Testing is the cornerstone of a successful public health response to coronavirus disease 2019 (COVID-19). Nasopharyngeal sampling for nucleic acid amplification testing (NAAT) is the current, non-invasive criterion standard diagnostic test. However, nasopharyngeal testing requires trained personnel and handling of a specially designed swab, and the technique cannot be easily or reliably performed in all populations (i.e., children and quarantined individuals). A test that can be self-administered would greatly increase the options for case identification in the community.

Alternate sampling sites are being explored to allow the broader deployment of testing, increased access in remote regions, and testing among underserviced populations who may have limited access to highly qualified testing personnel. In a recent study, meta-analysis found that the diagnostic sensitivity for saliva NAAT is approximately 83.2% which is comparable to that reported for nasopharyngeal swab NAAT.

Given the ease of sample procurement and increased patient comfort, testing centers should strongly consider adopting saliva as their first sample choice, especially in community mass screening programs. This method will likely not be universally adopted however if testing is made easier and more comfortable, we may have more compliance with the CDC recommendations on testing. Stay the course, stay well, get vaccinated, and stay tuned!