Back in January there was a bunch of buzz around using standard rapid
tests but swabbing the throat. Ex:
On one side are well-regarded experts who argue that swabbing your
throat in addition to your nose may increase the chances that a home
test can detect omicron. On the other side are similarly well-regarded
experts, including those at the Food and Drug Administration, who urge
Americans to avoid experimenting with kits that were developed and
tested using only nasal swabs.
if you want to know if you have infectious Covid-19, you need to
use throat swabs. It's still not 100% sensitivity or anything, but
it's a lot better, whereas nose swabs are useful but in no way all
Then the buzz died down, and it seems like everyone just forgot about
it? No clear recommendation either way, just a lot of Tweets, a few
blog posts, news stories about the controversy, and then not much
else. Google Trends shows the spike and drop-off:
[EDIT: I wouldn't read too much into the chart: it turns out that most covid-related keywords followed as similar trend, as did covid itself]
What happened? Why did we all stop talking about it, without what
seems like any firm conclusions? Some of this is maybe that there
were conflicting studies: Schrom et. al. posted a preprint
on 2022-01-19 (published
version) where it looked like it worked poorly, but Goodall
et. al. posted a
different preprint on 2022-01-21 (published
version) where it did look good. I also saw speculation that some
of the cases where people got a negative with nasal swabbing but a
positive with throat swabbing may have been false
positives—rapid tests are sensitive
to pH, and especially if you've been eating or drinking recently
your throat might be pretty far from neutral.
Ten months later, why hasn't this settled out into recommendations
that either say to swab throat and then nose, or that seem to have
considered the new evidence and say still don't? We're doing a lot of
testing, and if this is a better way to be using the tests we already
have it would be great to know! Does anyone whose been following this
have a better understanding of what happened?
Comment via: facebook
I don't think the following does anything to answer the question, but the information might be of interest. In the earlyish days of the Plague, the rapid tests available in the UK came with instructions telling you to swab both nose and throat. Later on, all the ones we got just said to swab your nose. Anecdotally, I am pretty confident of my ability to swab my nose in the approved manner and very confident of my inability to swab my throat in the approved manner (my gag reflex activates before I can get the swab to the right place), and I wonder whether someone made a conscious decision to go for tests that are slightly more sensitive (and have slightly more false positives) for a given mode of use, and recommend not bothering with throat swabbing, because while that's worse in a world where everyone can swab their throat effectively it might actually be better in a world where some people can and some people can't.
Anecdotally speaking, about two months ago a friend of mine tested this with several tests, and while she was consistently positive with nasal tests, she was only sometimes positive even when she swabbed her throat as much as she could.