Canada 'grossly underutilizing' rapid tests, experts warn — even as COVID-19 cases tick up

Across Canada, there’s patchwork access to rapid COVID-19 tests, even though the country has millions of the devices. With cases rising this winter, medical experts say more Canadians should have those tests in hand.

94 million rapid tests purchased by Ottawa, yet many Canadians face limited access

Across Canada, there’s patchwork access to rapid antigen tests, even though the country has millions of the devices. (CBC/Radio-Canada)

When Dr. David Juurlink joined some friends for dinner in the U.K. during a September vacation, he was surprised to learn they had a stockpile of rapid COVID-19 tests at their home. Hundreds, in fact — all provided for free by British public health officials.

Those friends gave Juurlink's family a few tests to bring back to Toronto, while other friends overseas later sent him another 14 from their personal trove.

"We've kind of treated these things like gold," he told CBC News. "Because it's been so hard to get them otherwise."

Across Canada, there's patchwork access to rapid tests, even though the country has millions of the devices on hand. In certain provinces, affordability remains an issue.

While some jurisdictions are handing the tests out broadly, others are using them primarily for schools and businesses — all while the general public can't easily add this extra piece of protection to their pandemic toolkit.

Multiple medical experts who spoke to CBC News said with temperatures dropping and indoor gatherings growing more frequent in the holiday season — and given concern over the delta and omicron variants — more Canadians deserve easier access to rapid testing.

WATCH | Ontario physician describes experience trying to get rapid COVID-19 tests:

Ontario physician describes his experience trying to get rapid COVID-19 tests

8 months ago
Duration 2:30
Ontario physician Dr. David Juurlink shared his family's experience with rapid COVID-19 tests, from paying for one in Canada for $40 to getting multiple free tests from friends overseas -- an experience that made him question why many Canadians have such limited access to at-home tests.

Juurlink, a toxicologist at Sunnybrook Health Sciences Centre in Toronto, acknowledged the tests aren't perfect or foolproof, but said they make up for that in their speed and convenience. 

"If you could go to your bathroom medicine cabinet, open up a test, put a small swab in your nose, and within 10 or 15 minutes know whether or not you pose a risk to others — I mean, just imagine how much easier that would be to do," he said.

80 million tests sent to provinces, territories 

Unlike the polymerase chain reaction (PCR) tests offered at hospitals and other health-care settings, which are considered the gold standard in testing, rapid antigen tests offer a quick way to detect a coronavirus infection.

While the highly sensitive PCR tests are sent off for lab analysis and typically take at least a day to provide patients with results, rapid tests are a bit like an at-home pregnancy test: A do-it-yourself version that shows results in around 15 minutes.

To get a cross-country picture of rapid-test usage, CBC News reached out to the federal government and each province and territory, finding various regions are providing these tests only to certain segments of the population.

"In general, in Canadian settings, we're still grossly underutilizing these," said Dr. Isaac Bogoch, an infectious diseases specialist in Toronto. "These are cheap, easy-to-use tests that can really drive smart behaviour."

The federal government has purchased more than 94 million rapid tests as of Nov. 30.

Of those, nearly 80 million have been sent to the provinces and territories, according to government data — but millions haven't actually been used yet by Canadians, the same figures show. 

Provinces distributing tests differently

"While each province and territory decides how to test their residents, they're guided by a common, national approach to testing," a Health Canada spokesperson said in a statement.

That national approach includes making sure long-term care homes, schools, vulnerable communities and other sectors have access to rapid tests.

And in most provinces, those are the areas where rapid tests have been distributed. 

Nova Scotia gave out free at-home tests to families of kids in pre-primary to Grade 6 public schools, and P.E.I. is offering the tests to families with school-age children who cannot yet be vaccinated.

In Alberta, families can get free rapid tests at K-6 schools if there is an outbreak, while in Quebec, they are used in primary schools if a child develops COVID-19 symptoms or on children in a classroom after a kid tests positive, according to their health departments. And as of Monday, Quebec also began distributing rapid tests to parents with kids in public or subsidized daycares.

At least five of the provinces are also offering rapid tests to businesses that apply through provincial programs. There's also the federal government's rapid-test program for businesses and not-for-profits.

WATCH | How rapid COVID-19 tests work:

The advantages, challenges of rapid, at-home COVID-19 tests

10 months ago
Duration 2:36
Rapid antigen tests for COVID-19 aren’t as precise as PCR tests, but are faster and more convenient and there’s a growing push to make the tests more accessible so Canadians can do at-home testing.

Participating pharmacies in Alberta, Manitoba, Saskatchewan and Ontario are also able to distribute rapid antigen tests to small and medium-sized business owners through a federal program. Some pharmacies in certain provinces are also offering a rapid test for a fee to those who meet the criteria.

In B.C., non-profits, charities and Indigenous community organizations are also receiving free tests through the Canadian Red Cross, according to the provincial health department, while in Ontario, free rapid antigen test kits are available to high-risk communities, organizations and workplaces, with pop-up sites planned for the weeks ahead.

In that province, medical professionals have been ringing alarms that broader access is crucial, as COVID-19 cases are rising, the omicron variant is spreading, and more people are set to gather indoors over the winter holiday season.

Birgit Umaigba, a Toronto-based registered nurse working in intensive care, said the roughly $40 cost to get a rapid test at some Ontario pharmacies is prohibitive, and questioned why more tests aren't being doled out to the general public from the province's stockpile. 

"As an ICU nurse, we're seeing more patients with COVID coming to hospitals," she said. "It's paramount that the government takes proactive measures to provide free tests to families."

While PCR tests are considered the gold standard in COVID-19 testing, experts argue rapid, at-home tests can offer an added layer of protection, alongside other precautions. (Tatyana Makeyeva/Reuters)

Broader access in N.B., N.S. and Sask.

In some provinces, the tests are already being offered more broadly. 

In New Brunswick, Nova Scotia and Saskatchewan, people can access tests for free by getting them at public places like health centres, pop-up testing sites or libraries. Nova Scotia is also offering rapid tests to incoming travellers at the Halifax airport. 

Experts say there's a lot of value in making these tests more widely available.

"There's still a lot of discussion in some corners of professional and governmental agencies in Canada about whether or not it's 'worth it' or important to do no-symptom or few-symptoms rapid tests for and by people themselves," said Dr. Lisa Barrett, an infectious disease specialist and a member of Nova Scotia's Vaccine Expert Panel.

"I think we've probably pretty much shown in Nova Scotia, in addition to other health measures, that it's not a waste and that it is important in early detection and management of folks who have low-symptom infection."

WATCH | Canadians need better access to rapid COVID-19 testing, experts say:

Experts call for expanded rapid COVID-19 testing nationwide

8 months ago
Duration 2:03
Access to COVID-19 rapid tests varies across Canada, and as Ontario promises expanded access, experts say the whole country should make the tests more readily available.

The differences in how people in Canada can access tests also differs from other countries.

In the U.S., the tests are found on some pharmacy shelves. Germany also has widespread adoption of the tests

Consider rapid tests an extra layer of protection

Juurlink said there's a striking contrast between how those other countries are handling test distribution and what many Canadians are experiencing.

"There will come a time when these tests are widely available, and inexpensive or free," he said. "And I think it will be important to educate people, not just how to use them … but when to use them. But again, the first step is getting them ready to be delivered to homes."

Canadians who do get their hands on rapid tests should consider them an added layer of protection alongside other precautions, Bogoch said. They're best used right before a family gathering — not days before an event, he added, and anyone who does test positive should stay home, isolate and still get a PCR test to confirm the results.

"It's important for people to remember that rapid tests basically address the question: Am I contagious to other people with COVID-19 at this moment: yes or no?" he said.

"That's the whole point: rapid tests are rapid. They're only as good as when you do them."

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