If tests are unwanted, then provinces should return
Time for some rapid logic to enter equation
‘Trust public health experts,” as an ethos — a pretty reasonable one, usually — has taken quite a kicking in North America over the past 12 months. And rightly so. There are days when I wonder how it can survive the pandemic.
Jan. 25 was such a day, when the sainted dr. Anthony Fauci said it’s common sense two masks would be more effective than one. And it is. but that was only nineand-a-half months after another such day, when Fauci told us one mask might be worse than none. Which was ridiculous (and which the hardcore anti-mask wackosphere quotes to this day). Then there was June 12, the day Fauci admitted he exaggerated his concerns about masking to protect PPE supplies for front line healthcare workers.
We went through the same basic narrative arc in Canada. It’s going to leave a serious mark on public trust.
Then there was Wednesday, when CBC News managed to quantify the provinces’ well-known failure to roll out, or even try to roll out, rapid antigen tests. With every province save Saskatchewan reporting back, it seems only 11 per cent of 12.5 million tests distributed to the provinces beginning late last year have been administered.
Ontario, whose Premier doug Ford was among the loudest rightly demanding such tests be approved and procured, leads the way at a not-so-impressive 18.5 per cent. Alberta, whose Premier Jason kenney was just as loud, is in last place at less than one per cent.
Quebec wants nothing to do with these tests, despite opposition pleas to roll them out as a screening tool in high-risk environments — which is precisely what they’re for. “especially in the second wave where we have been able now to test 35,000 to 40,000 (people) a day and even more than that, we don’t need additional tests,” Health Minister Christian dubé sniffed last month.
In the week ending Thursday, Quebec tested fewer than 29,000 people a day.
According to data compiled by journalist Nora Loreto, 38 long-term care homes in Quebec have seen more than one-third of their residents die. keeping the coronavirus out of long-term care homes, or stopping it before it runs riot, is one of the great hopes for rapid tests. In Germany, some facilities have been testing their entire staff before every shift for months now. The mortality rate in German long-term care homes is less than one-quarter of what it is in Canada’s, despite Germany’s overall death rate being 40 per cent higher. Perhaps they’re on to something?
Schools are another obvious place to roll out as much rapid-screening testing as possible, because children tend to have mild or no symptoms and are thus difficult carriers to detect otherwise. retail, food processing or any other potentially risky environment makes sense. Pick some environments, ship the tests. With a modicum of organization, there is literally no downside.
False negatives are the biggest knock against rapid tests: Health Canada rates Abbott’s Panbio COVID-19 rapid Test device (which was distributed to the provinces) at 91.4 per cent sensitivity, versus 100 per cent for some of the lab-processed PCR tests. but a false negative is no worse than no test. Finding even one per cent positivity among a previously untested asymptomatic population — as Slovakia did when it tested its entire population in October — can make a huge difference. Many top medical minds, including some who were initially skeptical, have been arguing passionately for this for months. This is not a concept that needs proving. And yet, here we are.
“The challenges we have are that they’re not as sensitive, so they don’t pick (up) certain things,” dr. bonnie Henry, british Columbia’s health officer, said in November. “We’re still needing to study how much would COVID be missed by tests that are falsely negative,” dr. Vera etches, Ottawa’s medical officer of health, echoed. “If people use a ... negative test as a free pass to do risky activity over the following week that would actually make the situation worse,” Alberta Chief Medical Officer of Health dr. deena Hinshaw warned last month — a concern literally no one seems to have about negative PCR tests. On Wednesday, b.c. Premier John Horgan described the Panbio test as one that “may or may not be accurate.”
It’s as if they don’t even understand the basic concept at hand. What’s an 8.6-per-cent false negative rate against the nearly 100 per cent of asymptomatic cases that go undetected because asymptomatic people can’t get tested in this country unless they’ve had a known exposure? Ottawa’s 20-million rapid-test orders aren’t enough to make a huge difference, but they’re more than enough to leave a dent. The situation is bewildering.
If the provinces don’t want them, perhaps they might at least give them back to Ottawa. (Fat chance.) As you may have noticed, Ottawa woke up one morning recently having caught a fullblown case of border Fever: at some point soon, we are told, all arriving travellers will be locked up for three days at massive expense, to await the results of COVID tests.
As I argued earlier in the week, one gaping epidemiological hole in this plan as a bulwark against new COVID-19 strains is the Canada-u.s. border. roughly 400,000 Abbott kits a month would let us rapid-test every single truck driver entering the country and intervene as necessary.
The roughly more than 10 million tests the provinces are sitting on could cover at least two years at that rate. It’s certainly not where I would direct a scarce resource, but it would do infinitely more good than leaving them in a warehouse while provincial experts stroke their chins and stare into the middle distance.
THE NARRATIVE ARC CONTINUES TO HARM PUBLIC TRUST.