Rapid Test Hacking: Swabbing the Throat?

 Recently, there has been a twitter craze associated with using at-home rapid tests in a new way. While the tests are supposed to be used as nasal swabs, some people have become convinced that swabbing the throat is a better and more effective way to see if someone is positive for COVID. 

This article from NPR Goats & Soda (https://www.npr.org/sections/goatsandsoda/2022/01/12/1071362475/coronavirus-faq-why-are-some-folks-hacking-home-covid-tests-by-swabbing-their-th) discusses this phenomenon and whether it has any scientific merit. The authors discuss how in other countries, such as the UK and Canada, rapid tests are designed to swab the throat. Interestingly, this idea of throat swabbing is linked to the omicron variant specifically. 

This is because some researchers believe that unlike previous variants omicron replicates in the throat prior to replicating in the nose. This means, in theory, that someone could swab their nose and test negative but then swab their throat and test positive. This phenomenon appears to be backed by a study conducted in South Africa. For people with any other COVID variant, the throat swabs were only 71% effective at recognizing it while the nasal swabs recognized it every time. However, for the omicron variant, nasal swabs were 86% effective while throat swabs were 100% effective. 

However, there are some holes that I think it’s important to recognize in this research. The sample size of patients in this study was fairly small, with less than 400 people total. Furthermore, the study used PCR tests rather than the rapid antigen tests that people have been using at home in the United States. Finally, the NPR article states that the research has not undergone peer review, so it is difficult to say whether the methods and conclusions are sound. 

However, several individuals in the United States have tried to informally test whether throat swabs are more effective. One advocate for this approach is Micheal Mina, a former epidemiologist and immunologist at Harvard. Other health experts such as infectious diseases expert Jill Weatherhead of Baylor College says that this approach could just be producing a higher rate of false positives rather than a lower rate of false negatives. It is also important to note that the swab sticks are designed for use in the nostrils, so it may be dangerous for people to stick them down their throats (perhaps accidentally injuring their tonsils). As of right now, the FDA has warned against using the testing kits as throat swabs. 

-Sophia (from Week 2)