Experts recommend using more rapid tests, so why is Canada so far behind other regions?

In some regions of the world, rapid tests, also known as lateral flow tests, have been a regularly used tool in the pandemic toolbox. But in Canada, these tests are scarce, except for in a few areas, leading some experts to say we are underutilizing them.

In the Kitchener-Waterloo region in Ontario, a unique program is handing out a hot commodity — do-it-yourself COVID-19 swabs, which allow people to know with reasonable certainty within 15 minutes if they are infected or not.

The program is called StaySafe, and it’s delivered more than 400,000 rapid tests in the last few months at no charge, supplied by Ontario and federal governments to give business owners and families peace of mind. StaySafe offers on the spot rapid tests as well as ones that people can take home with them. 

The project has been met with support from locals, who told CTV News that they are using them for attending school, ensuring that they aren’t spreading the virus after travelling, and using them to stay safer when visiting elderly relatives, among other activities.

And with children returning to class and people returning to workplaces, demand is growing.

“I get emails daily from other regions and other provinces, ‘How do we get this in our [region]?’” Ying Jiang, StaySafe Program and Volunteer Manager, told CTV News. “Whatever we are doing in our region, Waterloo, they want it.”

But the tests are not so easily available across Canada. Some hospitals are now handing out tests to school-aged families, while other Canadians are paying $15-$40 dollars per test at some pharmacies.

David Juncker, department chair of Biomedical Engineering at McGill University, told CTV News that rapid tests are available here “in kind of a fragmented manner.”

“They're not being rolled out in a large scale and these are very difficult to get, or they're very expensive,” he said. “And so as a result, they're not being used and not being used to their potential.”

Some say Canada has been slow to approve different forms of rapid tests, and provinces have been slow to distribute them.

Compare that to the U.K., where rapid tests are widely used by everyday citizens to catch infections early. And in Germany, they cost only a few dollars a box.

Federal reports show that rapid tests have been a consideration.

In fact, just a few weeks ago, a federal advisory committee wrote “in the event of a COVID-19 resurgence, self-testing should be accessible at no cost and at various locations in communities.”

If rapid tests were utilized in workplaces and schools, they could assist in catching cases early.

Juncker pointed out that with the Delta variant, many cases are asymptomatic, particularly breakthrough cases.

“That's why regular testing and having a fast result are so critical to be able to isolate people before they can transmit it to others,” he said.

The rapid test is one of the many tools we could implement at a low cost to keep things functioning as Delta continues to cause issues this fall.

“We should use them to go visit your grandmother, you know, you have a runny nose, you want to go to university or come to school or to work, well you can even say you're vaccinated, you could do a quick test, and to give some reassurance,” he said.

He said that not many rapid tests are approved in Canada, making them scarcer and more expensive, while in Germany, for example, they have around 60 tests approved.

Nova Scotia has had frequent free rapid test pop-ups, but this hasn’t caught on in other provinces.

Other regions have been giving out kits to businesses through the chamber of commerce, but the StaySafe program offers them for free.

Juncker said that one roadblock is a hesitancy about rapid tests on the part of the medical community.

"The medical establishment […] has been kind of skeptical of rapid tests from the beginning,” Junker said.

The issue is accuracy — the PCR tests that are checked in laboratories are the gold standard for confirming a COVID-19 case, and rapid tests are not thought to be quite as accurate.

But when you’re using them not to replace PCR, but as a tool to help identify outbreaks early, they can be a valuable part of the response, experts say.

“The doctor wants to know what treatment to give you, for that we need a PCR test,” Juncker said. “If you want to have it for breaking chains of infection in terms of a pandemic, then rapid tests are a much more efficient tool.”

And studies have shown that the rapid tests do provide fairly accurate results, with some studies suggesting that they could be almost as accurate as PCR.

A study published in late July in BMJ that compared two types of rapid antigen tests found that both types were more than 60-per-cent accurate.

Another July study by the National Institutes of Health found that rapid antigen tests were on par with PCR tests for COVID-19 screening when used every three days. And an August study from Austria looking at lateral flow tests found that 95 per cent of lateral flow tests were accurate.

Whether or not Canada will heed the recommendations that call for us to utilize rapid tests more widely this fall is still up in the air.

But people in Waterloo are in favour.

“I think this program should be available for everybody,” one citizen told CTV News.