Self-Swabbing Tests Could Address Challenges in Mass Testing: Study
Mon, April 19, 2021

Self-Swabbing Tests Could Address Challenges in Mass Testing: Study



Testing for COVID-19 is critical in controlling the disease and treating patients. But the current situation is difficult for everyone. So, a group of researchers developed self-swabbing tests to make things easier for all.

The self-swabbing tests for COVID-19 were developed by researchers at Stanford University, a private research university in the US. The collection kits could be done by people themselves, which lessens physical visits in testing sites. This would also lower the risk of transmission to frontliners. At the same time, the method could reduce the need for personal protective equipment or PPE. They published their findings in the journal JAMA Network Open.



The Current Testing Types for COVID-19

According to the US Centers for Disease Control and Prevention, a federal agency, there are two types of tests used to confirm COVID-19 diagnosis. These are the antibody and viral tests that detect the signs of possible infection using two approaches. The antibody tests, commonly called rapid testing, identify the presence of antibodies reacting to SARS-CoV-2, the virus of COVID-19. A person who has been tested this way may get a positive result if their body produced the antibodies, with or without symptoms. Thus, a person can be COVID-19 positive from an antibody test even if they feel fine.

Meanwhile, the viral test that involves the polymerase chain reaction (PCR) machine specifically detects the presence of the pathogen, with or without the antibodies. Between the two, the PCR test is superior as it looks for the viral signature. However, PCR tests are not 100% accurate in all instances. For COVID-19, scientists considered such tests to be pretty accurate in confirming suspected cases. So, viral tests are preferred in detecting a current infection while antibody tests are selected to trace back a previous infection.



Due to the shortages in testing kits, not everyone must be tested for COVID-19 using PCR. First, it is up to a healthcare professional to decide what test is appropriate. Second, government agencies and health departments have guidelines that determine when to use PCR tests. And third, if symptoms are mild, patients are instructed to stay at home, isolate themselves from others, and take good care of their bodies to recover fully. Most cases of COVID-19 are mild and do not require any tests.

In terms of results, a negative test result does not ultimately suggest that the person is not infected. It only means that they are clear at the time the sample was taken. They may get infected by the virus in the following days after the sample was obtained. As such, it is highly recommended to follow preventive measures to avoid contracting COVID-19 since there is no specific treatment or vaccine yet.



COVID-19 Self-Swabbing Tests Confirmed Accurate and Safe

Because there is a major shortage in test kits on a global scale, mass testing is not applicable in every city or country. This issue makes it difficult to effectively contain community transmission. Just one person carrying the virus who missed both antibody and viral tests can unintentionally start a new outbreak. Simultaneously, allowing health workers to collect samples in communities can increase their exposure risk to the virus.

At Stanford University, a research group offers an innovative way to address one problem in mass testing. Their approach involves self-swabbing tests, wherein people themselves are taught to take nasal swabs, instead of relying all the time on medical frontliners. This way, they can submit samples to authorized receiving sites without going inside a hospital or testing facility.



"There is an urgent need to increase our testing capacity to slow the overall spread of the virus. A sample collection procedure that can safely and easily be performed by the patient in their own car or at home could reduce the exposure of health care workers and also allow many more people to submit samples for testing," said Dr. Yvonne Maldonado, the senior author of the study and professor of pediatric infectious diseases, and of health research and policy.

In the June 16, 2020 report by the World Health Organization of the United Nations, the total confirmed cases of COVID-19 reached 7,941,791 worldwide. The total deaths from the pandemic reached 434,796 globally. While these figures showed how severe the pandemic is, the numbers only reflected confirmed cases, not the actual statistics. Some people, who might or might not have COVID-19, only developed mild symptoms and were not tested for confirmation. Others who died from suspected COVID-19 might not even be tested prior to cremation.

The self-swabbing tests are composed of sample collection kits. The kits can be used to collect and store nasal swab samples. To assess the performance, researchers sought out COVID-19 patients. A total of 129 individuals infected with SARS-CoV-2 were eligible but only 30 of them participated in the study. Out of 30 participants, 16 were males and 14 were females, and collectively, with an average age of 48.2 years. These individuals tested positive in March at Stanford Health Care.

About 66% of the participants were Whites, 10% were Asians, 7% were either Hispanics or Latinos, 3% were either Native Hawaiians or Pacific Islanders, 7% were from unknown lineage, and 7% were from other unspecific ancestries. The investigation on the viral exposure showed that 17% of participants were likely exposed from travel, 13% from close contact with a COVID-19 patient, and 10% from close contact with an illness mimicking influenza. But the exposure of the 60% of participants was unknown.

Participants were contacted by researchers through phone and given a short video and instructions on how to collect their own nasal swab samples. Next, they were asked to return to the medical facility for drive-through testing. After that, participants collected their nasal swab samples with a doctor observing them. Then, the doctor collected two extra samples: nasal swab samples and swab samples of the back of the throat and tonsils.

All samples were tested and compared to determine if self-swabbing could lead to accurate findings. Results revealed that out of 30 samples from participants, 29 were identical to the results from samples taken by the doctor. A total of 11 participants tested positive while 18 tested negative. The single unidentical sample, self-collected at the drive-through testing area, tested positive but the doctor's two extra samples tested negative.



The experiment included interesting insights on how long an infected person would test positive for COVID-19 after they experienced the initial symptoms. A total of 23 participants reported initial symptoms between four and 37 days before they returned for the drive-through test. Out of 12 participants who returned within 14 days after the symptoms started, seven tested positive. Out of 11 participants who returned over 14 days after the symptoms began, two tested positive.

The self-swabbing approach might be a solution to the inability of governments to conduct mass testing. In drive-through test areas, people simply have to take their own samples and give them to doctors. They no longer have to walk inside the facility and risk other individuals to COVID-19. This spares the lives of medical professionals and hospital staff who work tirelessly to save everyone.