It’s almost an understatement that at-home COVID tests are hard to find at this point in the COVID-19 pandemic. But once you find them, the challenge isn’t over. It’s not as simple as it sounds to give yourself a COVID test correctly… and it’s even harder to give it to a squirmy 4-year-old. Add to this the fact that for kids, we’re sticking adult-sized swabs into their tiny nostrils — a painful fact that they are all too aware. Altogether, this means there are way too many ways to mess up the test: not swabbing far back enough in the nose and not correctly interpreting your results chief among them. Luckily, the tests do come with fairly easy-to-follow instructions, and Christina Johns, MD, a pediatrician & senior medical advisor at PM Pediatrics, makes it even easier to do an at-home COVID test with the tips below.
Tip #1: It Needs to Go Pretty Deep
If you want to do a COVID test properly, it’s going to suck for your kids. One of the places where the coronavirus actively replicates is the nasopharynx, or where the upper part of the throat meets the nose, so it’s important to get a mucus sample from deep within the nasal cavity. The good news is that although nasal swabs are unpleasant, the idea that they poke the brain is just an exaggeration — no brain bleeds here.
“When testing at home, the entire cotton tip of the swab should be inserted into the nostril, and the directions should be followed exactly,” Johns says. Those directions, provided with the tests, will include swirling the swab around the nostril for at least a few seconds, and often for a certain number of twirls.
“Swirling the swab allows for a more robust sample to be collected. The more of the specimen obtained, the more accurate the results,” Johns says.
Tip #2: Skip the Throat Swab… For Now
A new pre-print study, which hasn’t yet been peer-reviewed, found that saliva swabs may be best for detecting Omicron because it infects and replicates more effectively in the airways that lead from the lungs to the throat. However, the CDC and FDA are encouraging people to only swab their noses at this time.
The at-home tests available in the U.S. were developed and researched as nasal swabs. And it’s more than reasonable to believe that sticking a swab down your child’s throat isn’t a good idea, both because you don’t know what you’re doing and you’re likely to hurt them. Good luck trying to test your kid again after that.
It’s also more likely you’ll contaminate your sample when swabbing your throat along with your nose. If you’re interested in a throat swab, go to the professionals.
Tip #3: Stay Still, Very Still
COVID rapid test swabs are only available in one size, which is awful for kids who have, you guessed it, kid-sized nostrils. So although your child’s instinct to run when you bring out the nasal swab may be understandable, it’s critical for sample collection and safety to keep their head stable during testing.
Try harnessing the power of co-regulation by encouraging your child to breathe deeply with you and count out loud as you swab their nasal passages. Make sure items they use for self-soothing, such as a blanket or stuffed animal, are close at hand.
“I encourage kids to stand up against a wall as you swab the nose. That way they can’t pull or tilt their head back,” Johns says.
And although restraint might be necessary, she notes that positive reinforcement can motivate kids to sit still and help them recover more quickly following a swab. “This is the time for fun, positive rewards when the task is complete: special time with a parent, or a sweet treat. Any positive incentive to help make the process more palatable is worth it!”
Tip #4: A Faint Line Is Still a Line
“Any line, even a faint one, should be interpreted as positive, especially if a person has symptoms,” Johns says. If you do see even the hint of a line, contact your local health department so they can record your result for official tallies and provide up-to-date guidance about how you should isolate. This is an important step because it helps provide local health officials with a more accurate picture of how prevalent COVID is in your area, as well as the risk of possible spread.
Let anyone you’ve been in close contact know that you’ve tested positive, pronto. And be sure to inform your doctor so they can evaluate your situation and guide you on what to do during recovery to make it as least painful as possible.