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Omicron is here, and Canada needs to revamp its rapid testing strategy now

Photo: Guido Hofmann

Like any public health measure to counter the spread of Covid-19, rapid antigen tests are not the be-all-end-all. These tests alone will not end the pandemic, but they have a significant role to play as “red light tests” (explained below) alongside vaccines and mandates.

And yet they have not been made available to the Canadian public in the capacity needed.

Rapid antigen tests (RATs) are different than the standard PCR test used to diagnose whether or not someone is a carrier of Covid-19. PCR tests are administered, quite uncomfortably, through a nasal swab. PCR tests also need to be shipped to a lab to be processed. This can take a day or two to get the results back.

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RATs, on the other hand, are quick and easy with results delivered in about 15 minutes. When used widely by the public as a screening measure they can detect asymptomatic and cases that would have otherwise been missed. This is crucial to preventing outbreaks and further transmission.

Red Light, Green Light

Proponents of rapid tests understand that there is a trade-off, which the BCCDC explains:

General Benefits: 

  • Accessibility: tests are more mobile and able to be deployed closer to people who need testing.
  • Fast: quicker results to enable a public health response (typical turnaround is 15-20 minutes).
  • Affordable and Available: relatively low cost and currently high availability in terms of supply. 

General Disadvantages: 

  • Accuracy: higher chance of missing individuals who have COVID-19.
  • Staff and Time: requires a regulated health care worker to administer, and administering tests for a higher number of people is slow and still requires compliance with implementation standards.
  • False sense of security: compliance with public health measures could be decreased due to a false sense of security based on results from a test with a lower sensitivity.

While rapid tests are less accurate (more false positives and false negatives) than PCR tests, they are still pretty good. Using rapid tests on a mass scale, frequently, is an effective layer of protection as they screen the population for unknown carriers of the virus. The more tools in the toolbox, the better.

An easy way to think of it is like this: Rapid tests are not a green light test, they are a red light test. Testing negative doesn’t guarantee that you aren’t carrying the virus, but testing positive means there’s a good chance you are. If a rapid test result comes in as positive, a PCR test would be used to follow up.

Colorado provides a very practical solution: Anyone can order a box of 5 rapid tests for free, weekly, from the state. It’s really that simple.

Why aren’t we funding this?

No seriously, why not? As of December 11, 2021, the federal government has shipped about 81 million tests to the provinces. So about 2 tests for every person in Canada. 

Only 15 million of these tests have actually been used. So 2 in 5 people have received a test, statistically speaking. Of course, some may have had more than one test so the number is deflated even further.

This far into the pandemic, that’s it. Less than half of the population has gotten even 1 rapid test.

Earlier on in the pandemic, this was justifiable. The main argument against mass rapid testing was availability. There simply weren’t enough to go around so the tests needed to be rationed and used in a targetted manner.

Over a year and a half into the pandemic, this is simply no longer the case. Rapid tests are widely available (as mentioned earlier in this article) and could even be mass-produced in Canada. There isn’t an excuse anymore. 

We could simply send a handful of rapid tests to every household in Canada over the holidays. Merry Christmas, from science. 

Government response (to the interests of capital)

Thus far, it is fair to say that Canada’s strategy around rapid testing has been focused on preserving capitalist interests, while workers’ interests have been cast aside.

The federal government admits that rapid tests “can be used as a screening tool to help protect workers, families and communities while helping keep workplaces safe and the economy running.” In the same news release, they seem to have chosen the side of keeping the “economy running.”

“More than 2000 local pharmacies have registered to distribute rapid antigen tests to small and medium-sized businesses and non-profit organizations,” announced Patty Hajdu, Minister of Health. Nothing geared toward workers or the community at large. It seems the federal Liberals are committed to keeping the capitalist wheels turning, at all costs.

Given this short supply of such a crucial layer of protection, especially in the face of a looming Omicron surge, the provincial response has been varied but lacking. 

Prince Edward Island leads* Canada at 232k rapid tests administered per 100k of its population. So just over 2 tests per person in the province. Nova Scotia is next at about 117K per 100K. This is throughout the entire pandemic, mind you.

Ontario, Northwest Territories, Saskatchewan, New Brunswick, and Alberta range between 40k and 66k per 100k tests administered.

In last place, British Columbia, Newfoundland and Labrador, and Quebec remain below 6500 per 100k. Manitoba, Yukon, and Nunavut don’t even keep track.

It’s safe to say that Canada’s rapid test strategy is severely under-utilized, especially as new variants such as Omicron emerge. While the data is still emerging regarding Omicron, preliminary data suggests that it may be milder, but much more transmissible than Delta. If true, the sheer speed at which it travels could cause significant, unnecessary amounts of death.

Canada needs mass rapid tests now. Vaccines and mandates have made a significant amount of progress in combating Covid-19 thus far, but it simply isn’t enough. New variants are emerging around the world, and the pandemic is likely to continue into the near future. 

Although not a silver bullet, like masks, rapid tests could be another layer of protection in the fight against Covid-19.

*Note: Data from federal government rapid test distribution and provincial populations. Sorted by tests/100k

ProvincePopulationTests UsedTests/100K
Manitoba1369000Not AvailableNot Available
Yukon35874Not AvailableNot Available
Nunavut38780Not AvailableNot Available
Prince Edward Island156947365140232651
Nova Scotia9713951139817117338
Northwest Territories448262039045486
New Brunswick77682732590441953
British Columbia50710003144686201
Newfoundland and Labrador521542257454936

2 responses to “Omicron is here, and Canada needs to revamp its rapid testing strategy now”

  1. […] Mass screening campaigns, N95 face masks, early booster rollouts, and swift, strong restrictions could have helped blunt the blow of Omicron, but our federal and provincial governments didn’t act. […]

  2. […] It was known early on in the pandemic that high-quality N95 masks would be an essential tool to hold off outbreaks. Same with rapid tests. […]

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