Policy Brief by Annabelle Linders
From Vancouver to St. John’s, Canadians have experienced COVID-19 very differently. Hotspots, like those in Toronto and Montreal, have consistently reported high case numbers for the past year, while the Atlantic Bubble has maintained single-digit case numbers for months at a time with minimal outbreaks. Much of this success can be attributed to less air traffic, low population density, and imposing hefty fines on anyone who does not adhere to the strict quarantine requirements for anyone and everyone entering the bubble. Many of these factors cannot be replicated in cities like Ottawa. But as Ottawa recovers from its second wave and approaches the summer, what can we learn from Nova Scotia’s use of rapid testing?
"There are several elements of this model that could help Ottawa. First, offering easy access to rapid testing in local community centres could offer a solution to the clogging of testing centres that Ottawa experienced last fall, exacerbated by asymptomatic people getting tested to obtain a “free pass” for a social event (2)."
As of December 7, 2020, people residing in Nova Scotia who do not have COVID-19 symptoms, have not travelled outside of the Atlantic Bubble within the last two weeks, have not been to any COVID exposure sites, and have not been in contact with any confirmed COVID cases can get a rapid test from within their own community (1). Although appointments were necessary when pop-up locations first started operating across the province, they are no longer needed.
I got a test done myself when I was at home in Halifax for Christmas - daily case numbers had returned to low single digits, but I was planning to see a few friends in different households for New Years, so we all got tested as encouraged by our provincial government. When I arrived at the pop-up testing location in a public library, I was immediately greeted by a young volunteer around twenty who asked me the standard screening questions. Then I gave my phone number to another volunteer, who explained that I would receive my results through a call or text within about an hour. Finally, a volunteer administered a nasal swab test, explaining every step while I was in and out in about five minutes, and got a negative test result via text about twenty minutes later. The friendly staff, upbeat music playing at the location, and simple explanation of how the test worked made a potentially chastising scenario into a welcoming environment.
There are several elements of this model that could help Ottawa. First, offering easy access to rapid testing in local community centres could offer a solution to the clogging of testing centres that Ottawa experienced last fall, exacerbated by asymptomatic people getting tested to obtain a “free pass” for a social event (2). This practice should not be supported; however, shaming people for attending social gatherings does not help to minimize risks if they are going to attend, test or not. Like an abstinence-only sex-ed curriculum, the government is losing an opportunity to instead educate the public about what resources are available, should they already be planning to gather socially. Considering social shaming’s negative impacts on HIV and other public health crises (3), correcting mistakes and offering resources to minimize risk should be prioritized over patronization that only leads to public resentment.
"Making testing available won’t necessarily cause more socialization, but it will make gatherings that take place safer for everyone."
Second, rapid testing sites also provide testing opportunities for essential workers, in a more accessible format and at a lower cost to the city. Rapid testing costs only $1 to $2 (compared to $60 for a normal test) (4). This means that, for a fraction of the cost, retail workers, restaurant staff, Uber drivers, and other people working with the public daily can receive routine testing before symptoms or exposure notices qualify them for a test. This is good for the mental and physical health of the employees themselves and for the public who they are interacting with.
Of course, there are also drawbacks to rapid testing. First, they are not as sensitive as normal tests, risking false positives (5). However, as explained earlier, a less sensitive test is better than no test. People with symptoms or who came into contact with confirmed COVID cases will still require the normal, more sensitive COVID tests, but the rapid test alternative provides opportunities for testing that would otherwise not be taken. Second, there is the risk that being tested will encourage imprudent social activity because of this concept of the “COVID hall pass” that drove the crowds of people to Ottawa’s testing centres in the fall. This concern may be valid during stay-at-home orders, but as Ottawa enters more lenient stages of restrictions, its citizens will be gathering regardless. Making testing available won’t necessarily cause more socialization, but it will make gatherings that take place safer for everyone.
As seen in Nova Scotia, rapid testing can be a cost-effective solution to increased COVID risks as restrictions ease. Ottawa should adopt this system to reduce public shaming around getting tested regularly and to ensure that our doctors, nurses, and other workers most directly at risk for contracting COVID can keep having access to the most reliable tests.
Chisholm, Cassidy. 2020. “ COVID-19 testing for asymptomatic people now available across Nova Scotia.” CBC News, December 7, 2020. https://www.cbc.ca/news/canada/nova-scotia/covid-update-monday-december-7-1.5831297
Goodwin, Natalia. 2020. “People who don't need a COVID-19 test clogging Ottawa's system.” CBC News, September 16, 2020. https://www.cbc.ca/news/canada/ottawa/ottawa-covid19-testing-symptoms-slow-1.5725659
Duong, Diana. 2020. “Does shaming have a place in public health?” CMAJ News, December 11, 2020. https://cmajnews.com/2020/12/11/shaming-1095910/
Gans, Joshua. 2020. “Rapid Tests: They do more. They cost less. It’s that simple.” Toronto Star, September 21, 2020. https://www.thestar.com/opinion/contributors/2020/09/21/rapid-tests-they-do-more-they-cost-less-its-that-simple.html
Carter, Devon. 2020. “Are rapid COVID-19 tests accurate?” MD Anderson Cancer Center, December 4, 2020. https://www.mdanderson.org/cancerwise/are-rapid-covid-19-coronavirus-tests-accurate.h00-159387468.html