National Post (National Edition)
Canada among top world performers in testing for COVID-19
In this age of the pandemic, it’s a hot commodity.
Canadians have lined up, driven up and in some cases waited for hours in recent days to try to get a test for the virus that causes COVID-19.
“Most of them are sick. The symptoms are a fever and a cough,” said Dr. Danielle Martin of the assessment centre at Women’s College Hospital in Toronto. “Many of them look like people who have a bad cold.”
A good proportion across the country have also left frustrated that they didn’t qualify to be swabbed, while doctors report that there are definite gaps in the system.
But the data suggest testing is actually a relatively good-news story amid the anxiety over COVID-19. Canada is screening for the novel coronavirus more widely than many countries in the world, and at a far greater rate per capita than in United States.
The latest figures available Monday indicated 34,000 had been swabbed for traces of the pathogen across the country, compared to 23,000 tests in the U.S., which has 10 times the population and number of COVID-19 cases.
Test kits do not seem to be in short supply at this point, said Martin, an executive vice-president at Women’s College.
“Would it be better if we could offer rapid testing more widely?” said Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta. “Yes, but we have to acknowledge the superior work that’s been done already.”
“What I’ve seen over last few days is a much more co-ordinated response than last week or two weeks ago,” Dr. Gigi Osler, president of the Canadian Medical Association, said in an interview Friday.
Saxinger has benefited herself from screening, after coming down with fever and cough after a trip to the U.S. Her test was negative, but she’s in quarantine until the symptoms are gone.
Testing is considered a key tool in combating the pandemic, giving public-health authorities intelligence on how and where the virus has spread, and what action they should take in response.
Tedros Adhanom Ghebreyesus, the World Health Organization’s director-general, made a forceful case Monday for countries to do more screening, suggesting they swab everyone suspected of having the disease.
“You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected,” said Tedros. “We have a simple message for all countries: test, test, test.”
It’s unclear whether Canada’s approach would meet his standards. Criteria vary from province to province, but tend to require that people have a combination of symptoms — one or more of a new cough, fever or trouble breathing — and a risk factor, like recent international travel or contact with someone infected with COVID-19.
B.C. said Monday it is testing anyone with respiratory symptoms who is hospitalized, lives in a nursing home, is a health-care worker or part of a cluster or outbreak of cases.
The guidelines are certainly leaving some ill people disappointed. Martin’s centre swabbed about twothirds of those who showed up Monday, but at other screening locations, the percentage has been lower.
“I think the most common issue I hear is people feeling frustrated with the current test accessibility, which in most places requires symptoms plus a defined exposure history,” said Saxinger. “In an ideal world we would test everyone with clinical features; it would reduce a lot of stress to know you have a common, less serious virus.”
Dr. Bill Cherniak, an emergency physician at Markham-Stouffville Hospital north of Toronto with a Master’s in public health, said he would like to see more liberal use of screening, if resources allowed it.
“I can’t see any harm in identifying positive cases of the virus, because knowledge is power,” he said. “If you can (isolate) those who are positive … you can keep everyone safe.”
In fact, guidelines could soon change if the virus spreads more widely within the community, said Martin. That could mean lifting the requirement in many places that someone has been outside the country or in contact with an infected person, she said.
Doctors say the independent screening sites provinces and hospitals are setting up are essential, helping prevent COVID-19 patients infecting others. But there’s still a lack of such centres in smaller and rural communities, said Dr. Alan Drummond, a spokesman for the Canadian Association of Emergency Physicians.
Small emergency departments have to do the tests instead, “exposing vulnerable patients in the waiting room, immune-compromised cancer patients, diabetes patients, congestive heart failure people, who are at risk should they develop COVID-19,” he said.
Said Martin: “From where I sit at the hospital front line, I think we’ve got a lot to be proud of.”