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Oral vs nasal RATs: Which is easier to use?

Posted: 11 May 2022 10:30 am

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Which of the 2 major forms of rapid antigen test is more simple and more comfortable to use?

With COVID-19 continuing to permeate throughout Australia, rapid antigen tests (RATs) continue to play a significant role in our lives. When looking to purchase RATs, you can either go for a nasal or oral option. So which test method is the easiest and most pleasant to use?

To find out, we conducted a hands-on comparison of the JusChek brand of nasal swab and oral fluid RAT kit. Here are our findings.

Note: The comparison deals only with the question of ease of use and comfort. This article makes no attempt to tackle questions of scientific efficacy or accuracy. The most important thing when purchasing RATs is to ensure the brand is approved by the Therapeutic Goods Administration (TGA).

Similarities between RAT kits

First, let's take a look at the commonalities between both of these RAT kits. In using both RATs, I felt confident that I was given the tools to conduct an effective test. Like other RATs, these JusChek kits involve collecting a sample, mixing it with buffer liquid and adding it to a test device to produce a result.

In both cases, the illustrated instructions provided on the back of the box were adequate in informing me how to perform the test. Both boxes included pamphlets with more detailed instructions and even include a QR code to take you to a video instructing how to use the test. In both cases, test results were easy to interpret.

As with most RAT kits, reliable results appear in around 15 minutes.

Nasal swab test

As most of us are aware, nasal rapid antigen tests involve inserting a swab around 2cm up both nostrils to collect a sample, in the same manner as PCR tests. This JusChek test calls upon users to twist and rub the swab against their nasal wall 5–10 times. It's not a very pleasant experience and there's no doubt that the oral fluid test is more comfortable.

JusChek tests provide a hole in the box where you can place the collection tube to make processes like filling it with the buffer liquid easier. In the JusChek test I used, the collection tube did not fit very well into the hole provided, causing it to tilt. However, the tube is so tall relative to the fluid that goes into it that it isn't a huge issue.

JusChek kits also require you to fit a tip onto the tube before dripping the solution onto the test device. The nasal kit I tested had a screw-on tip, which I found very easy to use. The oral fluid test had a tube tip that simply had to be pushed into the tube, which was a slightly trickier process, especially because if you are to spill the contents of the tube, the test kit is wasted.

Oral fluid test

There are different ways RAT tests collect oral fluid. This JusChek kit requires you to fit a funnel onto a collection tube and spit into it. For many consumers, this is a vastly preferable method to collecting a nasal swab.

Others may find the process of spitting into a test tube – and analysing the results to make sure the fluid reaches the scale line – a bit gross, for lack of a better term. Really, it's all just a matter of preference. Would you rather go through the discomfort and inevitable sneezing of a nasal swab? Or the possibly unsettling process of an oral fluid collection?

Oral fluid collection also requires a bit more background work. You can't put anything in your mouth for 10 minutes before the test, including food, drinks or gum, and you have to cough 3–5 times before spitting into the tube. It's not too taxing, but it's worth considering compared to the more simple process of the nasal kit.