Is it the beginning of the end of COVID-19 testing?

One expert says this is the beginning of the end of COVID-19 testing as we know it, while another suggests testing is here to stay in the long run.

While Omicron has hurt access to PCR testing, we could still see expanded capacity, one expert says

COVID-19 testing strategies across Canada have shifted in recent weeks due to Omicron's rapid transmissibility. Some experts say this is the beginning of a permanent shift in testing, while others say testing will remain important as ever. (Jean Delisle/CBC)

Since the earliest days of the pandemic, COVID-19 testing has never been less accessible for the general public — and one expert says the testing tides have changed for the foreseeable future.

"This is the beginning of the end of testing as we know it, or as we've seen it before," said Brenda Wilson, a public health physician and dean of community health at Memorial University of Newfoundland.

Wilson, who was a member of the federal government's former COVID-19 Testing and Screening Expert Advisory Panel, noted jurisdictions across North America are changing rules on widespread testing for COVID-19.

In Ontario, publicly funded PCR testing has been strained since before the holidays, and the government has since announced only priority groups will get tested.

"We have shifted pretty much to a much more selective testing," said Wilson. "With Omicron being so incredibly transmissible, and having spread to so many people, there's really no way that any of the health system can keep up with ... the way we've done it so far."

Though it depends on whether new variants emerge and how the disease spreads, Wilson believes there will be a gradual shift to testing fewer people — much like how public health units don't regularly test people for influenza.

This is the beginning of the end of testing as we know it, or as we've seen it before.- Brenda Wilson, Memorial University of Newfoundland

She says main indicators for COVID shifted from "who does and doesn't have [COVID]" to its impact on the health-care system.

"As this pandemic comes to an end, as we move into living with COVID and whatever endemic COVID is, I think we will see less and less testing," she said.

With less focus on PCR testing, health units and labs are able to redirect personnel and resources to other needs, she added. 

Though not as accurate, Wilson said individuals will rely more on rapid tests when seeking information on their health. Meanwhile, policy makers who need surveillance of community spread will turn more toward other methods such as wastewater testing.

People wait in line to pick up rapid COVID-19 antigen test kits in Ottawa's Barrhaven community in late December. Think tank CEO Kwame McKenzie says making rapid tests difficult to access will 'bake in inequities' into society. (Blair Gable/Reuters)

Testing not going anywhere, says expert

Kwame McKenzie, the CEO of the non-profit policy think tank Wellesley Institute, says though restricted, Canada is actually conducting more total tests for COVID-19 than ever before in the pandemic.

"People think fewer tests are being done. In fact, more tests are being done. The volume of tests that we're actually doing at the moment across Canada is much greater than it ever was," he said.

The volume of tests that we're actually doing at the moment across Canada is much greater than it ever was.- Kwame McKenzie, Wellesley Institute

McKenzie, who was also part of the federal government's former expert advisory committee on testing, said many factors can change in the near future regarding the PCR testing threshold, and society will still rely on COVID tests over the next few months.

"I would be very surprised if this is the beginning of the end of testing," said McKenzie, noting Omicron has likely infected only a small portion of the population so far.

With schools reopening and people eventually returning to work in person, he believes there will be another significant expansion of COVID-19 testing in the community, including both PCR and rapid tests

"While we've reached the capacity of our testing ... we will still be testing for the foreseeable future," he said.

WATCH | Think tank CEO says testing more important than ever: 

COVID-19 testing crucial for making informed decisions, policy expert says

5 months ago
Duration 1:39
Kwame McKenzie, the CEO of the policy think tank Wellesley Institute, says the availability of COVID-19 testing — whether at-home or PCR — is crucial and gives people the information they need to make informed choices.

He said without accessible testing, people will know less and less about their own health and the impact they have on others around them. 

"As soon as we make these things difficult to get, then we will bake in inequities into the impacts of the pandemic," said McKenzie.

"We're at a disappointing position ... where people can't make free choices about what they need and getting the information they need, in order to protect their health."

Wastewater replaces PCR testing as key measure

Tyson Graber, a scientist and co-lead investigator on the Ottawa wastewater project, says clinical PCR testing is extremely important as part of a pandemic surveillance system, but it is expensive and requires a lot of personnel.

Wastewater testing, meanwhile, is more affordable, robust and sustainable in the long term, he says.

"Wastewater testing might become more kind of this sentinel surveillance mechanism where we can test very efficiently, in other words, large numbers of people all at the same time," he said.

"Hopefully wastewater testing will become more important and clinical testing can be dialled back over the long term, but certainly there's still a need for [clinical testing]."

He did note PCR tests provide information on how the disease affects certain age groups — something wastewater can't.

The group responsible for PCR testing in Ottawa says it will continue to follow criteria set out by Ontario for testing reliability and it won't change course on its own.

"While the role of COVID-19 testing has shifted, that strategy is set by the Government of Ontario. The taskforce is applying that strategy and has not created a separate policy for Ottawa," a spokesperson said in an email.


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