Canada’s response to COVID-19 has been hampered for weeks by shortages of testing supplies and backlogs at laboratories, but the rollout of new Canadian-made testing technology means provinces may soon be able to increase testing in a significant way.
It remains unclear, however, whether health officials will follow the advice of many infectious disease experts and start using the new technology to expand testing and look for COVID-19 in people with just mild symptoms.
This week, the federal government, Alberta and Ontario signed deals with Spartan Bioscience Inc., a small Ottawa-based company that produces a hand-held DNA analyzer that can provide COVID-19 test results in about 30 minutes.
The Spartan test has not yet been approved by Health Canada, but the company expects to get the green light soon and anticipates shipping thousands of test kits to clinicians within weeks.
The majority of conventional COVID-19 tests are conducted by inserting a long, specially designed nasopharyngeal swab far into a patient’s nostril. Swabs are then collected and sent to a hospital or public health laboratory, where they are processed in a large machine designed for polymerase chain reaction (PCR) tests.
Spartan’s rapid COVID-19 test, on the other hand, uses a throat swab produced by the company, which is then inserted into a single-use cartridge that goes into the company’s hand-held DNA analyzer.
The U.S. Food and Drug Administration has also approved new rapid COVID-19 tests in recent days, including a test produced by Illinois-based pharmaceutical giant Abbott Laboratories that can produce results in less than 10 minutes.
Such systems are ideal for smaller, more remote areas, according to Jim Woodgett, director of research at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto. While the new rapid tests can’t process nearly the same volume of tests as large, hospital-based PCR machines, the hand-held DNA analyzers mean that small hospitals could get nearly instant results, without having to wait days for swabs to be sent to a central lab for processing.
Eric Jan, a professor in the department of biochemistry and molecular biology at the University of British Columbia, said the speed of the new tests will be critical to helping ensure patients stay isolated to help contain the spread of COVID-19.
But public health agencies and hospital labs will still have to do much of the heavy lifting when it comes to large-scale COVID-19 testing. That means there’s still an urgent need to increase lab capacity and get more nasopharyngeal swabs and chemical reagents, which are used to complete tests.
Alison McGeer, director of the infectious diseases epidemiology research unit at the Lunenfeld-Tanenbaum Research Institute, said supplies are short because of unprecedented demand for these products from countries around the globe. Infectious disease outbreaks typically hit different parts of the world in waves and it’s unusual to see so many countries clamouring at once, Dr. McGeer said.
Across the country, hospitals, universities, governments and private companies are working to source testing materials and increase lab capacity, but the nature of COVID-19 testing means it takes time to speed up, Dr. McGeer said.
The PCR tests used by hospital and public health labs are “finicky” and need to be done in an extremely precise way, Dr. McGeer said. Everything from the chemical reagents that are used to the plastic in the nasal swabs must be exactly right, meaning that any new test supplies have to be checked and rechecked to ensure they produce accurate results.
While Canada and other countries will be able to sort out these supply chain issues, Dr. McGeer said, the process of ramping up takes time, which isn’t ideal during a global pandemic.
Then there’s the question of whether provinces will broaden the criteria for who can get a test. Countries such as South Korea have successfully flattened the curve by conducting widespread testing, including checks of asymptomatic close contacts of people with COVID-19. This approach has allowed officials to quickly identify and isolate new cases, slowing the rate of transmission.
But in Canada, test rationing means that in most parts of the country so far, the only people being tested are those with severe illness or those in other high-risk groups, such as health-care workers.
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