Why it hurts so much: is it correct to take a swab for a coronavirus test?

One Canadian said the COVID-19 swab was painful, like a shot to the brain. The American heard a crunch in her head. The French woman started to have severe nosebleeds. Others had headaches, tears, or were in shock, reports The New York Times.

They have all been tested for COVID-19 using nasal swabs. While many people do not complain about their experience, for some, the smear causes internal dislike or tremors in the knees. Regardless, the smear is a vital tool in the global fight against coronavirus.

“I felt like someone was trying to switch something right in my brain,” said Paul Chin, a record producer and DJ based in Toronto, of his nose test. "There is nothing like that."

"Oh my goodness! He continued. "The cotton swab hits my nose deeper than I could have imagined or imagined - it's such a long, sharp and pointed object."

Since the advent of the coronavirus, millions of swabs have been taken from the noses of millions of people to check for the harmful virus that has killed millions of people around the planet. One way to combat the virus is through massive and frequent testing, officials said. It is imperative to use a test that people are willing to take repeatedly.

A tampon usually fits the bill

In parts of the United States medical workers give people a swab for self-examination. This provides a certain level of personal comfort. For many South Africans, a single COVID-19 test is painful. You see asterisks or you have a gag reflex because the tampon gets down your throat.

The movement of the tampons raises questions: who is doing it right? How deep should the tampon go into the nostril? How long should he stay there? Should an accurate test be so inconvenient? Fair or not, some countries have a reputation for brutal testing.

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First, a quick anatomy lesson: no, the smear doesn't actually pierce your brain.

The swab passes through the dark passageway leading to the nasal cavity. It is enclosed in bone covered with soft, sensitive tissue. At the back of this cavity - more or less at the level of the earlobe - is the nasopharynx, where the back of the nose meets the top of the throat. This is one of the places where the coronavirus is actively multiplying, and this is where you are likely to get a faithful sample of the virus.

Test vigilance can arise from a simple fact. Most people hate it when something is pushed so hard into their nose. In addition, tests conjure up some of our darkest fears: things that can crawl into our holes and enter our brains.

"A shot in the brain"

“People are not used to feeling this part of their body,” said Dr. Noah Kojima, a resident physician at UCLA and an infectious disease expert, about swabs that come in contact with the nasopharynx.

The pain becomes apparent when a tampon - a bundle of nylon attached to a lollipop-like stick - is inserted at the wrong angle, says Dr. Yuka Manabe, a professor of medicine specializing in infectious diseases at Johns Hopkins University School of Medicine.

“If you don't throw your head back, you can't get to your throat,” she said. "You hurt a person's bone."

Chin, a music producer, called his test a "brain prick." He compared the burning sensation to the effect of inhaling spices.

"Your whole face seems to be ready to leak," he remarked, and added, "I really don't know if there is a way to prepare for this."

Details about strokes

There are three main types of nasal swabs for COVID-19: nasopharyngeal (deepest), middle turbinates (middle), and anterior nasal passages (shallow part of the nose). In the early days of the pandemic, deep nasal swabs were used extensively and aggressively among adults. This method worked for influenza and SARS testing. As science advances, experts tend to agree that the deepest smear is the most accurate.

The research review was published in July in the scientific journal PLOS One. It says nasopharyngeal swabs are 98% accurate. And shallow strokes are 82-88 percent effective; middle turbinate swabs work in a similar way.

In South Korea, nasopharyngeal swabs remain the gold standard for testing for COVID-19, said Seung-ho Choi, deputy director of risk communication at the Korea Agency for Disease Control and Prevention.

“Depending on the qualifications of the medical staff, it may or may not be painful,” he said and clarified: “But the nasopharyngeal test is the most accurate. That's why we keep doing it. "

How to take a smear correctly

WHO has guidelines on how best to conduct testing; difficulties were rare. Australian regulations state that swabs must pass a few centimeters above the adult's nostrils. The US Centers for Disease Control and Prevention says that a swab from the middle turbinate should usually be injected less than 2,5 cm or until resistance is met. Some health care providers take swabs from both nostrils.

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The KDCA guidelines give healthcare providers some leeway when clearing the nasopharynx. For example, wiggling or rotating a tampon, or both. Choi said experience depends on the brand of tampon, the patient's pain tolerance, the anatomical structure of the nasal cavity, and the skill of the healthcare provider.

Dr. Lee Jaehyun, professor of laboratory medicine at Jeonbuk National University who helped develop the Korean government's guidelines for testing for COVID-19, said the test poses as little risk as taking blood.

The reaction to the test is individual

When leaving a clinic in Seoul this month, some people sneezed, rubbed their eyes, or blew their nose. Several people were crying.

“I felt like the tampon was scraping my brain,” said 19-year-old Chu Yumi.

Kim Kai, 28, who had bloodshot eyes, lamented, "I thought my nose was going to bleed right now."

Lee Eunju and Lee Jumi, both 16 years old, said they never want to take nasal swabs again. Eunju imagined chili powder was poured into her nostrils. Jumi said, "It hurt so much!"

Dr. Li says discomfort is a trade-off for accuracy.

“This does not mean that we can ignore the pain that every patient experiences,” he said.

Many people tolerate this test well. Dr. Paul Das, family doctor at St. Michael's Hospital, at Toronto's Unity Health network, said that children tend to have a harder time.

Some people associate their experiences with the methods or personalities of health care providers.

“It hurts, it’s a little uncomfortable, but I think this person was very delicate,” said 65-year-old Kim Sung Ok outside a clinic in Seoul.

Issa Ba, a 31-year-old footballer, recalls: “I took a COVID-19 test in Conakry, Guinea in August before coming to Senegal. I felt pain when a stick was stuck in my nose, but it was tolerable. And I was in much more pain. I am a man.

Some countries are striving to standardize tests and eliminate human error. Developers in Denmark, Japan, Singapore and Taiwan have invented robots for this job.

Johns Hopkins' Dr. Manabe insists that the smear does not damage.

Painful stories abound

Research shows that women often report more severe pain than men, but this may be due to facial structure. Some strokes may be too large for the woman's facial anatomy.

Briana Moler, 28, from Minnesota, suffered an excruciating test in 2020. So excruciating that she heard a "crunch" in her nose.

Audrey Benattar, who recently returned to Marseille, France, recalled her trip to a Montreal hospital in May to give birth. There, a nasal swab for COVID-19 left her with burst blood vessels and balloon catheters in both nostrils to stop the bleeding.

“I've never seen so much blood in my life,” said 34-year-old Ms. Benattar.

Some argue that nasal swabs rank relatively low on the scale of unpleasant coronavirus tests.

This year, China has demanded some overseas travelers, including diplomats, to have anal swabs for COVID-19, infuriating foreign governments.