British Columbia has significantly expanded access to its COVID-19 testing as part of a strategy to move beyond the current lockdown measures, but the number of tests being conducted each day is still far below the province’s capacity.
B.C. is also well below the national average for the number of tests on a per-capita basis conducted for COVID-19, the disease caused by the novel coronavirus. It is conducting an average of roughly 1,200 tests each day, but has the capacity to do 6,200 tests a day.
Alberta recently expanded its criteria to include anyone in the province with symptoms – the broadest testing coverage in the country. And it plans to continue that expansion, almost tripling its capacity to 20,000 tests a day by the end of May.
For weeks, Bonnie Henry, B.C.'s provincial health officer, has defended an approach that focused resources on the highest risks and most vulnerable areas, such as specific outbreaks, those who are critically ill or need hospitalization, healthcare workers and people in long-term care.
The strategy changed on April 8, when the province issued a new directive to clinicians, so that anyone with symptoms of COVID-19 can now be assessed and tested, either through a family physician or at a local community collection centre.
“We need to find the cases in our community, we need to contain these outbreaks so that they don’t spread,” Dr. Henry said Tuesday.
The increased testing availability is designed to help quickly identify and address any new community cases and outbreaks.
“We want to avoid another spike in community cases," she added. "That’s why we are changing the strategy again, to open it up and ensure that we continue to find everybody who needs to be isolated and where we need to be contact tracing in the province.”
Despite the new directive, the number of tests has not significantly changed since access was broadened. On April 7, B.C. conducted 1,073 tests and on April 17, the most recent day that the total testing figure was available, there were 1,483 tests.
Dr. Henry cautions the testing has limited benefits.
“While everyone can get tested, not everyone needs to get tested,” she said Monday when she announced the wider testing protocol. “If you do not have symptoms, this test has very limited benefit and is not necessarily valid.”
Dr. Henry said last week that the tests for someone who is in the early stages of infection are not as reliable as officials would have liked.
“We now know the false-negative rate can be as high as 30 per cent early on in infection," she said. "The norm is not to test people who do not have symptoms because we know the test doesn’t perform very well and we can have false negatives.”
Peter Phillips, an infectious disease expert, said B.C.'s public health officials need to figure out what obstacles are getting in the way of increased testing before the province can hope to begin to reduce some of the physical-distancing measures that have helped flatten the curve of infection rates.
“Even though there’s been messaging about increasing testing, it has not yet happened,” he said in an interview.
Dr. Phillips, a clinical professor in the Division of Infectious Diseases at the University of British Columbia’s Faculty of Medicine, said broader testing is critical for the province to begin reopening schools and businesses.
“There’s discussion about where we’re going to be going in the next few weeks, then hopefully there’s going to be some relaxation on the social-distancing measures in order to enable people to start to get back to work, and get the economy going again," he said. “There has to be a recovery phase to the economy, but it has to be done safely. And if it isn’t done safely, then we’re looking at a big second wave of the epidemic.”
He added that those jurisdictions that have shown the greatest success in containing COVID infections – Taiwan, South Korea, Hong Kong, Singapore and New Zealand – have embraced rigorous testing and contact tracing. “They printed the roadmap of how to deal with it, and Canada needs to adopt it.”
He said B.C. has the capacity to do better.
“It’s important that we really make use of the testing and not restrict it. That’s going to be the best way to be on top of where the epidemic is and its extent in the community.”
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