Are We Testing Wrong for Omicron?

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Some scientists say early infection is missing only in the nasal approach, but the FDA warns against sore throat

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But some scientists say that throat swabs may be more effective at detecting omicrons. Some are asking the FDA and test makers to better study throat swabs, saying that its reliance on nasal swabs may be one reason why the rapid test is less sensitive at detecting omicrons than previous variants. seem.

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Many consumers are also agitated, sometimes after discovering that a throat swab returns a positive test result if not a nasal swab. The #swabyourthroat hashtag is gaining popularity on social media. Some people swell both their nose and throat in hopes of increasing the chances of getting accurate results.

The FDA warned last week that nasal rapid antigen tests should be used as directed take to social media To plead: “Please don’t stick to that #COVID19 test that goes down your throat. Use the swab as directed: Through the nose.”

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The FDA said it has no data to indicate that there is an accurate or appropriate way to conduct a throat swab home test. The agency is also concerned that people could injure themselves by using a sore throat swab because it is more complicated than a nasal swab.

A spokesperson for Abbott Laboratories, which runs Binex Now rapid testing at home, said, “We continue to monitor and evaluate. Our testing is currently indicated for nasal use only.”

The idea that a person can strangle themselves at home for a Covid-19 test is not entirely out of left field. The UK Government supports the approach and is a how-to video Showing people how to do a throat-nose swab combination. Israel is also supporting throat-nose swabbing technology for rapid antigen tests. On Monday, its health ministry recommended that when people take home antigen tests, they should first clean the back of the mouth and then one nostril.

“There is ample evidence that we should really try this swabbing technique like the UK is doing,” says Kellyanne Jetelina, assistant professor of epidemiology at the University of Texas Health Science Center in Houston.

research has suggested That the omicron type can be detected in saliva before it is detected in the nose. Scientists believe the version is first and fastest mimicking the throat; A sore throat is a common first symptom for people infected with Omicron.

Dawn Milton, a professor of environmental and occupational health at the University of Maryland School of Public Health, whose lab’s research has shown that saliva tests can detect COVID-19 before nasal swabs, says that the approach by federal officials is Waiting to support may make the risk disappear. Dr. Milton says he thinks it makes sense to do a rapid test in the throat but says more data is needed from the FDA and test makers.

They say that other covid variants may also appear earlier in saliva than nasal inflammation. But with Omicron, infection develops so quickly that catching it early is more imperative to reduce the risk of transmission, he adds.

The potential downside of a sore throat, Dr. Milton notes that the approach may generate more false positives—telling people they are infected when they are not.

“There is a known risk of false negatives with nosebleeds and an unknown risk of false positives with throat swabs. For now you need to decide for yourself which one is at higher risk for you,” Dr. Milton it is said.

Rapid antigen tests have a very low false positive rate because the FDA requires that such tests have 98% specificity, or a 2% false positive rate.

Michal Caspi Tal, an immunologist who splits his time between Stanford University and the Massachusetts Institute of Technology, has been suffering from a swelling in his and his family’s throat and nose for the past two weeks. She swabs her throat, inside of her mouth and nose with the same swab.

“If we’re not doing active replication in the nose with Omicron, or at least not within the first few days, that could explain exactly why the nasal swabs are coming back negative,” she says. “If we don’t include the throat, we may miss cases of people who are actually contagious at this point in time.”

Write Sumati Reddy at [email protected]

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