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Finland exploring option of taking coronavirus samples at home

The Finnish Institute of Health and Welfare, THL, is considering the possibility of collecting saliva samples at home.

Lähikuva naisen auki olevasta suusta, josta lääkäri ottaa näytettä.
A nasopharyngeal swab is a common way of collecting samples for coronavirus testing and diagnosis. Image: Niels Christian Vilmann / EPA

Finnish public health officials are currently looking into the possibility of allowing people who suspect they have been infected with Covid-19 to take test samples at home.

"We are actively taking this forward, because it would be quite significant if sampling could be made easier," Finnish Institute for Health and Welfare (THL) specialist Niina Ikonen said.

Samples collected at home would be one way to break down bottlenecks that have recently accumulated in some areas.

"We are trying everything to find solutions to make it easier to gather samples and to increase testing capacity. Home sampling could be one option," Ikonen added.

According to Ikonen, researchers are currently reviewing sources to see whether or not there has been international experience with home sampling.

"We are looking at the [research] literature and asking if this has been done in other countries. I have the impression that it has been attempted in Sweden and Britain."

She added that the THL is not the only body in Finland looking into the matter.

"For example, clinical laboratories have also been considering this alternative," she noted.

Home sample could be saliva or sputum

The central question experts are wrestling with is whether or not there is a reliable alternative to a nasal or throat swab that people can take themselves.

"People could perhaps take a nasal swab sample at home. Of course a saliva or sputum sample could be one way," Ikonen speculated. Sputum is a mixture of saliva and mucus coughed up from the respiratory tract.

Researchers will also be trying to determine how to ensure the quality of samples taken at home. The samples should be taken so that they collect as much of the virus as possible, Ikonen pointed out.

"It is important that you don’t get a negative result simply because the quality of the sample was not good enough," she noted.

She added that it is also important to ensure that the sample is taken correctly.

"If the sample is not taken properly it could give a false negative result, even if the person is infected. That requires particular attention."

Ikonen said that it is already known that the virus can also be detected in saliva, but the quality of such samples is poorer than samples from nasal swabs, meaning it is possible to return a false negative result for an infected person.

All the same, Ikonen said that it is possible that a home sample might well be in the form of saliva.

It could be that a saliva sample will turn out to be the alternative, but it requires some investigation. There is not a huge amount of research into other types of samples," Ikonen noted.

Labs to continue analysing samples

The THL’s Ikonen said that home sampling for coronavirus would be a supplement to regular sampling procedures.

"It would be additional, not a replacement. Some would go to sampling points where healthcare professionals would collect the sample and others could possibly take it themselves," she explained.

Apart from easing bottlenecks, home sampling would also offer some relief to the healthcare system, which now has to re-allocate staff from other essential duties to take samples.

Ikonen said that she did not want to speculate on when it might be possible to take samples at home. She noted that apart from the issues already raised, officials needed to figure out how samples would be delivered to labs and who would do it.

She said that home testing was definitely hot on the cards.

"Sample analysis or coronavirus diagnoses can only be performed by licensed clinical laboratories."

Minister calls for parallel testing system

Meanwhile on Saturday, Science and Culture Minister Annika Saarikko (CEN) called for a significant increase to coronavirus testing in Finland. Saarikko said she backed a proposal for a parallel testing system advanced by THL director general Markku Tervahauta and director Mika Salminen in a Helsingin Sanomat opinion piece.

According to the minister, the so-called population testing could develop alongside testing provided by the health care system.

"You would not need a doctor’s referral for population testing. Anyone could independently get a coronavirus test, even if they have no symptoms. This would help break the infection chain in advance, because asymptomatic people can also be contagious," Saarikko wrote in a Facebook post.

She urged the government to investigate the costs and potential effectiveness of a parallel testing system and said the government foot the bill for additional testing.

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