Intended for healthcare professionals

Rapid response to:

News Exclusive

Coronavirus: home testing pilot launched in London to cut hospital visits and ambulance use

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m621 (Published 14 February 2020) Cite this as: BMJ 2020;368:m621

Read our latest coverage of the Coronavirus outbreak

Linked Opinion

Coronavirus: rolling out community testing for covid-19 in the NHS

Rapid Response:

Re: Coronavirus: home testing pilot launched in London to cut hospital visits and ambulance use

Dear Editor,
Coronavirus self Testing

I am interested in what steps would be needed to enable the well patients with suspected infection to self-test. This would reduce the contact time with any community HCWs. which would be important in the event of a larger outbreak of Coronovirus or other respiratory virus.
Would it not be possible to look at organising training on a youtube type video to allow nasopharyngeal, throat swabs to be taken ? Certainly this could be offered to patients and in the possibility of a large outbreak would be an option. I note this Mayo clinic article from 2012 looking at testing for influenza using self nasopharyngeal swabs which summarises as follows,

'.Self-collected midturbinate nasal swabs provide a reliable alternative to HCW collection for influenza A and B virus real-time reverse transcription–polymerase chain reaction'.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538476/

Whilst I am aware that correct samples using nasopharyngeal swabs are difficult even with highly trained HCWs it does seem that a patient centred approach involving this option could be trialled.
Patients in the UK are often allowed to self-test for many conditions and this would seem a reasonable approach.
The issue would also be where such samples should be delivered and who should do this but there must be less of a risk of infection to HCWs than face to face contact, even with the correct PPE..

Yours sincerely
Liz Fisher MBBS MRCGP DOccMed

Competing interests: No competing interests

16 February 2020
elizabeth Fisher
Staff Grade Cardiology
SASH
Pilfolds