Updated COVID-19 Specimen Collection Methods
On September 15, 2020 Public Health Ontario (PHO) stated that while nasopharyngeal (NP) specimens have been the gold standard collection method for COVID-19 PCR testing, deep nasal or a combined throat swab with both nares (nostrils) are preferred alternatives to NP specimens for COVID-19 testing by PCR, particularly in the ambulatory setting.
It is important to note that swabs are designed for specific purposes depending on the physical characteristics that will be comfortable for the patient. Thin flexible swabs are used to collect NP specimens; however, nasal or deep nasal collection is also acceptable for NP swabs. Larger swabs are recommended for deep nasal, nasal, and throat (PHO FAQ document).
The benefits of non-NP swabs (PHO)
- faster to collect
- more comfortable for patients and allow for future retesting (after one experience with NP swab, a child is unlikely to allow another)
- alleviate pressures on limited resources, e.g. PPE, world-wide shortage NP swabs
- amenable to observed self-collection, reducing pressures on health care staff
Deep nasal swab technique—insert swab less than 1 inch into nostril (less for children) (until resistance is met at nasal turbinates); rotate several times against the nasal wall then repeat in other nostril.
Combined throat swab and both anterior nares technique
- PHO advises one swab with throat first then both nares
- follow deep nasal technique but only insert swab about 1/2 an inch (less for children) and leave in place 10 to 15 seconds
On the Lab Requisition, check off “Other,” and enter “Deep Nasal Throat” for either non-NP swab method.
For an in-depth summary of the available testing methods, please see the latest PHO Evidence Brief and associated FAQ document.
In HPE, the local CACs are in the process of refining processes to offer these alternative testing methods.
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