Massively scaling SARS-CoV-2 testing would require at-home swab collection. We asked if errors made during at-home collection for @seattleflustudy precluded detection of pathogens by PCR.
Short answer — they don’t.
This is a fun story for a few reasons https://www.medrxiv.org/content/10.1101/2020.12.05.20244632v1

My awesome lab manager Peter Han noticed that some study participants were using the mid-turbinate swabs backwards and ~1% samples were arriving with the handle in the UTM instead of the swab. This is what the swab looks like!

While we were shut down due to an “FDA clarification” this summer, my techs who had little data analysis experience, TAUGHT THEMSELVES TO CODE and dug into whether we could detect pathogens or a human marker off of these hard plastic handles.

They found that while there was a small difference in Ct values for the human marker, there was no difference in failure rate due to low detection. They also found NO DIFFERENCE in the ability of the handles to pick up respiratory pathogens, including SARS-CoV-2.

Maybe swab type or at-home collection doesn't matter so much, eh? Just stick something up there... LET'S GO PEOPLE!

So, who was using the wrong end of these swabs? Turns out it was the older folks and that they had more confidence that they had done it correctly!

@Molecular_MD and Izzy Brandstetter provided key guidance and @_M_Richardson_ helped wrangle data. Thanks to the whole @seattleflustudy team and the participants. @debnick60 @jshendure, @HelenChuMD, @LockwoodDNA, @mjonasrieder and Jan Englund.

I think these tweets might be longer than our little paper