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Nose or throat? Testing for omicron raises questions about most accurate method

Posted at 9:56 AM, Jan 08, 2022
and last updated 2022-01-08 10:56:58-05

OMAHA, Neb. (KMTV) — It's a new year, with a new variant, and there may be a new way to do testing on the horizon.

Dr. James Lawler, an infectious disease expert with Nebraska Medicine said research is showing that throat swabs are getting more accurate results with the new omicron variant.

“It does appear from data that we’re getting in omicron infections that saliva and oral secretions seems to have more virus in it than with previous variants," Lawler said.

But swabs meant for saliva are not widely available at this point.

Some people are instead using at-home kits made for nasal testing to swab their throats. Lawler and the FDA both recommend against this.

“I wouldn’t recommend just taking a home test for instance, that’s designed to be used with a nasal swab, and just on your own start swabbing your mouth," Lawler said.

Lawler says tests go through a rigorous validation process, and using a test in the wrong way could interfere in results.

But he would like to see more proper saliva testing more widely available.

UNMC has a saliva tests for students, staff, and faculty for example. But the testing done at stores like CVS, local pharmacies like Kohll's, and at-home tests use nasal swabs.

“Saliva testing is an easy mechanism to scale," Lawler said. "It’s very reliable, the results are quite good, even before omicron and with and with omicron - again- they may be even better.”

At the same time, Lawler says some early research is showing that antigen and PCR tests used in the nose are more often coming back with false negatives.

"It may just be a particular feature with antigen tests with omicron, that they just are later to convert the positives," Lawler said. "Regardless, we've seen that with the antigen tests, and I think it's certainly true early on with PCR comparing nasal swabs to saliva. Saliva just seems to have better sensitivity especially early with infections, where you could pick up somebody with a saliva test that you might now pick up with a PCR test with their nasal swab."

With long lines for testing, sometimes having to wait days for an appointment and now knowing at-home tests may not be catching omicron quickly, Dr. Lawler says it's important people are staying home when they feel sick.

When asked if the CDC's new isolation guidelines could make that hard for people to avoid going back out into the community too early, Dr. Lawler said this:

"Yeah.I think it does. I don't understand the scientific basis for that decisions the CDC used to put out that guidance. I have not changed my personal recommendation, that we know that people infected with COVID, and that includes with the omicron variant, can she infectious amounts of virus for 10 days.”

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