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Doctors stress importance of accurately performed nasal swabs during COVID tests

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BATON ROUGE - Due to the prevalence of novel coronavirus cases and the need for COVID testing to take place as swiftly and efficiently as possible, an increasing number of testing sites are having patients collect their own samples in self-administered nasal swabs.

But doctors say if the nasal swabs are not performed correctly, test results will be inaccurate. 

Dr. Connie DeLeo, an Infection Preventionist at Baton Rouge General Regional Medical Center addressed this concern, saying, "If you don't collect a good swab, you don't get any virus on the swab, and so your test results may be a false negative."

Dr. DeLeo said physicians and other medical personnel are trained in collection procedures, but the general public is not. As this is the case, it's essential that members of the public who use drive-thru self-swab testing sites ensure they know how to perform a nasal swab properly. 

"I know there are a lot of drive-thurs that are letting people collect swabs themselves and I think that's a great thing because it speeds up the process," Dr. DeLeo said. "But we need to make sure people collect that swab correctly." 

This leads to the question of how exactly the self-swab should be performed. 

The Centers for Disease Control and Prevention (CDC) provides guidelines in a document detailing collection procedures for healthcare workers.

The four-step procedure is listed below:

1. Tilt patient’s head back 70 degrees.

2. Insert swab into nostril. (Swab should reach depth equal to distance from nostrils to outer opening of the ear.) Leave swab in place for several seconds to absorb secretions.

3. Slowly remove swab while rotating it. (Swab both nostrils with same swab.)

4. Place tip of swab into sterile viral transport media tube and snap/cut off the applicator stick.

If anyone doubts their results or is worried they didn't collect a good sample, doctors strongly suggest contacting the testing site or a specialist who can advise whether to retake the test.

Health care experts say if done correctly, self-swabbing is acceptable. Testing sites often have a health care provider watching the patient administer the swab and kits include directions on how to do it properly.

As for why self-testing is allowed now, when it was done only by health care professionals at the start of the pandemic, some experts chalk this up to the natural progression of how scientists approach new diseases. When there's a new virus, initial guidelines are typically ultra-conservative.

For example, doctors testing for COVID-19 used to collect multiple nose and throat swabs, but also blood and urine samples. As doctors learned more, that changed. They've since dropped the blood and urine samples.

Now, federal guidelines allow for self-sampling and even at-home tests, which is why different testing sites administer different tests.

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