I don't think the following does anything to answer the question, but the information might be of interest. In the earlyish days of the Plague, the rapid tests available in the UK came with instructions telling you to swab both nose and throat. Later on, all the ones we got just said to swab your nose. Anecdotally, I am pretty confident of my ability to swab my nose in the approved manner and very confident of my inability to swab my throat in the approved manner (my gag reflex activates before I can get the swab to the right place), and I wonder whether someone made a conscious decision to go for tests that are slightly more sensitive (and have slightly more false positives) for a given mode of use, and recommend not bothering with throat swabbing, because while that's worse in a world where everyone can swab their throat effectively it might actually be better in a world where some people can and some people can't.
Anecdotally speaking, about two months ago a friend of mine tested this with several tests, and while she was consistently positive with nasal tests, she was only sometimes positive even when she swabbed her throat as much as she could.
Back in January there was a bunch of buzz around using standard rapid tests but swabbing the throat. Ex:
or:
Then the buzz died down, and it seems like everyone just forgot about it? No clear recommendation either way, just a lot of Tweets, a few blog posts, news stories about the controversy, and then not much else. Google Trends shows the spike and drop-off:
[EDIT: I wouldn't read too much into the chart: it turns out that most covid-related keywords followed as similar trend, as did covid itself]
What happened? Why did we all stop talking about it, without what seems like any firm conclusions? Some of this is maybe that there were conflicting studies: Schrom et. al. posted a preprint on 2022-01-19 (published version) where it looked like it worked poorly, but Goodall et. al. posted a different preprint on 2022-01-21 (published version) where it did look good. I also saw speculation that some of the cases where people got a negative with nasal swabbing but a positive with throat swabbing may have been false positives—rapid tests are sensitive to pH, and especially if you've been eating or drinking recently your throat might be pretty far from neutral.
Ten months later, why hasn't this settled out into recommendations that either say to swab throat and then nose, or that seem to have considered the new evidence and say still don't? We're doing a lot of testing, and if this is a better way to be using the tests we already have it would be great to know! Does anyone whose been following this have a better understanding of what happened?
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