Would you let this robot stick a nasal swab up your nose to test for COVID-19?

nasal swab test robot covid-19
Photo via Brain Navi/Vimeo

The experience of getting screened for COVID-19 with a nasal swab test can best be described as “unpleasant” for most people and downright painful for others. For the uninitiated, a COVID-19 test is performed by inserting a 6-inch long swab into the nose, all the way to the nasal cavity, where it is rotated several times for 15 seconds, and then, repeated in the other nostril to ensure enough material is collected.

Though we currently rely on medical professionals to perform these tests on humans, a MedTech startup in Taiwan is testing an autonomous Nasal Swab Robot to perform the tests more quickly and efficiently. The real question, however, is whether people will trust a machine with what is clearly a very delicate operation that can vary wildly depending on the individual. 

But that is just what Brain Navi is hoping to accomplish. The company based the machine on its proprietary autopilot brain surgery navigation robot, along with facial recognition and 3D imaging so that the test could be tailored to each individual subject.

To perform the nasal swab test, a patient places a clip on their nose and rests their head in a metal brace, similar to an eye exam. The patient’s face is then scanned using a depth-sensing camera which measures the distance from the nostril to the ear canal. Finally, the robot inserts the swab into the nose and places samples into a vial.

Here’s a video showing the procedure. 

Not only does Brain Navi claim that the robot completes the test approximately 10 minutes faster than a human, but it was also developed to protect the safety of medical staff by giving them the “peace of mind to fight in critical situations and prevent medical system stress,” according to the company’s website.

What may give people decidedly less peace of mind is that the robot has no pressure sensors to alert it to accidentally pushing into a patient’s flesh. Even the company’s founder, Dr. Jerry Chen Chieh-Hsiao, was allegedly “terrified” when testing the machine for the first time. But in subsequent in-house testing, the machine has proven to be successful enough that it was recently approved for a clinical trial in Taiwan.

Brain Navi is also in the process of approving the Nasal Swab Robot for Emergency Use Authorization (EUA) within the United States Food and Drug Administration (FDA) as well as the Taiwan Food and Drug Administration (TFDA).

Chen said his motivation for developing the robot was actually a result of the SARS outbreak from 2002-2004—not the coronavirus pandemic—when a doctor friend died due to exposure from a sick patient.

“The learning of the SARS outbreak 17 years ago was a profound experience but also left me deep wounds after losing a dear friend while we were saving lives,” Chen writes on the website. “So I decided to develop a robot to help save lives and be the first human to test Nasal Swab Robot.”

Potential disadvantages of a robot performing a nasal swab test

Despite Chen’s seemingly noble intentions, some doctors are skeptical about a robot that can perform nasal swabs—first and foremost, because medical staff wearing appropriate protective gear aren’t actually in that much danger of being infected. Furthermore, they believe the robotic process may actually be slower than tests performed by humans.

Johns Hopkins Sinus Center director Andrew Lane expressed concern over safety procedures in an email to the Verge—though he says the basic concept is “reasonable and interesting.”

“Nasal anatomy can be variable,” Lane said. “The nasal septum is often deviated to one side or the other, and there are structures in the nose that can vary in size and shape.”

“As a result, it is necessary to insert the nasopharyngeal swab carefully with attention to whether resistance is being met and/or the patient is feeling pain,” he continued. “With the head somewhat restrained, my concern would be that the machine might either malfunction or simply be improperly designed, such that the swab goes somewhere that it shouldn’t … The worst-case scenario would be the swab being pushed through a sinus wall into the eye or brain.”

Another area of concern is the lack of communication between a patient and a robot.

“Nasal swabs are painful even when you do it to yourself, and I think anyone would be extremely uncomfortable letting a machine do that,” a doctor working in the UK’s National Health Service (NHS) told the website. “I think for me and for the majority of patients I’ve come across, they would want a human who understands what it’s like to be on the other side of the swab.”

One thing most can agree on is widespread testing—preferably, rapid, at-home testing—will be crucial in the following weeks and months in getting COVID-19 under control.

Sources: The Verge, UC Davis, Brian Navi

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