Deploying millions of stockpiled unused tests to asymptomatic individuals working in high-contact environments – such as health care and senior care – could save lives among those most at risk from COVID-19.
Canada’s testing and screening for COVID-19 has so far been broadly mediocre. Grand promises have consistently led to lackluster results such that, to date, Canada has conducted just half of the COVID-19 tests per capita performed in the UK or the US. Many were baffled last month as news broke that Quebec has had nearly 1.3 million rapid COVID-19 tests warehoused and collecting dust even as the number of cases and deaths steadily marched on. In fact, across Canada, as of mid-November, an estimated 3.8 million unused tests were in storage while bureaucrats debated how to use them.
Those same bureaucrats might point to federal regulations requiring tests only be used on symptomatic patients leaving the likely much larger number of asymptomatic, yet still contagious, carriers to continue spreading the virus to the most vulnerable. Those bureaucrats might also blame Health Canada’s delays in approval from testing, to treatments, to vaccines.
Meanwhile, caregivers worry about unwittingly infecting their at-risk patients. The CEO of SafeCare BC reported that “staff are currently living in fear that they could bring COVID-19 into the care home, or home to their families. This is a huge mental health burden that our health-care workers shouldn’t have to bear.”
This bureaucratic foot-dragging is emblematic of the government’s response to COVID-19. More precisely, the one-size fits all policies that remain unresponsive to new data and new facts on the ground. After all, it may have made sense to hoard tests early in the pandemic when there was a shortage, but today, those millions of tests collecting dust could be used for heading off precisely the deadliest type of outbreak, that is those that occur in senior homes and similar care environments.
We’ve seen a similar problem with lockdowns, where early decisions made with imperfect information were frozen in amber by bureaucratic inertia. Namely, had we known how starkly COVID-19 discriminates by age and morbidity – with the average age of an excess COVID-19 death in Canada being over the age of 85 – then we might have focused far more resources on senior centres and preventing hospital transmission, rather than sending home preschoolers or paying construction workers to stay home. With such smarter “targeted” intervention, we might have saved many more lives with far less social and economic devastation, ranging from mass unemployment and bankruptcy to an epidemic of drug overdose, depression, and even suicide.
Instead of inflexible rules that dissipate limited resources, we need focus: a careful assessment of where restrictions have the most impact, and where rapid testing can be best used to fend off outbreaks. This could mean, for instance, a concentrated effort to deliver plentiful rapid tests on a regular schedule and regardless of symptoms, to caregivers and health care workers interacting with the elderly or most at-risk.
This targeted mass testing could be paired with testing of asymptomatic elderly or vulnerable patients, to head off peer-to-peer transmission. By deploying these tests in a focused manner, they could do the most good as soon as possible, rather than continuing to collect dust awaiting their deployment.
We all want government responses that are flexible and responsive to changing realities. With such widespread need across Canada, we cannot waste any more time with scattershot approaches, outdated data, or fighting yesterday’s wars in terms of resource constraints. Targeted mass testing of those in sensitive positions interacting with the vulnerable can ward off the deadliest outbreaks before they get out of hand.
Peter St. Onge est chercheur associé senior à l’IEDM. Il signe ce texte à titre personnel.