Should rapid testing for coronavirus be used at airports and borders?

Click to play video: 'Experts call for better virus screening at land borders' Experts call for better virus screening at land borders
B.C. Premier John Horgan has announced strict new measures to help slow the spread of COVID-19, as questions are raised about the lack of testing at land borders, and the potential for terrorist groups to weaponize COVID-19. – Apr 8, 2020

The new coronavirus pandemic has halted nearly all travel between Canada and the United States, but thousands of essential workers, such as nurses, doctors and truckers, continue to cross the border on an almost daily basis.

While people entering Canada are asked if they feel sick and are observed for signs of illness, Canada’s screening measures for COVID-19 at airports and border crossings do not include actual testing.

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The frequency of travel between the two countries — especially between Windsor, Ont., and Detroit, Mich., which has become an epicentre for the global outbreak — has caused some local health officials to worry.

This includes Dr. Wajid Ahmed from the Windsor-Essex County Health Unit, who earlier this week asked health-care professionals working on both sides of the border to choose between Canada and the U.S.

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READ MORE: No public health officials screening for COVID-19 at Canadian land borders

Ahmed said he’s not sure about the effectiveness of testing for COVID-19 at the border, but he has heard “spot tests” could be introduced as part of the government’s enhanced screening measures.

Global News asked the Public Health Agency of Canada (PHAC) and the Canada Border Services Agency (CBSA) if rapid testing would be deployed at international points of entry, but neither agency responded to questions.

Rapid testing delivers fast results

As of Thursday, Michigan had 21,504 confirmed cases of COVID-19 and 1,076 associated deaths. Ontario, which has four million more people, had 5,759 confirmed cases and 200 deaths.

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Rapid diagnostic machines — produced by five companies in Germany, the U.S. and Canada — use a DNA-based detection system similar to that used in traditional testing, but tests can be done almost anywhere and results are available in as little as five minutes, according to American manufacturer Abbott Laboratories.

Spartan Bioscience, an Ottawa-based company, said its rapid testing device, which is awaiting Health Canada approval for detecting COVID-19, is intended for use at remote locations, including airports and border crossings, Spartan’s CEO Paul Lem said.

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Unlike laboratory testing, which requires trained technicians to complete the tests, rapid testing machines use cartridges with pre-packaged chemicals and are designed specifically for people with little to no medical expertise.

“There are controls built in with every test cartridge that you run,” Lem said. “It’s pretty hard to screw up.”

In March, Canada’s minister of innovation, science and industry, Navdeep Bains, said the government plans to use Spartan’s rapid testing technology to detect COVID-19. Bains said he is hopeful the company’s device will provide reliable test results in just 30 minutes, compared to the days it can take when testing is done at a lab.

“If successful, its diagnostic platform and COVID-19 test could be used in airports and in clinics,” Bains said.

Rapid testing ‘part’ of the solution

The Canada-U.S. border was closed to all non-essential travel on March 20. This includes air and land travel.

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According to data released by the CBSA, roughly 478,000 people entered Canada in the two weeks after border restrictions were implemented. About 65 per cent of travellers entered Canada through a land border.

READ MORE: Ontario reports 478 new coronavirus cases, 22 deaths as total cases top 6,200

Dr. Amesh Adalja, an infectious disease specialist at the Johns Hopkins University Center for Health Security, said rapid testing for COVID-19 could be used as part of the screening measures in place at airports and borders. He said this would likely result in positive tests due to the number of people being tested.

But Adalja is cautious about testing measures targeting airports and borders because he fears this could lead to a “false sense of security” and create the potential risk for scandal if someone tests negative in the early stages of the illness and is later found out to be positive.

“Imagine somebody aboard a 19-hour flight between New Jersey and Singapore,” he said. “They test negative in New Jersey, but then 14 hours later they could be positive. So it’s not going to be ironclad.”

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And while Adalja understands why people might want to see rapid testing deployed at airports, he believes the millions of dollars it would cost to implement these systems might be better spent elsewhere.

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Boosting testing capacity at existing labs or dedicating more resources to contact tracing for people who test positive would likely have a bigger impact on reducing transmission rates, he said.

But Adalja isn’t opposed to rapid testing altogether. He said using devices like the one designed by Abbott would increase screening efficiency and produce better outcomes for patients because they’d get results sooner.

Screening at airports and land borders

Anyone who enters Canada, whether by land or air, is asked if they feel ill, have a cough or a fever. Travellers are also observed for physical signs of sickness.

The CBSA’s screening measures require anyone who is sick or displays symptoms consistent with COVID-19 to be given a mask and provided instructions on mandatory, 14-day isolation requirements, plus restrictions on how they travel home, such as not being allowed to use public transport.

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At airports, travellers who appear sick are directed to on-site PHAC officials for additional screening. But as Global News reported Wednesday, there are no public health officials currently stationed at land border crossings.

When someone appears sick at a land border, the CBSA will contact a PHAC quarantine officer by phone. The officer can then conduct an assessment and may order the traveller to undergo a medical examination.


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