Testing for COVID-19 at the border is a drain on Canada’s limited resources. Should we still be doing it?
OTTAWA - The federal government's COVID-19 testing requirements for travellers entering the country are a drain" on capacity so overwhelmed by the Omicron surge that officials can only guess the true number of daily infections, Canada's top public health officer says.
While Dr. Theresa Tam stopped short of calling for the requirements to be dropped, she said she believes it is time to stop sequencing" COVID-19 samples from travellers arriving from abroad at Canadian airports, given the global prevalence of the highly contagious Omicron variant.
That means specialists Ottawa contracted to conduct the tests would no longer perform a procedure to determine whether each detected case is Omicron or another form of the virus.
The whole world has Omicron," Tam said, when asked Friday about Canada's use of testing resources on travellers from abroad when the virus is already smashing domestic records for new infections inside the country.
We could do sampling for the tests, instead of testing maybe every single vaccinated individual coming from other countries, but we will evaluate that over time," Tam said.
It is a capacity drain on the system as a whole."
On Nov. 30, just days after the Omicron variant was first detected in South Africa, the federal government announced it would test travellers flying into Canada, even if they were fully vaccinated against COVID-19. Officials have since said they want to test all incoming travellers, but as of this week, descriptions of the requirement online said it is only testing those who are unvaccinated and a random selection of people who are vaccinated.
Still, some health experts are questioning whether it's time to scrap or reduce the requirements.
Dr. Zain Chagla, an infectious diseases physician and professor at McMaster University, said the prevalence of COVID-19 in Canada at the moment means testing people entering the country from abroad is less relevant" than in previous stages of the pandemic.
Ottawa's latest projections for COVID-19 cases predicts infections will continue to outpace the capacity to test for it in the coming weeks and that the true number of new daily cases, a figure that Tam said is unknown due to limited testing capacity, could increase to between 170,000 and 300,000 before the end of January.
Meanwhile, according to federal data, from Nov. 28 to Dec. 25, around 1.6 per cent of 76,613 unvaccinated or partially vaccinated travellers entering Canada were positive for COVID-19. The proportion was lower - around 1.1 per cent - for the 325,578 fully vaccinated travellers who entered Canada over that period.
What are we trying to prevent here?" Chagla asked. The border is sort of the least of your worries."
Chagla also noted the federal government has contracted COVID-19 testing services to three private companies. The contracts for Smart Health, LifeLabs and Dynacare are worth up to $631 million, Procurement Minister Filomena Tassi's office confirmed Friday.
Chagla said there are better ways to use the money and testing capacity, including boosting testing capacity for people who are homeless, for healthcare workers, and for teachers and for students in schools. Two weeks ago, amid a backlog of more than 100,000 tests, Ontario limited access to molecular COVID-19 tests to people showing symptoms who are deemed at high risk or who work in high-risk settings.
You can list off a litany of different places that could use testing to help protect their environments or determine if there are outbreaks," he said.
If we're putting hundreds of millions of dollars aside for testing ... it should probably be applied to the highest-risk settings, so that we prevent most of the mortality, while not worrying about asymptomatic travellers coming across the border."
The Greater Toronto Airports Authority, which manages Pearson airport, said in a statement to the Star on Friday that it supports redirecting" resources now being used for arrivals testing to where government statistics tell us they're needed most."
Another issue with the testing is that the time it takes to get the results has increased in some cases due the strains on lab capacity. Jordan Paquet, a spokesperson for Switch Health, one of the companies the government contracted to conduct arrival tests, said most people are still getting results within three days, but that a growing proportion are now taking up to five days.
Paquet said his company is hiring more staff and trying to assemble more resources to speed things up. We're doing absolutely everything we can," he said.
Health Minister Jean-Yves Duclos's office forwarded questions about the testing regime to the Public Health Agency of Canada, which defended the requirements as an important" way to prevent even more community spread inside Canada. Duclos himself defended the regime on Wednesday, and suggested it would stay.
We have the responsibility to make sure that there is as little importation as possible of COVID-19 and Omicron cases across the border," he told reporters at a news conference.
Dr. Isaac Bogoch, an infectious diseases expert at Toronto's University Health Network, said the statistics show imported cases represent a fraction of cases in the country, even as Omicron surged globally in December.
While it's important to monitor for new variants and potential surges from outside Canada, this could be accomplished through smaller testing regimes based on random sampling, Bogoch said.
Aiming to test everyone who flies to Canada would make sense only in a perfect world" of unlimited testing capacity and resources, he added.
We're at a time when testing resources need to be triaged appropriately," said Bogoch. If there's so few positive tests coming into the country ..., it would make sense to point your resources toward an area that's more fruitful."
Alex Ballingall is an Ottawa-based reporter covering federal politics for the Star. Follow him on Twitter: @aballinga