While I agree the swab being stuck deep in your nasal cavity is bullshit and not necessary. Ethylene Oxide gas is commonly used to sterilize medical device products. I worked for a medical device manufacturer and everything we produced was sent out for this sterilization process before it was shipped to the hospitals for use. The sterilization process uses gas, heat, pressure, and time to kill any germs on the device including the packaging. This cycle is closely monitored and tests are completed to ensure residual gas is below specific levels.