As the Delta strain threatens to disrupt a third year of schooling, some parents and doctors are calling for rapid COVID-19 testing to be used as a screening measure to keep children safe, despite the reluctance of public-health officials.
Several infectious-disease experts warn that as the virus circulates among the under-12 population, for whom there are no approved vaccines, classrooms will be moved into an online learning environment – a situation that could be limited if rapid tests became part of the safety protocols adopted by schools, especially in communities with high infection rates. The measure, doctors added, wouldn’t have to be in place for long if a vaccine is approved for children.
“If you truly value schooling for children, and if you value the health of these children, this is a cost-effective tool,” said Leyla Asadi, an infectious-diseases physician in Edmonton. She added that the U.K. and parts of the United States have implemented a test-to-stay strategy, where students who are a close contact of a positive school case can continue learning in their classroom if they receive a negative result on a daily rapid test.
Alberta piloted rapid tests in a handful of school districts during the past academic year, but government spokeswoman Nicole Sparrow said “localized rapid testing in schools may be considered should the need arise.” The government found that of the 34,000 tests conducted in its pilot, 72 had preliminary positive results that then required a PCR lab-based test.
In Ontario, the government requires two rapid tests a week for unvaccinated school staff, paid for by taxpayers, but it excludes students. The province’s Chief Medical Officer of Health, Kieran Moore, recently said that “there’s no additional value” to testing students because of low community infections, and that he was concerned about false positives. He added: “It’s a tool that we will use wisely and we’ll put in play if our risk goes up.”
Only in Quebec has the government deployed rapid tests, using them in four neighbourhoods in Montreal and Laval with higher infection rates. Jean-François Del Torchio, a spokesman for the province’s Education Minister, said that the tests will be deployed in all elementary schools shortly, because “it is another tool for us to keep our schools open.”
Canada relies on polymerase chain reaction (PCR) tests, which are conducted in labs. Rapid tests, however, can be done on the spot for screening purposes of asymptomatic people in contexts such as schools or work sites. The tests use a short nasal swab and take 15 minutes for results. A PCR test would be administered to confirm a positive result.
In the absence of government efforts, some parents have taken the matter into their own hands. Twice a week, about 200 children at Toronto’s Earl Beatty Junior and Senior Public School are signed up for a nose tickle.
A group of parents have organized the pickup and distribution of COVID-19 rapid tests to families in their neighbourhood so that students and their siblings are nasal-swabbed, ideally before the school day begins.
“I believe that we should be using every tool we have to prevent kids from getting sick unnecessarily with a new and potentially acute and chronic disease, but that it’s also important to keep them in schools as much as safely possible,” said Sam Kaufman, a parent at the school who organized the initiative.
“I think our project is showing that with the right supports in place, asymptomatic testing programs can be organized in every school in the province, and that the desire for these programs is huge.”
Mr. Kaufman receives the tests at no cost from StaySafe, a program run out of the Kitchener-Waterloo region that provides taxpayer-funded rapid antigen tests to businesses and community groups. He said parents in other schools have expressed interest in the initiative.
Sarah Mostowich, the program lead at StaySafe, a collaboration between the province, startup incubator Communitech and local chambers of commerce, said there are as many as 4,200 “ambassadors” such as Mr. Kaufman, who organize rapid testing for their businesses or in their communities.
“It’s really a program that’s quite open to anyone, to share rapid testing with their communities,” Ms. Mostowich said.
In late August, parent Ryan Waddell made the hour-long drive to Kitchener from his home in Oakville to pick up tests for his children and his neighbour’s children. He heard about the program through social media. His older child, who is 12, is fully vaccinated, but his nine-year-old is not yet eligible.
“I just want to make sure that we’re doing our part to prevent the spread,” he said. “The last thing I want is for our kids to be asymptomatic and us not to know and have them pass it along to another kid.”
Mr. Waddell planned on informing others at his school. He said he was frustrated that parents, not government, were forced to put the measure in place.
“It feels sort of like a lot of our COVID responses. They’re waiting for things to be bad before they react. It’s all reactive and never pro-active,” he said. “Yes, you will get false positives. It’s better to have some small percentage of false positives if it means catching significantly more school cases before they turn into outbreaks and schools shutting down.”
Janine McCready, an infectious-diseases physician at Toronto’s Michael Garron Hospital, acknowledged there are equity issues: Some parents can be more involved and have the capacity to launch rapid-testing initiatives. But she applauded the parent community that has initiated rapid testing, and she is working with partners to try and launch it elsewhere, including in higher-risk communities.
Her work in schools in Thorncliffe Park, a COVID-19 hot spot, showed her that many parents welcomed the safety measures in school, she said, including when the hospital brought testing on-site. Dr. McCready and her team are supporting the parent group at Earl Beatty if there is a positive case identified in the rapid screening tests. Concerns about false positives are “very rare,” she said.
“One of the things about the response in this province is it’s been all or nothing. If we can’t do it everywhere, maybe we shouldn’t do it anywhere. But I don’t think that’s really fair,” Dr. McCready said. “It would be great to prioritize and to see if we can pilot this in the schools with the highest needs, and give extra supports to the parents and the admin in those areas to be successful.”
She added that rapid testing in schools would likely be short-term, because a vaccine for young children could be available soon.
“Really, to me, what’s the big harm to it? Will it be a panacea and fix everything? No. But does it have the potential to be helpful and potentially prevent transmission in schools? I think so,” Dr. McCready said. “Especially with all the unknowns that we’re dealing with, I think it’s something that we can use.”
Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.