Are Nasal Swab Covid-19 Tests Better Than Saliva At-Home Test Kits?

Some people find the RTK saliva test kit inaccurate, some say we’re all testing wrongly.

(Credit: @Hussamuddin/Twitter, covid-19.moh.gov.my)

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Currently, with rising cases of Covid-19, we ourselves are worried if we may or may not be having Covid-19.

Asymptomatic cases which are positive cases but without any symptoms (category 1) are possible and quite a lot. Nowadays, categories 1 and category 2 make up around 99% of the daily Covid-19 cases and categories 3,4,5 (those with serious conditions) make up around less than 1% of the total cases. Check out if you have category 1 or 2 symptoms here.

Hence, if you’re feeling a little bit under the weather, you’re a close contact or you just wanted reassurance just as a precaution, self-test kits (RTK-Ag) are important to detect Covid-19. The PCR tests are done by professionals. Do note that you don’t have to get the PCR test if you’re positive and below 60 years old without comorbidities in categories 1 and 2A.

But the issue here lies in which Covid-19 self-test kits should you rely on? As of 11 February 2022, there are 123 products made by companies that are approved for Conditional Approval by the Medical Device Authority (MDA).

The RTK-Ag self-test kits are either saliva or nasal swab sample type. There’s also an option for both sample types to be tested in one test tube to increase the detection rate.

The Rakyat Finds Inaccuracies

However, there have been issues regarding the accuracy of these RTK-Ag self-test kits as the public found out that some of them might give you false negatives. Some did the saliva test and was found negative but when tested with a nasal test, they were found positive. Some had the other way around.

According to a Twitter user, he had a friend that tried the saliva test 4 times and it turned out to be negative. However, it tested positive when his friend tried the nasal swab sample test.

Kawan aku buat 4 saliva test semua negatif dia buat nasal poff terus positif. Better buat nasal nep pic.twitter.com/G46CVXiid8
— SEKETUL HILMIE ⁷ (@HilmieHafizx) February 10, 2022

A medical doctor who’s also a Twitter user replied to the thread saying that according to research, the accuracy for both types of sample products are almost the same. He thinks the results might be that way because of the way people collect the sample. He also thinks that it could be negative because they might be in the early phase of the disease and it’s too early to be detected.

Another person also reminded us that for an accurate reading of a saliva test, we need to cough deeply a few times to ensure the samples come from within the throat. Most people skip this part and that could lead to a negative test result.

One person said that he got the other way around. But, at the end of the day, if either the nasal swab or saliva test, tests positive, then it should be considered positive.

Furthermore, recently, Alliance for Safe Community chairman Tan Sri Lee Lam Thye also calls the MDA to take quick action to reassure the public by giving a list of accurate test kits and banning the ones proven to give false negatives.

What KKM Suggests

The MDA doesn’t specifically recommend which one are the best or most accurate as both methods have a step-by-step tutorial on the Health Ministry (KKM) website. And there’s also a National Covid-19 Testing Strategy module to guide you with Covid-19 testing.

Following the request from Tan Sri Lee Lam Thye, the MDA said that all of the approved self-test kits have undergone strict evaluation processes and have been tested at accredited laboratories.

They further urged the public to only buy the products that are approved by them (check the list here) and follow the instructions of the self-test closely. They also warned not to buy self-test kits with unusually cheap prices because they may be counterfeit ones or even expired.

What To Do After The Test?

Effective 7 February 2022, the government asks you to do your own Covid-19 self-test kit at home. If you’re positive and asymptomatic or in category 2A with no comorbidities, you don’t need to go to the nearby Covid-19 Assessment Centre (CAC). Instead, self-quarantine at home (follow the recommended time) and update your MySejahtera.

However, if you’re positive and the symptoms persist, (you’re in the 2B category or in categories 1 and 2A with existing comorbidities and aged 60 above), you should go to the nearby CAC for an RT-PCR (professional nose and throat swab) test or further action.

Whether you’re positive or negative, you should update your MySejahtera status. If the RTK-Ag test is invalid, there might be other external factors that affected the test and it should be done again.

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