Faced with a tidal wave of COVID-19 cases, health officials in Alberta and in Montreal are asking residents to rely on rapid home test kits rather than line up for the more reliable PCR lab tests.
Alberta axed general access to PCR tests on Thursday, despite the widespread shortage of rapid test kits. The province’s Chief Medical Officer of Health, Deena Hinshaw, asked those with forthcoming PRC test appointments to cancel them.
Dr. Hinshaw said the province dialled back PCR access to conserve the more accurate tests for high-risk groups, such health care workers, continuing-care residents, and those who qualify for antibody treatment because of their clinical condition.
“As Omicron is spreading farther and faster than anything we’ve ever seen before, no one in Canada will be able to maintain PCR testing for every community case with mild symptoms,” Dr. Hinshaw told reporters.
Meanwhile in Montreal, public-health director Mylène Drouin said Montrealers who get a positive result from a rapid antigen test should assume the outcome is well founded and need not undertake another screening to confirm their status. “With the widespread transmission we have now, all the types of tests are reliable,” Dr. Drouin said.
Montrealers with a positive rapid test result need to self-isolate for 10 days. They also need to notify their close contacts.
In Alberta, people with COVID-19 symptoms must now use a rapid test. If it is positive, they should assume they are infected, isolate and notify their close contacts. If the test is negative, they must still isolate and take a second test 24 to 48 hours later. If the second test is negative, they must stay in isolation until their symptoms resolve, Dr. Hinshaw said.
“It is actually quite a reasonable thing to tell someone who is feeling symptomatic that they probably have COVID-19, and we will have to go back to management protocols that we used in the very early days of COVID, before we had sufficient lab capacity to test everyone,” she said.
At-home kits are considered less accurate than lab-confirmed PCR, or polymerase chain reaction, tests. It is usually recommended that people validate a rapid test positive result with a PCR test.
However, the new Omicron variant has spread the coronavirus to unprecedented levels. Ontario reported Thursday a record 5,790 new cases. But that paled next to Quebec, which had a daily increase of 9,397 additional infections. Testing centres have been overwhelmed, with lengthy queues of people waiting hours to undergo a PCR test.
Dr. Drouin’s position on rapid tests clashed with the view of the Quebec Health Department. Marie-France Raynault, senior public-health strategic adviser for the department, said it was still better to follow a positive rapid test with a PCR confirmation.
“Even in a context of widespread transmission there can be false positives. A false positive can have a lot of impact. It means people will be away from work, that their close contacts have to be away from work,” Dr. Raynault said.
She added that PCR lab results also enable the government to record and monitor the spread of the virus. “It’s preferable to get it confirmed but it’s not urgent. Take an appointment.”
Alberta’s new policy also raises the prospect that it will no longer have a precise understanding of how many people are infected with the virus.
“With Omicron, that is not possible because of how fast and how far it spreads,” Dr. Hinshaw said. Alberta did not require residents using rapid tests to report a positive result.
The province will still track severe outcomes, such as death, she said. Alberta, she said, will also monitor the prevalence of COVID-19 with other tools, such as wastewater data.
Exposure to the coronavirus has put thousands of health care workers on the sidelines.
Sonia Bélanger, chief executive officer of Montreal’s south-central health authority, said about 1,200 health care workers in the city are missing from their workplaces because of COVID-19. “It’s a critical time for Montreal’s health network,” she said.
Meanwhile, Alberta Health Services said, because of the potential for pressure on the health care system, the government instructed it to ditch its policy that all staff and contractors be vaccinated.
As of Thursday, about 1,400 staff members who were not fully immunized were placed on unpaid leave, Alberta said. Now, they will be cleared for work if they take “frequent” tests, the government said in a statement.
Montreal recorded 3,668 new cases in the past day but Dr. Drouin said, “It’s surely an underestimation of the reality because many people of course didn’t manage to get an appointment for a test.”
The city’s proportion of Omicron cases is 90 per cent. Also, the testing positivity rate is around 20 per cent, meaning that one in five Montrealers who get screened had been infected. “That’s unheard of,” Dr. Drouin said.
Premier François Legault said Wednesday that private gatherings could include up to 10 people on Christmas, dropping to six people starting on Dec. 26.
Dr. Drouin, however, urged Montrealers to “reduce our gatherings as much as possible.”
The current wave in Montreal is mainly hitting young adults, with people between 18 and 44 accounting for 60 per cent of new cases. Unlike the first wave, which hit working-class neighbourhoods hardest, central Montreal districts are driving the latest surge.
The transmission among young adults is likely caused by “social activities,” Dr. Drouin said euphemistically when a reporter asked if pre-Christmas parties played a role.
“Our aim is to nip the transmission before Christmas so that the rise we’re seeing in young adults doesn’t spread to other people, their parents, their grandparents.”
In British Columbia, the local health authority that serves more than a million people living in and around Vancouver has begun rationing PCR tests and sending most people home with rapid antigen tests to perform on themselves. Vancouver Coastal Health said, in a statement e-mailed late Thursday that only people deemed by medical experts to be “at greater risk of severe disease from COVID-19″ are being given these tests on site.
With reports from Oliver Moore in Toronto and Mike Hager in Vancouver
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