Instructions for collecting, packing, and shipping at-home nasal swab for the ComPACT study

List of items provided to you in the purple ECU Public Health bag at your most recent study visit:

• 1 insulated shipping box
• 4 3oz gel cold packs or 2 6oz gel cold packs
• 2 clear ziplock bags
• 1 biohazard bag
• 1 blank sticker label (in biohazard bag)
• 1 collection vial (in biohazard bag)
• 1 sterile swab
• 1 paper towel (for absorbing spills during shipping)
• 1 COVID-19 Test form for the NC State Laboratory of Public Health
• 1 ultra fine point sharpie
• 1 roll of packing tape

List of items mailed to you:

• Pre-printed FedEX shipping label
• List and map of FedEx self-service drop boxes around Greenville
• These instructions for collecting, packing, and shipping the nasal swab

Before you begin:

1. Place ice packs into the freezer.
2. Look at the schedule below. The nasal swab sample must be collected the night before or the morning of the day you will be dropping of the package for shipping. Packages must be dropped off at a designated FedEx drop box (not a shipping location like inside a Walgreens). On Monday, Tuesday, or Wednesday before 5:30 pm (in most cases)

There are 3 major sections to this process. Each will be described in the following pages:

1. Collect nasal swab, label, and fill out the testing form
2. Pack the nasal swab in the insulated shipping box
3. Drop off the package at a designated FedEx drop box (only available in and around Greenville).

If you have questions at any time, call Dr. Kipp at 252-744-2629 or email kippa19@ecu.edu.

Collect nasal swab, label, and fill out the testing form

1. Collect nasal swab specimen as described in video tutorial and as done on Saturday ComPACT study days. The video tutorial is available on the study website at https://compactstudy.ecu.edu/info-for-participants/

2. Using the fine point sharpie, fill out the white sticker label with your name, date of birth, and the date the swab is collected.

3. Affix the label lengthwise to the collection tube. The label fits perfectly between the bottom of the cap and the bottom of the tube (see picture #1).

4. Place tape around the cap to seal it (OK to use piece of packing tape if needed).

5. Fold paper towel so it fits into the biohazard bag. You may need to fold the towel into thirds. In the event the vial leaks, the paper towel is there to absorb the liquid.

6. Place nasal swab collection tube in the biohazard bag. Securely seal the ziplock.

7. Fill out the laboratory testing form – all highlighted sections, don’t forget date of sample collection at the bottom right.

8. Fold and place the form in the outside sleeve of the biohazard bag (see picture #2)

9. If you have collected the nasal swab sample in the evening, place in the refrigerator (DO NOT freeze) overnight until ready to pack in the shipping box in the morning.

Packing the insulated shipping box

1. Remove the Styrofoam lid from the box. Stick your finger or the flat edge of a utensil about ½ inch down between the Styrofoam and the cardboard and pry the lid off.

2. Place one 6oz frozen cold pack into one of the clear ziplock bags and place the bag in the bottom of the Styrofoam box. The 6oz pack should lay flat (see picture #3).

3. Place the biohazard bag that contains the nasal swab, paper towel, and testing form on top of the frozen cold pack (see picture #4)

4. Place the remaining 6oz cold pack into the remaining clear ziplock bag and place on top of the biohazard bag (see picture #5a). You may need to place one or two additional paper towels (not provided) on top of the 2^nd cold pack to ensure the contents are snug when the Styrofoam lid is put on (see picture #5b). To see if extra padding is needed, place the lid on and fold the cardboard flaps over the lid. Give the box a quick up-and-down shake. If you hear or feel the contents shifting around, reopen the lid and place one or two additional paper towels inside, then replace the lid.

5. Use the packing tape provided to tape the cardboard box closed over the Styrofoam box.

6. A shipping label sticker should be included. Simply apply the sticker to the top of the box.

IF you are using a printed label on a piece of paper instead of a shipping label sticker, use the following instructions and picture:

Fold the shipping label in half so that the instructions and warning text are folded behind the label barcodes. Place the label on the box. You will see that the label is a little too long for the box (see picture #6a). Fold the bottom 1 inch to 1 ½ inches of the label up underneath the label so that it fits neatly on top of the cardboard box (see picture #6b).

Tape the label to the box using at least 3 strips of tape across the top (1), middle (2), and bottom (3) of the label (see picture #6b). By taping over the two barcodes, it helps ensure the barcode is not torn or damaged during shipping.

Dropping off the package

1. The package will be shipped via FedEx Ground. However, because it contains a biologic specimen, it cannot be dropped off anywhere that handles FedEx shipping. Instead, refer to this map and drop-box list to find a drop-box that is closest to you. Unfortunately, these drop-boxes are only located in the Greenville area. For specific directions from your house, use a mapping or GPS application with the specific drop-box address provided in the list.

2. If you will be keeping the packed box with you during the day before dropping it off in the afternoon, please do not leave the packed box in a hot car during the day as this will cause the cold packs to melt more rapidly and the sample may not stay cool enough.