Earlier this month, the RCPA announced its support for the use of self-collection for COVID-19 Polymerase Chain Reaction (PCR) tests, when performed under the direction of a medical professional. During a recent trial, self-collected specimens were shown to be an acceptable alternative to specimens collected by healthcare workers and will therefore help to meet demand for COVID-19 testing in the community.
RCPA Fellow, Dr Jenny Robson explains that self-collection offers additional convenience and flexibility, as well as conserving personal protective equipment (PPE), which is essential.
“From the beginning of the pandemic, there has been a great deal of pressure on supplies of PPE. Each time a new patient presents to a dedicated collection room, the collector is required to put on full PPE and then discard it once testing is complete. It was therefore suggested that the use of PPE could be reduced if we could confirm that self-collection was a suitable alternative collection method.
“A trial was therefore set up to compare specimens collected by a collector and specimens collected by a patient. When we compared the results, we found that both methods gave a very similar positivity. Although the number of other circulating viruses at the time of the study was limited, these also had equivalent detection rates for the two collection types,” said Dr Robson.
A combined throat and deep nasal swab is required for a COVID-19 self-collect test, and both collections are performed using one single swab. Easy-to-follow patient instructions and a detailed animated video are provided, along with the required swab for both throat and nasal specimen collection. Once the patient has completed the collection, the specimen and request form can be returned to a dedicated COVID-19 collection centre or drop-off location.
“Early in the pandemic we found that patients did not want to come to COVID collection rooms as they were worried about picking up infection, even though appropriate infection control practices were in place. For some medical practices, with reduced numbers of collection centres available, significant delays in collection were also occurring. By offering patients the option to self-collect, both patients and doctors have greater flexibility, and potential for transmission of the virus to others is reduced,” said Dr Robson.
All self-collected specimens require a valid request form completed by a medical practitioner. Once a patient has this pathology request for COVID-19 testing, which may follow a telehealth consultation with their doctor, a collection kit can be made available from:
A dedicated COVID-19 pathology collection centre
Certain doctors’ surgeries which may have these collection kits available
This method of collection is recorded on the report and each laboratory monitors the results (percent positivity of the various viruses tested) according to collection type.
“Self -collection has now been approved for COVID-19 and has been included in the Public Health Laboratory Network (PHLN) guidelines. We are therefore increasingly using this method both in our collection rooms and also as an option for patients to collect outside the collection centre. Results are returned to the referring Doctor as usual.” said Dr Robson.