.S. Additionally, collecting swab samples can increase the risk of transmission to health care workers conducting the testing, especially when personal protective equipment (PPE) is in short supply.
Consistent with the goal of efficiency, recent data supports the validity of self-administered testing that can be performed at home by the patient. The person then submits the sample to a reference laboratory where it is examined for presence of COVID-19. In a study conducted in Puget Sound, Washington State, 530 patients with symptoms of an upper respiratory infection tested themselves. Healthcare workers tested these same patients using a nasopharyngeal (NP) technique so that the results could be compared.
The researchers found that when patients collected tongue, nose, and mid-turbinate (inside the nasal cavity) samples on themselves, the sensitivities (meaning the likelihood that their tests were comparable to the tests conducted by a healthcare worker) for detecting the virus was 89.8%, 94.0%, and 96.2%, respectively. This suggests that patients are able to collect their own samples and that they may accurately predict COVID-19 infection, especially from nasal and mid-turbinate regions.
Self-administered sample collection may improve efficiency for testing while also reducing the risk of exposure for the healthcare workforce.
Self-administered sample collection may improve efficiency for testing while also reducing the risk of exposure for the healthcare workforce. The study needs more rigorous evaluation and, ideally, replication; but the concept of widespread self-administered testing in the U.S. may prove to be a possible method to help reduce the spread of COVID-19. In fact, the Food and Drug Association (FDA) has approved a home testing kit via the Emergency Use Act (EUA).
Already in the United Kingdom (UK), individuals are given the option to order a free home testing kit. Once delivered, patients can test themselves and return the swabs to a lab site for analysis. This process provides several advantages:
- Less discomfort for the patient
- Safer for healthcare workers because of reduced exposure
- Diminished use of PPE
The British National Health Service (NHS) has released a tutorial on how to conduct a self-administered test at home. As a result, the UK has recently seen great improvement in the number of people they are able to test. They’ve even been able to extend asymptomatic testing and regular retesting to thousands of workers who may come in contact with people through their daily jobs, including taxi drivers and cleaners.
As countries like the UK step up testing in order to create a safer environment for its citizens, they may serve as a role model, setting a precedent to apply this approach to help contain the spread of COVID-19. Perhaps the FDAs application of the EUA to approve a home testing kit is a sign that this may be an option coming soon to the US as well.
Written by Rohan Prabhu; Edited by Dr. Jacki Hart
