Evolved Saline Lavage Set to Replace Nasal Swabs for Future Respiratory Outbreaks

While COVID-19 may no longer dominate headlines, healthcare workers know firsthand that upper respiratory infections (URIs) remain a consistent clinical concern. With flu, RSV, and other threats perpetually lurking, we’ve learned better virus management starts with better URI diagnostics—which is heavily dependent on being able to obtain the highest quality specimen.

While nasal swabs became the default sampling method during the pandemic due to convenience, traditional nasal lavage has long been the gold standard for producing higher-sensitivity samples and more accurate diagnoses, faster.

The only problem? Flushing the nasal cavity with sterile saline, then recollecting that saline as specimen, was impractical to rapidly deploy worldwide. 

Recent innovations, however, have made way for more comfortable, reliable nasal lavage solutions that could be the key to improving sampling for providers, patients, and laboratory professionals alike—and the reason why we may never need to use a nasal swab again. 

The COVID-19 default: Nasal swabs

Although the nasal swab was invented for household use in 1919, its medical potential was untapped until it was used for influenza specimen collection in the 1930s. Since then—nearly a century and several global pandemics later—nasal swabs have hardly changed.

Despite an abundance of data suggesting saline lavages yield higher specimen adequacy (up to 49 percent greater sample sensitivity), nasal swabs became the collection method of choice during the COVID-19 pandemic out of desperation and necessity. 

We turned to swabs because they were accessible, cost-effective, and produced an acceptable sample for URI pathogen testing—not because they were a vetted specimen collection system, (like nasal lavage already had been for decades).

Along with lower sample sensitivity, nasal swab downsides include short shelf life, injury risks, no reimbursement pathway for healthcare organizations and patient discomfort resulting in public avoidance.

Swabs certainly served their purpose during COVID-19, but these drawbacks left experts wondering if more lives could’ve been saved if we had a better solution.

What’s next? Evolved nasal lavage solutions

Using lessons from COVID-19, nasal lavage has again emerged as the sampling gold standard—this time, improved for future nasal sampling and testing.

Higher-sensitivity samples

Nasal swabs coupled with antigen tests frequently produce false negative results and missed diagnoses during the critical treatment window—when antiviral therapy is most effective. Evolved nasal lavage has far greater PCR testing sensitivity, especially early after symptom onset. 

Nasal lavage also captures specimen from the entire nasopharyngeal cavity, while the swab’s insertion depth constraints limit sample capture range.

Longer shelf life

Swabs typically have a one- to two-year shelf life, limiting stockpiling capabilities and increasing inventory costs. A nasal lavage sample device with extended shelf life can be economically stockpiled and used whenever needed.

Simple lab integration

Labs shouldn’t have to overhaul current processes for new sampling methods. Evolved nasal lavage effortlessly integrates to decrease extraction errors, increase throughput and minimize exposure.

Greater public acceptance

Patient testing aversion during COVID-19 often led to one of two outcomes:

• Flinching during swab insertion, causing inadequate samples or injuries
• Avoiding testing altogether

Evolved nasal lavage delivers a comfortable patient experience without sacrificing specimen quality.

Safer for All

Nasal swab sampling comes with multiple potential risks, from nasal passage injuries to CSF leaks. Additionally, lab professionals must manually extract samples from specimen tubes, leading to processing delays, higher infection risk and other mishaps that compromise technician safety and specimen quality. New nasal lavage innovations can eliminate all these issues.

The big-picture impact on global health

• Patients can expect virtually painless nasal sampling, reduced anxiety and trustworthy results that get them the treatment they need to feel better, sooner.
• Providers can protect their own health and prescribe appropriate URI treatments to provide the best chance of success, including decreased hospitalization, need for ICU care, and/or death.
• Clinical laboratories can minimize personnel exposure risks and extraction errors while maximizing sample throughput.

Looking ahead to future outbreaks, steps we take today define tomorrow’s health outcomes—making now the time to leave swabs behind for a more comfortable, scalable and reliable diagnostics solution.