Months after Ottawa and the provinces promoted rapid testing as a key tool in the fight against COVID-19, the latest data show that almost all of the 43 million rapid tests procured by the federal government are sitting unused.
As of early May, about 95 per cent of the tests have not been administered. Millions of them have been distributed to federal agencies and provincial and territorial governments.
The federal government has spent $1.4-billion on testing equipment, as of December, 2020, including both rapid tests and the gold-standard diagnostic test known as polymerase chain reaction (PCR).
Some experts say a full rollout of rapid testing could have helped stem the current third wave.
Rapid tests are not as effective as the PCR type at detecting the virus early on in an infection, they say, but are useful screening tools for infectious cases in workplaces and other congregate settings. As well, they return results in minutes, while PCR test results take hours or days.
Of the nearly 600,000 rapid tests reserved for federal use, roughly 8 per cent have been administered, according to Health Canada’s recent figures. These include tests distributed to the Department of National Defence, Correctional Service Canada (CSC), the Public Health Agency of Canada and remote, Northern and Indigenous communities. On May 7, the federal Ministry of Health announced measures to increase access to rapid testing in workplaces.
It was reported last month that the federal government had used only about 0.3 per cent of its tests, the smallest percentage in the country. However, Health Canada recently changed the federal allocation reported on its website from 16.5 million to 600,000 after receiving questions from The Globe and Mail on the government’s low rate of test usage.
Twelve million of the tests, designated as a countrywide emergency supply, have not been distributed to either federal agencies or provinces. This figure was previously not reported on the site but the Health Ministry says most of the original 16.5 million federal allocation was always considered an emergency stockpile. The Health Canada website does not account for the remaining roughly four million tests.
According to CSC, it has received 240,000 rapid tests and has used 38,000, about 16 per cent of them, on inmates and correctional staff. A spokesperson for the Canadian Armed Forces said more than 1,000 rapid tests have been used by the CAF as of April 29, or 2.5 per cent of the 40,800 tests received by the military.
The numbers on rapid-test use in the provinces are incomplete because some provinces and territories – including PEI and Yukon – had partial or missing numbers. Nova Scotia and Ontario used the highest percentage – 10 and 12 per cent, respectively. Manitoba, New Brunswick, the Northwest Territories and British Columbia used the lowest – about 1 per cent.
The federal advisory panel on COVID-19 testing released a report in January in which it recommended using rapid tests to help with virus screening. The first COVID-19 rapid antigen test was approved by Health Canada in October, 2020.
Irfan Dhalla, co-chair of the advisory panel, said he is disappointed by the slow rollout. “If we had done that, we could have detected outbreaks earlier, minimized transmission and blunted the impact of the third wave,” Dr. Dhalla said.
In March, Ontario lifted restrictions that had allowed only health care workers to administer rapid tests. On April 26, Alberta also lifted this restriction. The moves were aimed at making it easier for workplaces to use rapid tests. The tests must still be given by a trained individual, but workplaces can train their own staff to administer them.
Dr. Dhalla said insufficient human resources thus far to distribute and administer rapid testing might explain the low usage of the tests.
Cole Davidson, a spokesperson for federal Health Minister Patty Hajdu, did not directly answer when asked by The Globe why so many federal tests are sitting unused.
“To date, we’ve procured 43.5 million rapid tests, distributed over 25 million directly to provinces and territories as well as hundreds of thousands of tests directly to the private sector,” he said.
David Naylor, professor of medicine at the University of Toronto, said misconceptions about how rapid tests should be used and how their accuracy compares with PCR tests may be contributing to their low use. He said because rapid tests are seen as less accurate in detecting COVID-19, some infectious-disease experts are wary of them.
“The focus on the PCR as [the] gold standard means that you end up with a misunderstanding of the value of the rapid antigen test,” Dr. Naylor said.
Larissa Matukas, head of the microbiology division at St. Michael’s Hospital in Toronto, said one particular brand of rapid test can only handle up to four specimens per hour, which can be time-consuming. In addition, she said there are many requirements to make sure that the testing is done safely and accurately.
“There are a lot of logistics that prevent you from just using these tests even though they’re readily available,” Dr. Matukas said.
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