Nasal Swabs Are Approved for COVID-19 Testing

The NEJM Online June 3 edition reported a study from the University of Washington and United Health Group comparing the efficacy of COVID-19 testing in 530 subjects by nasopharyngeal swab vs. patient-collected anterior nasal swab, or mid-turbinate swab, or tongue swab.  This well-done study found similar sensitivity and specificity to that of our gold standard for RT-PCR testing, the  uncomfortable and universally detested nasopharyngeal swab.  An audio interview with Editor-in-Chief, Dr. Eric Rubin, and Deputy Editor, Dr. Lindsey Baden, endorsed these alternative collection sites.  Since that study, the public health departments of San Diego and Contra Costa Counties have approved the anterior nasal site as a collection option for SNF patients and staff.  PPE isn’t required for patient-collected swabs, and adherence to our mandated and recommended testing protocols will likely be better.  

On the June 11 CDPH HAI Program Q&A call, anterior nasal patient-collected swabs were tentatively approved, but formal guidance is still pending.  On this call, CDPH also clarified that the mandatory COVID-19 testing in AFL 20-52 includes non-contract workers who enter our SNFs, such as hospice workers and attending physicians.   CDPH also stated all health insurance companies in our state are mandated to cover this test.  With this information, I have requested that my local public health department endorse this option.  Please see links to NEJM article and audio interview.


Audio Interview:
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