Federal panel recommends rapid COVID tests in long-term care; B.C. still reluctant

The co-chair of a federal advisory panel whose job is to provide guidance to the federal government and the provinces on COVID-19 testing and screening says B.C.’s provincial health officer is correct to say that rapid tests are not always as accurate as PCR tests, which take longer to return results.

But Sue Paish said that’s not a reason not to deploy them, especially in high-risk settings like long-term care homes, in conjunction with other testing strategies and “layers of protection.”

“One of the things we heard a lot at the testing panel is that ‘perfection is the enemy of the good,'” she said.

“Rapid tests are not as accurate as PCR testing. However, there’s lots of evidence to show that when rapid tests are deployed on a consistent basis and when positive results are then confirmed with a PCR test, we can identify people who may be infected but be asymptomatic.”

Paish co-chairs the Testing and Screening Expert Advisory Panel, which presented a report to the federal government last week recommending that rapid tests be deployed to high-risk settings.

“Settings where there may be lots of people, or where there’s regular engagement between people such as in a long-term care home, especially among the staff,” she told Global News.

“And some of these rapid tests are quite easy to deploy and can be used and deployed without the need for a doctor or a nurse. And again, other provinces have used other health care professionals, whether it’s pharmacists or others, to administer these tests.”

B.C. provincial health officer Dr. Bonnie Henry has said she’s reluctant to start using rapid tests in long-term care homes in the province, calling them ‘cumbersome’ and ‘time-consuming,’ and raising concerns about their accuracy.

That’s based off of a pilot program that launched in December, with rapid tests being used at five long-term care homes.

1:49 BC Care Providers Association repeats call for rapid testing

B.C.’s testing strategy has also focused thus far on testing people who are showing symptoms only.

The BC CDC testing guidelines say testing is not recommended for people who do not have any symptoms of COVID-19, even if they are a contact of someone who has tested positive.

But Paish said research that’s come out in more recent months has found asymptomatic transmission of COVID-19 to be a real concern.

“We believe that maybe up to 40 per cent of people who have the virus may be asymptomatic. We didn’t know that 11 months ago,” she said.

“And so having asymptomatic testing through a rapid test or rapid screening program can be very, very helpful because then you can streamline and stratify, who goes in for PCR testing.”

While the BC CDC website does not mention asymptomatic transmission under a COVID-19 information page called “How it Spreads,” public health experts in the United States including Dr. Anthony Fauci have been saying since at least September that up to 40 per cent of transmission could be asymptomatic.

Paish said she understands that public health officials don’t want to bog down PCR testing resources by sending everyone who may have been exposed to COVID-19 for a test.

However, she said that makes the case further for deploying rapid tests to outbreak settings.

“What’s important is that we need to balance the stress and the pressure on the health, human resources with the need to catch this virus, especially in asymptomatic, asymptomatic cases, so that we can limit outbreaks before they become explosions,” she said.

“And so I think we’re learning as we go that when we see an outbreak deploy testing as quickly as possible to every person in the institution and then make sure that they’re isolated to make sure they’re supported, if they are positive, so that they can not infect others perfectly.”

Representatives of the long-term care sector have been calling for weeks for B.C.’s pilot program to be expanded.

Terry Lake, CEO of the BC Care Providers Association, told Global News on Tuesday that the province already has access to 1.3 million rapid test kits purchased by the federal government, and that they would add an additional layer of protection.

As for Dr. Henry’s comments that the rapid tests are cumbersome, and deploying to long-term care homes would be unrealistic, Paish said that perspective was news to her.

“We did brief all provinces, both at the public health officer level as well as as well as the administrative leadership in ministries of health across the province. We didn’t hear those comments when we were consulting,” she said.

“All I can say is that the evidence that we heard from over 80 professionals and experts that we heard from in our panel consultations is what provided the basis for the recommendations that we’ve made, and the evidence that we see both in Canada and jurisdictions around the world.”