There are more than 14 million rapid COVID-19 tests available in Canada, yet few are being put to work to stem the spread of the coronavirus. There is a lack of urgency to embrace rapid testing in this country – the same fatal hesitancy that has marked much of our response to the pandemic.
Rapid tests are not perfect – the chief critique of their value – and certainly do not replace the gold standard of lab-based PCR tests. But because they can produce a result within an hour, and as quickly as 15 minutes, they can be an important tool to screen for COVID-19 when the presence of the disease is not obvious.
Rapid testing can – and should have already – become part of the arsenal to battle back the virus.
The second wave in Canada appears to have peaked, but the number of infections remains elevated. New and more dangerous virus variants are looming. While mass vaccination promises eventual salvation, the immediate threat will be ever-present well into the spring.
Given this situation, it is difficult to understand why some health officials are not more enthusiastic about rapid testing. British Columbia, in just one example, has more than one-million rapid tests sitting unused in storage. Provincial Health Officer Dr. Bonnie Henry has expressed skepticism about their use. Last week, she questioned the amount of work it takes to conduct rapid tests in long-term care homes.
This position, however, runs counter to the findings from a panel of experts assembled by the federal government.
In mid-January, the panel issued a report on how Canada can better test and screen for COVID-19. Its members acknowledged “there is no single, perfect approach,” but they highlighted rapid testing as a key tool, in particular for screening of people without symptoms.
This is the whole point of rapid testing – to root out the virus among people who do not seem to be infected.
The panel said rapid tests could be used as standard practice in schools, workplaces and communal living facilities, such as LTC, homeless shelters and jails, to “identify COVID-19 infections before they spread.”
While rapid tests do not detect the virus as reliably as PCR tests, they “are able to identify individuals who are shedding larger amounts of the virus,” the panel said. Immediate test results enable “timely action.”
The panel also stressed that clear communication around the use of rapid tests is critical. Canadians need to know the tests are not perfect, that a negative result does not provide a green light for reckless behaviour and that it is always essential to abide by local health rules.
Nova Scotia, whose success against the virus should be a model for other provinces, started rapid testing two months ago. It stages mobile clinics to test people without symptoms. About 14,000 people have been tested so far. Every discovered case matters: Nova Scotia’s rapid testing has so far found 15 asymptomatic people with the virus.
And conducting a rapid test is not rocket science. “They do not need to be performed by a health professional,” the federal panel said. Nova Scotia chose this route; trained volunteers do the work. Chief Medical Officer Dr. Robert Strang was wary of this, but he has since said rapid testing is “a fundamentally important part of our overall testing strategy.”
Other provinces would do well to heed any advice Dr. Strang offers. Nova Scotia on Thursday reported zero new cases. There are only 11 active cases in the entire province.
The reluctance to go big with rapid testing may be shifting. Ontario has about 3.5 million tests in hand. While only one-quarter have been distributed, the province expects to receive about 8.5 million more rapid tests in the months ahead.
They are currently being used on visitors and staff in about 150 LTC homes, and workers at 160 employers. Ontario aims to test 150,000 workers a week in the months ahead.
Such goals have been lacking for too long. Rapid testing has potential in many venues. Think about the border, where more than 100,000 essential truckers cross between Canada and the United States each week.
This pandemic is unrelenting. The second wave may be ebbing, but some experts have warned of a possible third wave ahead. Before Canada reaches mass vaccination, a surge in rapid testing can help minimize infections and reduce the need for strict measures that hold back the economy, and rob us of a semblance of regular life.
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