As novel coronavirus cases rise globally, along with deaths, developing a rapid test for COVID-19 is one of the key areas that researchers in Canada and around the world are targeting.
Experts have said widespread testing is necessary because it allows for better management of an outbreak. The British government, for instance, bought 3.5 million antibody testing kits from various suppliers in late March, with the intention of making sure they work before distributing them.
“The sooner you know if someone’s positive or negative, then the more infection control and outbreak control you can put in place,” said Dr. Anna Banerji, an associate professor at the Dalla Lana School of Public Health at the University of Toronto.
“Because in that time period, when someone may not be sure, they could be potentially spreading the virus. I think people practise more infection control when they know that someone has a condition.”
World Health Organization director-general Dr. Tedros Adhanom Ghebreyesus has also urged this: “You can’t win a football game by defending, you have to attack as well.”
Countries must “test, test, test, test” in order to know who is infected and who needs to be isolated, he said earlier this month.
As of March 28, more than 184,000 people in Canada had been tested at provincial and national labs across the country. The total number of confirmed cases across the country have exceeded 5,500, with 61 deaths and 472 recoveries. But getting tested can be slow, with more than 8,600 people in Ontario still awaiting test results as of March 28.
Canada’s chief public health officer Dr. Theresa Tam has previously said testing centres have to “be smart” about who they test, due to supply issues.
Testing in Canada has been slow in getting set up, but Banerji said she expects it to increase.
“I expect in the next few weeks that the testing will be a lot more streamlined,” she said in a recent interview with Global News.
Current testing for COVID-19 in Canada varies by jurisdiction, according to infectious disease expert Dr. Alon Vaisman.
In Toronto, University Health Network’s lab has a “fairly good” turnaround time of less than 24 hours, sometimes shorter, he said. But more remote areas might have a longer turnaround time. So it depends, he said.
“But in the places where they’re doing it rapidly and efficiently, it could be even as short as less than 12 hours, actually,” Vaisman said.
A rapid point-of-care test for COVID-19 would be “great,” he said. But until it’s published in a peer-reviewed journal, “it’s hard to know what exactly is the reality.”
Point-of-care testing is essentially “medical diagnostic testing performed outside the clinical laboratory, at or near, where a patient is receiving care,” according to the College of Medical Laboratory Technologists of Ontario.
It may or may not be carried out by lab personnel, with the results used for “clinical decision making.”
Point-of-care testing exists for HIV, for instance, where a nurse can draw a sample, place it in a testing tray and run the test right then and there, Vaisman said.
“It would help hospitals make decisions regarding isolation and movement of patients and treatment,” he said. “So it’d be a pretty significant development.”
Developments in Canada
Canada has allocated millions in research dollars towards the new coronavirus, including a rapid point-of-care diagnostic test for the “quick isolation of those infected.”
Federal Health Minister Patty Hajdu signed an interim order around mid-March to expedite access to two new diagnostic tests to allow provincial labs to speed up testing.
The government’s plan to mobilize industry has also tapped into an Ottawa firm called Spartan that makes diagnostic equipment. The company has signed a letter of intent with the federal government.
Spartan is developing a portable device that could provide rapid COVID-19 test results, according to a statement by the Prime Minister’s Office.
The firm is in “discussions” with Health Canada as well as the U.S. Food and Drug Administration for approval for the device, which could provide results within 30 minutes. A commercial test could be eight to 12 weeks away, according to Spartan.
“There’s a portable DNA analyzer, so you take that swab sample, you put it in the cartridge, the cartridge goes into the device and then it gives you results,” Spartan CEO Paul Lem told Global News Radio.
It’s a diagnostic test that can detect infection in a person, and could be used in health-care facilities, community centres, airports or border crossings, he said.
Around the world
From Ireland to Japan, there have been new developments in recent weeks when it come to rapid tests for COVID-19.
For instance, an Irish company called Assay Genie says it has a rapid test for COVID-19.
“Using a rapid COVID-19 test can identify more people who do not know they have been infected,” the website says, describing the test as for research use only.
A disclaimer adds: “While we believe this kit is to be an effective indicator of infection, we cannot guarantee 100% accuracy.”
Company co-founder Seán Mac Fhearraigh told Global News the rapid point-of-care test would use a drop of blood. The company began working on the test kits as soon as they heard about the new coronavirus, which first appeared in Wuhan in December 2019.
“We can see that every health-care system is under a terrible burden at the moment,” he said. A rapid test for COVID-19 could mean quicker decision-making for nurses and doctors.
He says the test kit detects an immune response, and that the company is starting to test with a hospital in Ireland this week.
“Say we have an incredibly sick person,” Mac Fhearraigh said. “You have a fast result, 15 minutes, we can say: ‘Go isolate first for the six or seven hours that it might take to get a test result by the traditional method.'”
In the U.S., two rapid tests were recently approved by the U.S. Food and Drug Administration.
One developer, Cepheid, received emergency use authorization from the U.S. FDA on March 21 and says the tests, with an approximate detection time of 45 minutes, will be shipped for use in hospitals.
The second, Abbott Laboratories, says its tests can give results within 15 minutes.
Researchers at Oxford University have touted a rapid COVID-19 test. The university’s engineering science department has teamed up with the Oxford Suzhou Centre for Advanced Research (OSCAR).
The university says the new test is “much faster” — with results in just half an hour — and negates the need for a complex instrument. Researchers there are arranging clinical validation trials soon.
— With files by Reuters, Global News reporter Leslie Young