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Nasal Swab All The Way Up The Nose? 5 Myths About COVID-19 Tests

January 10, 2022

The Omicron peak in Connecticut, by most estimates, is almost here.

“I’m going to double-down on my prediction,” said Dr. Ulysses Wu, Hartford HealthCare’s System Director of Infection Disease and Chief Epidemiologist, at a Jan. 10 media briefing. “We said middle of January, way back in September. We’re getting hopefully to the top point of the curve.”

An Omicron peak should mean COVID-19 testing demand is also nearing its peak.

For now, if you have a runny nose, a cough or cold or flu-type symptoms, get a COVID test.

“They should assume they could actually have COVID given the spread in the community at the moment and get tested,” said Dr. Ajay Kumar, Hartford HealthCare’s Chief Clinical Officer. “And if it is negative, then at least you have most likely — not 100 percent — have reduced the chance of having COVID based on the testing. Two days later you could get tested and you might turn out positive. It depends a lot on your history and exposure, if you’ve been traveling or you’ve been exposed  to somebody who’s positive, your goes high.”

Five myths about COVID-19 testing:

Myth: Getting a Vaccine Will Cause a Positive Result on a Viral Test.

No authorized COVID-19 vaccine can produce a positive result on viral tests, says the Centers for Disease Control and Prevention. A vaccination helps create an immune response in your body, however, which could result in a positive result on some antibody tests. These tests reveal if you’ve had a previous infection or if you’ve built up some immune protection against the virus, perhaps through vaccination.

Myth: A PCR Test, Under Any Circumstances, Is Better Than an At-Home Antigen Test.

A polymerase chain reaction, or PCR, test is used by Hartford HealthCare and other healthcare systems as the most accurate COVID-19 test. It detects the virus’ genetic material, but results are often unavailable for at least 48 hours because samples must be sent to a laboratory.

If you’re experiencing no symptoms but seek a test before traveling or visiting an elderly family member, an antigen test is a more convenient, and often better, choice than a PCR test. An antigen test, also known as a rapid test, can detect an active viral infection without identifying it precisely. So its results can be less accurate than a PCR test. The advantage is the almost instant result.

“We tend to take a positive (at-home) test and interpret it as a real positive,” said Dr. Wu. “Where the disparity happens is really the negative at-home test. A negative at-home test doesn’t mean you are truly negative at this point.”

The antigen test can miss lower levels of infection, so if you test negative using an at-home kit, it’s a good idea to test again 24 to 48 hours later.

“It really depends on the test kit,” said Dr. Wu, “but I would follow the directions of the kit. That’s how it was studied and that’s how they produced it. I would not deviate from any of those instructions.”

Myth: An At-Home Test Requires Inserting a Swab Uncomfortably High Up Your Nose.

The discomfort zone known as the nasopharynx, where the nose extends to the top of the throat, actually produces the most accurate test results — 98 percent accuracy, according to a study last year. But a more comfortable test would mean more tests, so scientists turned to less-invasive swabs, known as mid-turbinate and anterior nasal, that allow patients to do the test themselves at home with a sample from a shallower area of the nose. This type of swabbing, in that same study from last year, was up to 88 percent accurate.

Myth: Sudden Spikes in COVID-19 Cases Are Caused by Excessive Testing.

Health officials care more about the percentage of positive results than the actual number of tests, so they can provide the best safety recommendations to local schools and businesses. A thorough testing program is the best way to determine how quickly the virus is spreading in specific communities. An extraordinarily high test positivity percentage could actually mean not enough people are being tested in certain areas.

Myth: At-Home Tests Have No Expiration Date, So You Can Stockpile Kits for Personal Use.

Unfortunately, at-home tests have a short shelf life, so it’s impractical to accumulate a large supply of test kits. Abbott Laboratories, makers of the BinaxNow COVID-19 Home Test, reportedly destroyed close to 9 million test components at a Maine factory and jettisoned 2,000 workers last summer during low demand for the kits and test components with a dwindling shelf life. BinaxNow test kits were originally marked with a six-month expiration date, now extended to one year.