The new saliva COVID-19 test can be used instead of the current mouth and throat swabs. Getty Images
  • A new saliva-based test for COVID-19 has been given the go-ahead by the Food and Drug Administration and is available in some places.
  • The manufacturers of the test say results can be produced in a matter of hours.
  • Experts say this could encourage more people to get tested as well as allow treatment to begin sooner on people who test positive.
  • They add that negative test results allow people to return to work and school sooner.

Alana Weinstein was in a panic and for good reason.

Her 6-year old son was showing symptoms of COVID-19 and his pediatrician administered a test.

Then, they spent 8 days without test results, worrying and wondering if her son had contracted the novel coronavirus.

“We waited and waited,” Weinstein told Healthline.

Eight days, she said, when doctors wanted her to wait to treat her son. Eight days when she worried about exposure to her and other family members.

“He’s asthmatic and his sister has type 1 diabetes, so it was important I find out the results,” Weinstein said.

In the end, the test was negative, but the trauma of the waiting time stays with her.

“It was frightening and frustrating,” she said.

Weinstein is not alone.

A survey conducted by CNBC and Dynata of more than 9,400 people in the United States found that 40 percent of those tested for COVID-19 got their results well past the 2-day turnaround that health experts believe is optimal for taking action.

Saliva test may be the answer

Now, it appears there may be a solution, right in our own saliva.

A Yale-produced testing method called SalivaDirect has received emergency use authorization from the Food and Drug Administration (FDA), meaning labs can begin using it immediately.

The test requires a person to spit into a tube or cup, and then, in minutes, the saliva is tested for COVID-19.

The test creators say they can use a variety of products to achieve results, meaning less impact on the supply chain.

They also note the test uses spit instead of swabs and can be administered by nonmedical trained people.

They add it also can provide results in a few hours and is relatively affordable.

For Weinstein, this quick result would have meant not just less angst, but quicker treatment of what turned out to be an asthma flare-up for her son.

What the impact could be

Is saliva testing an important breakthrough?

Experts are encouraged at the early results but say there’s more to learn.

“Having a test more available, easier than swabs, quicker, and at a reasonable cost? That would be wonderful, not just for diagnosing patients, but also for things like contact tracing,” Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine in Tennessee, told Healthline. “We could change our whole paradigm of follow-up.”

Schaffner said he’s “cautiously optimistic” about the tests. 

“There are still concerns,” he said. “Let’s get some more data.”

And while the test producers say the need for less material is a positive step, Schaffner pointed out, “Even a saliva test is not created out of thin air.”

The tests have been given to NBA players in their Orlando, Florida, bubble with apparent success.

The new tests also come at a time when testing is reportedly decreasing, as people like Weinstein realize the turnaround time makes them not so valuable.

Jordan S. Savitsky oversees COVID-19 testing programs for businesses as chief executive officer of ATC Alert Health.

A trusted saliva test, he said, solves many of the problems they’re facing with testing now.

“We work with many employers who need to continuously test their employees on a weekly basis,” Savitsky told Healthline. “The most readily available tests right now are nasopharyngeal swabs, which are extremely uncomfortable, especially when you’re getting tested every few days. If a saliva test were readily available, there’s no question that more people will get tested, which will significantly slow the spread of the virus.”

Savitsky said supply chain issues are “significant right now” for the nasal swab test, with the swabs themselves in short supply.

Since SalivaDirect can use a variety of reagents and does not need to be in a special tube, supply chain issues should be reduced.

“Saliva-based tests don’t need this component, and therefore you could test many more people,” Savitsky said.

And since people themselves can do saliva tests, nurses are not needed, cutting the cost of testing exponentially.  

“They can even be done from home, minimizing the risks of exposure when going to get tested,” Savitsky added.

Looking at accuracy

Are the saliva-based tests accurate?

While test creators say they are, some experts are still waiting for more proof of that.

“The challenge with saliva is that it’s not consistent among people,” Steve Blanc, a life sciences sales executive and founder of Blanc Ventures LLC, told Healthline. “It can change with how much food or drink you have. We are going to need a protocol to work with that.”

Still, he said, saliva tests are worth pursuing and look promising.

“It is great and advances are being made,” he said. “There’s a lot of effort in trying to make these work because they are easy to do and you get an answer right away.”

How to go forward

Blanc believes the solution to testing may not purely be in saliva testing in place of swabs.

“It’s not one or the other,” he said. “It’s the combination. A rapid (saliva) test may not be as accurate, but you can take action from it. ”

Picture it like this: A student or factory worker could do a saliva test twice a day.

That would allow more people to go back to work or school with confidence.

Should a positive test come from a saliva test, Blanc said, it could be followed with a swab test to confirm or retract.

“Conversations are taking place about rapid testing,” he said. “It could be something you give a kid before and after school. It may not be as accurate, but you can take action from it. It may not be the optimal solution, but it will be much better.”

Benjamin Tanner is a physician assistant working in emergency rooms in Las Vegas for the Valley Health System.

While he believes saliva tests may not, as of now, be as accurate as swab tests, he sees a great need.

“Currently, the COVID tests we do take at least a few days to result,” he told Healthline. “Even though these tests are a little more accurate than the proposed saliva test, we don’t really get to use the results in a timely fashion, so they are useless in the short term.”

“Having a quick test that would at least give us an idea if a patient is infectious to other people (which is part of the purpose of the saliva test) would be very useful, and we could run it immediately upon their arrival in the ER,” he added.

Tanner said a saliva test would also be helpful for staff members when they may feel sick or just want a general screening.

“I’m definitely in the camp that cheap saliva tests could be a game changer,” he said. “The main reason the economy is still struggling is because of all the uncertainty about coronavirus, and these tests could give us a great deal more information in much quicker fashion.”

The Yale lab that created SalivaDirect plans on making it available to labs for free and labs will be able to begin offering them immediately.

Schaffner said the test looks promising and he expects to see other faster, more streamlined tests soon.

“There are a number of testing modalities that are still in the works,” he said. “Finger pricks or other easy-to-get sample choices are [being looked at]. Some, should they pan out, really will make a difference. We can do an awful lot of good with a really accessible test.”

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