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The inside story on desperately needed swabs: 7 things to know

“We need swabs,” Gov. J. B. Pritzker said at his Sunday briefing. “We don’t have enough swabs.”

The White House Holds Daily Briefing On Coronavirus Pandemic
Mass COVID19 testing can’t take place without enough swabs. President Donald Trump holds up swabs as he speaks at the daily coronavirus briefing at the White House on April 19, 2020
Photo by Tasos Katopodis/Getty Images

“We need swabs,” Gov. J.B. Pritzker said at his Sunday briefing. “We don’t have enough swabs.”

Earlier on Sunday, Pritzker said in an interview on CBS’ “Face the Nation,” “Recently we got a call from the White House telling us that in May they’re sending us 600,000 swabs, and I’m very grateful for that.”

What is a swab?

It’s an item as light as a feather but in short supply as the demand for COVID-19 testing grows. Mass testing is key to trying to reopen our lives, schools and economy.

The federal Food and Drug Administration in recent weeks has expanded swab testing options and materials, fast tracking decision making in the wake of the coronavirus pandemic.

Swabs are essential to collecting samples from a nose or throat. Swabs are put in a package with a reagent — it could be some kind of a liquid — to preserve the sample. The sample is sent to a lab with a testing machine to see if it is positive for COVID-19.

No swab, no test.

Merriam Webster defines a swab as “a wad of absorbent material usually wound around one end of a small stick and used especially for applying medication or for removing material from an area.”

That definition doesn’t go far enough.

Medical swabs for COVID-19 testing, it turns out, are quite bespoke tools. Here are seven things to know about swabs in the era of the novel coronavirus:

• Q-tip, the best known swab brand used every day for a variety of purposes, is made of 100% pure cotton and is bonded to a short paper stick. It is not approved by the FDA for COVID-19 testing.

According to STAT, the health and medical publication, a Q-tip does not work for testing “in part due to the fact that the cotton on the tip contains its own DNA; cotton, after all, is a plant.” That DNA could be confused with the DNA from the testing sample and trigger a false result.

The swabs being used currently are nylon or foam, STAT reported.

• Most COVID-19 testing swabs used in the U.S. are made mainly by two companies: Puritan Medical Products in Maine and a company in Italy, a coronavirus outbreak epicenter.

• Not all medical swabs are the same. There are COVID-19 testing swabs for use by health professionals and swabs for self-collection that are just emerging on the market.

Tests used by the pros involve swabs on long sticks that can reach deep into a throat or nasal cavity, an uncomfortable procedure. That means the person collecting the specimen has to use PPE — personal protective equipment, also in short supply. Self collection means less need for PPE.

• On April 16, there was a breakthrough. The FDA allowed fully synthetic swabs to be made with polyester tips to be used on shorter sticks. These Q-tip size polyester swabs can be used for front of the nose testing and sent to the lab preserved in a saline solution.

Front of the nose testing is “notable,” the FDA said, “because it allows self-collection for patients, thereby limiting exposure of health care providers; it is more comfortable for patients, and it can be performed by a swab that is more readily available and manufacturable at scale.”

• With the FDA approval, U.S. Cotton, based in Cleveland, was able to launch the large-scale manufacture of polyester swabs.

• While cotton has not been used on COVID-19 swabs, on April 21, the FDA, using emergency authorization, gave permission to the Laboratory Corporation of America, known as LabCorp, to use a specially made Q-tip style cotton swab it developed for home collection kits.

Addressing the exception allowing the use of cotton, an FDA spokeswoman said, “These swabs have been evaluated to see if they caused false negatives/positives or if they impacted the controls [which they do not].”

During the pandemic, the FDA said it has been working with more than 380 test developers.

• On April 29, the Department of Defense announced it was awarding a $75.5 million contract to Puritan Medical Products using the Defense Production Act. A Pentagon spokesman said that will “quickly” double its capacity to 40 million swabs a month, with production to begin in May.

Pritzker said last week on NBC’s “Today” show that the White House was “promising to deliver to us for the month of May about 20,000 swabs per day, which is very important.” The state is also procuring swabs through its own sources, with no number available of what’s on hand.

Pritzker’s aim is to have enough swabs for 18,000 tests per day, with the average now at about 15,000, spokesman Jordan Abudayyeh said.

“We need as many swabs as we can get our hands on,” she said.