On Nov. 23, the University replaced the rapid nasal swab tests with saliva tests for its COVID-19 community screening as part of a larger goal to bring students, faculty and staff back on campus by the fall.
The most notable difference between the tests is in their turnaround times — the saliva test, produced by Quanterix, gives results in 24 to 48 hours, while the nasal swab tests, which were conducted by Peachtree Immediate Care, yielded results in 20 minutes.
Executive Director for COVID-19 Response and Recovery Amir St. Clair, who joined the University in early December, noted the saliva tests are more precise, comfortable and less expensive per unit than nasal swab tests — factors that all informed the switch.
Emory replaced rapid nasal swab tests with saliva tests for its COVID-19 community screening on Nov. 23. (The Emory Wheel/Gabriella Lewis)
The nasal swab test reported a lower sensitivity, or how often a test correctly generates a positive result, and the same specificity, or how often it correctly generates a negative result. While both tests reported a 100% specificity, the swab reported a 80% sensitivity compared to the saliva test’s 98%.
“[Quanterix] allows us to scale efficiently so that we can test more of our population more reliably,” St. Clair said. The test involves an individual filling up a tube with their saliva, a process he said students found “more comfortable” than the nasal swab test.
The saliva test is also less expensive per unit but less costly overall because the University aims to control the entire test supply chain. While testing in the fall relied on outside labs and delivery services, the University is working to directly control every step of the process.
This change, St. Clair said, will help drastically increase the amount of tests offered per week.
“The move actually represents a larger and more sizable investment from Emory, because it positions us to increase our testing tenfold,” St. Clair said. The University’s goal is to reach a test capacity of 30,000 per week by August, up from 2,500 per week this past semester.
Vice President of Communications Nancy Seideman could not state the exact total cost the University incurred from the switch. However, St. Clair noted that “cost is not a limiting factor. It’s not a component that helps us determine if we’re going to do a test or not.”
Test expansion will be gradual. Currently, the University does not have the capacity to mandate screening tests for off-campus students or employees, St. Clair noted, though the University is working up to reach this point.
Campus Services employees previously raised concerns about not being regularly tested, and many remain unsatisfied with the amount of paid time off permitted to quarantine or recover from the virus.
Two facilities management employees, who requested to remain anonymous out of fear of retaliation, expressed frustration with the lack of mandatory testing and the difficulty in getting tested. These workers said they had difficulty getting tested at Emory and have had to schedule outside tests.
“A lot of frontline staff do not have access to a computer. Some may not be computer literate. … We have employees that work three shifts,” one employee said. “It’s not always convenient to schedule the test. And even if they could schedule a test, they may not be able to get to that location.”
A third facilities management employee noted that she does not receive contact tracing notifications when other employees in the building she works at test positive.
“If I became positive, there are 50 other people in that building that would have never known, even though we may have shared the restroom and gone to the microwave, water machines,” she said.
Executive Director of Student Health Services Sharon Rabinovitz stated that those tested do not need to self-quarantine during the 24 to 48-hour waiting period and instead only need to follow “the three W’s”: wear a mask, wash hands and watch one’s distance.
“The diagnostic test is different,” Rabinovitz said. “Your behavior should not change based on the cadence of your testing for screening.”
St. Clair added that, for asymptomatic screening tests, “there’s no reason to believe you have COVID, you are not a close contact. We want to be able to just be able to detect community prevalence.”
St. Clair said this effort is guided by three main principles: a safe and healthy campus, long-term sustainability, and trust.
Isaiah Poritz contributed reporting.
Correction (1/13/21 at 9:30 a.m.): A previous version of this article stated that the University’s diagnostic testing procedures contradict Centers for Disease Control and Prevention’s guidelines. In fact, they do not.
Correction (1/13/21 at 9:30 a.m.): A previous version of this article stated that Peachtree Healthcare previously conducted the nasal swab tests. In fact, it was Peachtree Immediate Care.