Rapid tests hard to come by in B.C. as testing eligibility further limited

As B.C. strictly limits who is eligible for publicly-funded PCR testing, and take-home rapid tests are being traded and sold online — experts say the difficulties people are having confirming whether or not they have COVID-19 could have consequences.

Tests are now recommended only for those who have symptoms and are either at high risk for serious illness, or who live or work in high-risk settings. Those who are immunocompromised or unvaccinated are eligible, as are those who work in health-care facilities or who live in rural or remote communities. Testing is not recommended for people who have “mild symptoms,” according to the BC Centre for Disease Control’s updated criteria.

Anyone who is not eligible for testing is told to assume they have contracted the virus, and to stay home and isolate until their symptoms resolve.

“Testing has shifted to help identify those who may benefit from treatment to assist them to access early treatment and those who live and work in settings with people at higher risk of serious illness from COVID,” a spokesperson for the BC CDC writes in an email.

Dr. Anna Wolak, a family physician and UBC professor, says prioritizing those who are most at risk of serious illness or hospitalization for testing makes sense, particularly given that people who meet these criteria need a positive test result to be eligible for a recently-approved antiviral treatment.

“It’s almost a principle in medicine where we normally don’t test unless we know that the outcome will change our management,” she tells CityNews, adding there is only a five-day window in which to prescribe the Pfizer antiviral treatment.

“We can’t have people who we think may qualify for Paxlovid waiting for days for the results, because then it’ll be out of the treatment time.”

B.C. has deployed one in four rapid tests received from the feds 

However, questions remain about how B.C. is using the rapid tests sent to the province by the federal government. According to the most recent federal data, B.C. has deployed more than a million of these tests, which amounts to less than 25 per cent of the total received.

“There’s just not a lot of communication about where those tests are going,” Wolak says.

On @CityNewsVAN: it’s been a week since Dr. Bonnie Henry outlined who’d have access to #COVID19 tests. But this does come w/some repercussions. Talking w/those significantly smarter & more well-versed on this to find out what it could mean for the system. @drawolak @sarperotto pic.twitter.com/4rr8Z4eld8

— Ria Renouf (@riarenouf) January 28, 2022

Other provinces have taken different approaches to how they distribute these tests. In Quebec, free tests are available at most pharmacies. In Saskatchewan, they can be picked up at no cost at public libraries. Ontario made the controversial move to make them available at government-run liquor stores.

The province has recently announced plans to send 150,000 to child-care centres, and over 200,000 to K-12 schools so symptomatic staff can test themselves. Higher-risk workplaces like long-term care homes and prisons have also been prioritized. There is also a program called “Safe Screen B.C. that allows businesses to apply to receive tests from the province and launch an employee screening program.

RELATED: Rapid tests ‘underused’ tool in B.C., expert says

But for those who can’t get a test through their employer, trying to track one down is difficult, and the change to eligibility isn’t something Wolak says most people understand.

“I do see a lot on social media, people who, two weeks ago, would have qualified for a rapid test and they talk about going to going to the testing centre and unfortunately they do not meet the criteria anymore,” she says.

“The general population who want to be able to take ownership of their illness, of their health — a lot of that ownership has been taken away … Remember we’ve spent the last two years being conditioned to avoid this virus, and being told ‘As soon as you get sick you need to know if you have that virus so that you stop it from spreading.’ That’s what we’ve been dealing with for the last two years. So to have that rug ripped out from under us — there’s a lot of anxiety.”

In the absence of widely available, free, testing online groups have been started where people can share tips about which pharmacies have test kits in stock. Those groups also offer a way for those who have extra tests to give them to those who want one.

“There’s a lot of crowdsourcing going on,” Wolak says.

Positive test results requested by employers, required to get treatment for long-COVID

She also points out that there are reasons people may need a positive test result. Those who experience “long-COVID’ can’t get treatment or support without providing a positive PCR test result. Wolak says for these people — whose symptoms persist for months — self-isolating and waiting for symptoms to resolve isn’t really an option.

“It doesn’t look at the long term solution for this certain subgroup who may need access to long term care in the future.”

It’s similar for people who have contracted COVID on the job and are trying to make claims through WorkSafe BC. Although test results are not strictly required, a spokesperson says the process of claiming compensation is smoother if they are provided.

“WorkSafeBC policy guides us to adjudicate claims based on the best available evidence. Having test results available may speed up claim adjudication, so ideally test results will be available. However, if not we would consider the available evidence, and weigh that in light of all of the evidence provided by the worker and employer,” says an emailed statement.

On @CityNewsVAN: it’s been a week since Dr. Bonnie Henry outlined who’d have access to #COVID19 tests. But this does come w/some repercussions. Talking w/those significantly smarter & more well-versed on this to find out what it could mean for the system. @drawolak @sarperotto pic.twitter.com/4rr8Z4eld8

— Ria Renouf (@riarenouf) January 28, 2022

Beyond that, Wolak says family physicians are seeing patients asking for notes or tests to confirm cases of COVID after an employer has asked a worker for proof of infection.

“We don’t have access to the tests the same way you don’t.”

RELATED: Saskatchewan man sends family in B.C. rapid tests by mail

The BC CDC says these requests for notes or test results are not recommended by the province.

“Public health does not require a doctor’s note or a test result as part of return to work guidance,” a spokesperson writes.

“There are a number of private pay clinics that offer testing for a fee to people who require asymptomatic testing for reasons that fall outside of B.C. public health recommendations such as for travel or employment.”

More testing would give more clarity on rate of infection, trajectory of pandemic 

Dr. Sarah Otto says data from private workplace testing, used in the film industry, for example, shows 10 per cent of people given a rapid test in these settings had a positive result. Their widespread use, according to Otto, could be effective in limiting transmission.

“This means that people are going to work thinking that they’re not infected and finding out that they are. So that’s the use of the rapid test, it’s to really catch those people, inform them and let them stay home and isolate until they’re clear and not infectious to others.”

She notes the same difficulty finding the tests as Wolak does, saying she’s still waiting for the ones she ordered online more than a month ago to arrive.

“This lack of access makes it just challenging for those of us who want to do a better job of protecting our community or the people around us from knowing whether we’re infectious.”

Making rapid tests available to more people, and including the results of those tests in provincial case counts, Otto says, would help everyone better understand the rate of infection in the province.

“It is also very helpful in terms of planning … for us to know exactly where we are in the pandemic. Are we climbing a steep hill are we on the way down? Where are we? That is super challenging to know right now because of the change in testing policies,” she explains.

She says case numbers among younger people, according to data from the province, look as though they have “plummeted” after peaking in December of last year. But she notes testing has also “plummeted” among people under 70.

“I don’t think we can use case numbers in younger individuals at all to tell us where we are in the pandemic.”

CityNews has requested a comment from Health Minister Adrian Dix, but has not yet received a reply.