Sara Navin has gotten tested for COVID-19 three times now. And, each time, the process has been a surprisingly pleasant experience. “I just sign up on the city’s free website where you don’t need insurance or any symptoms to make an appointment,” she said. “It’s really easy.” Part of that ease, Navin said, was the painless sample collection process. She simply sat in her car, coughed three times, swabbed her mouth for 20 seconds and then sealed the swab in a vial. This was a relief since she’d heard horror stories from friends about invasive sample collections — called nasopharyngeal swabs — that involved getting long plastic sticks jammed up their nose. “Most of the other people I’ve talked to have gotten that [deep] nasal swab,” she said, “And so I was wondering why city of Chicago sites were doing the mouth swab and if there was any difference in the accuracy of those tests.” We’ve heard similar questions from other Chicagoans who wonder why they were subjected to the uncomfortable nasopharyngeal swab (NPS) — affectionately referred to as the “brain poke” — while their friends got to administer their own mouth or nasal swabs. Many assumed the less invasive collection methods must not be as good, and they wanted to know why there was such a wide variety of methods instead of one standard. We took these questions to doctors, researchers and health officials and learned that pandemic shortages have forced healthcare providers to use several collection methods in recent months. But we also discovered some good news for people like Sara: Emerging research suggests that self-collected mouth and shallow nose swabs can be nearly as good, or better, than nasopharyngeal samples at detecting COVID-19. In fact, in late April, federal health authorities officially removed their preference for the use of NPS in COVID testing. And, beyond accuracy, the non-NPS methods offer some important advantages when it comes to ramping up testing to fight the virus. The “brain poke” method has pros and cons Still, most microbiologists and pathologists we talked to maintain their preference for nasopharyngeal samples as a first choice. “The gold standard is the nasopharyngeal swab,” said Karen Kaulk, chair of the pathology and laboratory medicine at NorthShore University Health System. “The COVID virus, like other viruses including the flu, likes to live in the nasopharynx and so that is the best place to go.”  This is why you still primarily see NPS collection at big hospitals such as Northwestern Medicine, Loyola University Medical Center and NorthShore University HealthSystem. But Kaulk said they’re all looking into alternatives because NPS has some major drawbacks right now. "In order to collect [using NPS] you need an appropriate supply chain of swabs which is one of the problems we’ve been dealing with,” she said. “And it also requires a bit more training than other collection methods." An even bigger problem may be the danger to healthcare workers who have to wear PPE and change it often, because when you put a stick up people’s nose, they “sneeze and cough, [creating] a risk of exposure there,” Kaulk said. On top of that, some patients swing their arms, swat away the swab or even accidentally hit healthcare workers as they involuntarily react to the “brain poke.” So, in recent months, medical professionals have turned to alternate collection methods including throat swabs, shallower nasal swabs and mouth swabs. “At University of Chicago, we started collecting [samples] from the front of the nose rather than the back of the nose [using NPS],” said Dr. Kathleen Beavis, the medical director of Microbiology and Immunology Laboratories at UChicago Medicine. “We wanted to do that for a few reasons and one of them was comfort to the patient … so now most specimens are collected that way at University of Chicago.” Beavis said front-of-the-nose samples (also called anterior nasal sampling) are proving just as accurate for them and they will soon move

Like other cities across the nation, Chicago has seen an increase in residential garbage as a result of the state’s stay-at-home order, city officials said. And nestled in those garbage bags, you’ll likely find lots of pandemic related items, including disposable masks, gloves, takeout boxes, wipes and plastic grocery bags. This inspired Curious City listener Sandy Kaempen to ask: Just how much more garbage have we generated with this pandemic, with so much more medical waste, PPE items and carryout containers? This is tough data to track down locally because Chicago officials say they don’t calculate COVID-19-related waste separately from other waste. But we do know that Illinois’ pandemic equipment requests to the federal government included nearly 100 million disposable gloves, almost 17.5 million disposable gowns and nearly 12 million disposable N95 masks. The feds didn't fully deliver on the requests, but the numbers offer a glimpse of how much pandemic-related waste may be piling up around the state in health care settings alone. This disposable health care waste may be unavoidable, but Sandy wondered if that’s also true with non-health care waste. So she asked a second related question: How can regular citizens start reducing COVID-19-related waste now that we know more about how the virus is transmitted? To find out, we consulted experts, caught up on new policies and devised a few winning strategies of our own. The result is this handy list of ways to stay safe and relatively green during the pandemic. Skip the latex gloves for most things:  Early on, many people used latex gloves to run errands. But now, health experts including the CDC and Dr. Jennifer Grant, an infectious disease physician at NorthShore University HealthSystem, say that’s probably not necessary. They still recommend gloves for frontline workers, and when cleaning or caring for someone who is sick, but otherwise they recommend hand-washing. “The virus isn’t going to infect by penetrating your skin on your hands but rather through your mouth, nose or eyes,” Grant says. “So if your gloves are contaminated and you are scratching your nose or eyes, you are no better off than if you weren’t wearing them.” Pro tip: If you worry about dirty hands after doing errands, keep some hand sanitizer in your bag, bike basket or car. Despite what you may have heard, it will not ignite in a hot car. Opt for a reusable cloth mask:  Yes, we know they can be uncomfortable and hot in the summer, but masks aren’t leaving us any time soon. So it’s time to find some you don’t hate (or maybe even look great in) and learn how to wash and use them properly. Grant urges care when removing masks: “Think of the outside surface as a potentially contaminated surface. Handle it by the straps and wash your hands after taking it off.” To keep them clean, the CDC recommends washing masks after use with a five-minute soak in water and mild detergent. The agency recommends air drying in the sun or in a hot dryer. Pro tip: Machine wash and dry them in a lingerie bag (aka bra-saver) to avoid damaging or stretching out the straps. Know when and how to use (and reuse) other masks:  Surgical masks and high-quality KN95 and N95s are technically meant to be disposable. But with the current shortage, even frontline workers have been known to reuse them. The CDC does not have official rules on how many times you can reuse them, but offers some general guidelines here. Pro tip: N95s should still be reserved for frontline workers, but many people have found them at home stored with their tools from previous home projects. Make your own disinfection solution:  If you want to avoid using multiple disposable wipes, the CDC says you can make a disinfectant bleach solution with four teaspoons of bleach per quart of water. Spray it on a cloth or hard surface, wipe and let it air dry. Use with paper towels or, even better, clean reusable washable towels. The CDC warns against applying

Last week, Curious City answered a question on the safety of Illinois’ recently restored outdoor dining. We talked to health professionals about how to do it more safely. In the process, we heard about an innovative safety plan afoot at Uptown’s Sun Wah BBQ, famous for its roasted duck dinners. Co-owner Kelly Cheng told us she plans to require all diners to sign a declaration of health regarding COVID-19 and share all of their contact information before sitting down. Read more: All of WBEZ’s coverage of the COVID-19 outbreak in Chicago and the region Cheng hopes to get the restaurant’s new outdoor patio license this week from the city. But even if they don’t get it, she says they still plan to require customers to sign the declaration before diners head indoors later this summer. The following is an edited transcript about why Cheng — who started running the restaurant with her siblings when her dad retired — decided to do this and how she anticipates it will work. So you guys were getting by and keeping your staff safe during the pandemic with just a brisk curbside pick-up business on weekends. Why did you decide to apply for a patio permit at this time? Kelly Cheng: If we don’t have an outdoor space, we don’t have a learning curve. … And I’ve been hearing a lot of horror stories, people that have been opening right away, and then they get bombarded with customers and then people get upset. And then you have basically fights breaking out, you know, whether it’s verbal or actual fights breaking out, because people have been locked up for three months and they don’t honestly know how to behave in public anymore. And so having read a lot of those weird, crazy stories and knowing that we can be a draw for crowds, I really didn’t want to just jump back in. My staff are willing to work, but they’re also fearful. They’re like, ‘Well, you know, what if we have crowds? How are we going to control that?’ We only have a skeleton crew. How did you get the idea to have people sign an affidavit of sorts about their health? Cheng: I was also doing research and a lot of people were throwing the Black Sheep Restaurant handbook at me. Black Sheep is a restaurant group in Hong Kong. And I pay attention to the restaurant industry in Hong Kong, not just because they have good food and stuff, but because they are such a crowded, densely populated space. And eight times out of ten, they’re ahead of the curve. And what they essentially did was make rules for what their employees should do, what would happen. They made a health declaration form, and I think that is the most brilliant thing on earth. What does their form look like? Cheng: So they basically tell you you have to attest that you don’t have covered symptoms, that you’re not sick, that you haven’t exhibited the symptoms, and for their form, that they haven’t been outside of Hong Kong for the last 14 days. In other words, you’re not in quarantine and you’ve snuck out to come for some food. And they were very strict about the form. … But they had trouble getting people to sign the form. So what they did was they turn people away. They said the first night they reopened, they turned away like 50 parties … because those people wouldn’t sign the affidavit. And then they created a WhatsApp group with their entire restaurant group team so that those same groups that refuse that store A couldn’t go to store B, C and D and try to pull off the same stunt and get in. [Eventually many diners warmed up to the idea. The restaurant group’s manual is now being shared across the world, and their safety protocols have allowed them to survive and even make expansion plans amid the pandemic.] What will your form look like?  Cheng: I’ve made it much more simple. And this is America, so obviously lawsuits will happen, and they have privacy concerns. … I’ve essentially said, OK, you have attest that you are not sick. You haven’t exhibited signs of COVID-19. You haven’t had COVID[-19] in the last 14 da