FDA cautions against throat swab for at-home COVID tests

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FDA cautions against throat swab for at-home COVID tests

The FDA is warning people to follow the instructions of at-home Covid-19 rapid tests and only swab their noses — pushing back against viral reports that the tests are more accurate when users also swab their throats.

The at-home rapid antigen tests currently available in the US were only developed and studied using nasal swabs. Swabbing your throat along with your nose could actually contaminate your sample, the FDA said.

“The FDA advises that COVID-19 tests should be used as authorized, including following their instructions for use regarding obtaining the sample for testing,” the agency, which approves Covid tests, told the Post in statement.

The FDA said it has also “noted safety concerns regarding self-collection of throat swabs,” which can harm a patient if done incorrectly and should be collected by a trained professional.

Despite the FDA recommendations, people are swabbing their throats because they don’t feel confident in the accuracy of at-home tests and think the Omicron variant, which often lives in the upper airways, might be more commonly found in throat.


Follow the latest news on the Omicron variant with the New York Post’s live coverage


Dr. Roy Gulick, chief of infectious diseases at Weill Cornell Medicine and NewYork-Presbyterian, said he isn’t surprised to hear people who experimented with at-home tests have found different results, but advised against “coloring outside the lines” when self-testing.

A throat swab is taken from a patient to test for COVID-19 at a facility in Soweto, South Africa, Dec. 2, 2021.
The FDA has warned at-home testing users to not swab their throats as it could contaminate the sample.
AP Photo/Denis Farrell, File

“The FDA has cautioned that the at-home tests can be less sensitive to pick up the Omicron variant,” he said “But that doesn’t mean they’re worthless.”

PCR tests remain the gold standard in the industry, but Gulick said early tests are an important starting points if available.

“Always start with a home test, and if it’s positive, certainly believe the result,” he said. “If it’s negative and you have classic covid symptoms or were in contact with someone who had Covid, the best thing to do is not to swab your throat but to go in and get the PCR test.”

An at home Covid-19 test shows up positive in a Memphis, Tennessee household over the Christmas Holiday.
The FDA has issued a stern warning after many social media users recommended swabbing throats for more accurate testing results.
Karen Focht/ZUMA Press Wire

Covid “is not a do-it-yourself disease,” Gulick said, and if you’re worried about accuracy, ignoring clinical instructions won’t help.

If anything, it’s this scramble to ensure accurate test results that emphasizes the importance of easy access to PCR testing.

“Early on when you’re not showing symptoms, you likely don’t have a lot of virus in your system, and rapid tests can’t pick up those low levels of virus,” Kara Cannon, the operations manager of Enzo Clinical Labs, which runs labs in the New York area that do Covid testing, previously told the Post. PCR tests, meanwhile, do take longer to process and require a lab but are able to capture smaller amounts of the virus.

A health worker collects a swab sample from a person for COVID-19 testing at a mobile COVID-19 testing site in midtown Manhattan.
Infectious diseases expert Dr. Roy Gulick argues the PCR COVID-19 test is the most accurate for detecting the bug.
Shawn Goldberg / SOPA Images/Sipa USA

Abbott, which manufactures the popular BinaxNow test, told the Post its tests remain “highly accurate” and said if users want to “ensure accurate test results, is important to follow the instruction for use” — stressing the test is only authorized by the FDA to work for a nasal sample.

But not everyone thinks a throat swab is a bad idea. Dr. Purvi Parikh, an immunologist at NYU Langone, thinks the throat swab is a good “add-on” to the nose swab.

“I would do both: nose first and then throat,” Parikh said. “If you’re sending out for a PCR and you’re able to do both, that’s helpful.”

A BinaxNOW COVID-19 at-home test.
Manufacturer Abbott says their at-home rapid test only works with a nasal sample.
William Farrington

Parikh says her suggestion stems from concerns that people aren’t swabbing themselves properly, failing to go deep enough in their nasal cavity and missing the virus.

Post-nasal drip from congestion might mean the virus will find its way into your throat, making it a useful site for sampling, she said.

For Brooklyn resident Jocelyn Silver, 29, a throat swab made the difference.

Silver, the managing editor at the website Gawker, began feeling sick on Monday but tested negative on a rapid antigen test. On Tuesday, a friend sent her a TikTok from a journalist suggesting you swab both your nose and your throat. Silver tried the method and tested positive.

“I can’t be making my medical decisions based on TikTok and I’m still planning on getting a PCR, but it seems like there’s some validity to it,” she said.

Still, she gets why the FDA is worried about people swabbing their own throats.

“It did make me gag and it was awful…I fully cried,” she said. “My landlord lives downstairs and she texted me and asked if everything okay.”

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