Rapid Testing Update and Essential Worker Letter Template

April 21, 2021

Essential Workers Sample Letter Template 

On Monday April 19, 2021 the Government of BC announced new travel restrictions to help stop the spread of COVID-19. Included in these restriction were potential roadside checkpoints. Organizations that require their team members to leave their “home” health authority for work are encouraged to provide a letter for team members to carry with them in the event that they are subject to a roadside checkpoint.

Update on COVID-19 Rapid Testing as it Pertains to the BC Construction and Engineering Industry

BC construction will shortly have the opportunity to screen asymptomatic employees for evidence of the COVID-19 virus! The Government of Canada Health officials has supported asymptomatic screening of workers, especially those whose work in close proximity to one another. It is the view of Health Canada medical professionals that screening would have a positive impact of reducing the spread of the COVID- 19 virus. To that end Canada Health has approved a number of antigen testing devices, notably the Abbot Laboratory’s Pan Bio Nasopharyngeal and Nasal tests and the BD Veritor Plus Covid Test and Analyzer.

In the Fall Canada ordered 40.5 m antigen tests and shipped the first 19.5m to the Provinces for administration and distribution. The second shipments of + 20m have been shipped in mid Winter. These were provided at no cost to Provincial Governments.

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Responsibility for Establishing Guidance
The responsibility for establishing the guidance on how to administer these tests and under what conditions was left to the individual Provinces. Alberta and Ontario moved quickly to establish Guidance protocols for Point of Care Testing (POCT). Alberta published their Guidance documents in September and Ontario in November 2020. In March of this year Ontario published a revised Guidance document and Quebec published their Guidance document. BC has issued a Press Release indicating that they will be authorizing POCT but have yet to publish a Guidance document.

All the published Guidance documents share similar to identical warnings that antigen POCT is for screening only and not used as a diagnosis of COVID-19. Antigen POCT does not replace Provincial administered laboratory-based PCR tests. If a POCT is positive the person should quarantine and take a PCR test.

In the earlier AB and ON Guidance documents the antigen testing needed to be preformed by health professionals, in prescribed circumstances. This remains the case in the Quebec Guidance. The new Ontario Guidance has moved significantly to widen the parameters for who, how and where to test. In part this is reflection of changed tools in the Abbott Pan Bio tests. The originally approved test kits from Pan Bio included the Nasopharyngeal Swab (NPS). This was a very discomforting experience as this long swab was inserted deep into the nasal passage a stirred 5 times in each nasal passage.

Pan Bio Nasal Swab
In February Health Canada approved the Pan Bio Nasal swab which only required taking specimens from the front of the nasal package. Health Canada bought millions of these new swabs for Provinces so they could switch out the NPS for the Nasal swab. The rest of the test kit remains the same. With the advent of this less invasive swab ON lessened need for “health professionals” to administer these POCT to “trained individual”, regulated or unregulated. In addition, with this ease-of-use POCT could be self-administers under the supervision, which meant the supervisor has consulted Ontario Health “self-swabbing training resource”.

Also, now ALL persons conducting COVID 19 POCT are now exempt from the Laboratory and Specimen Collection Centre Licensing Act. To have access to the free supply of POCT antigen test kits, companies enroll as a participant in the Provincial Antigen Screening program. In so doing they must submit data in the form requested by the Province.

In addition to the Federally purchased and distributed antigen tests, the Province of ON has purchased an additional 9.5 m tests for distribution.

Ontario companies are moving quickly to rapid testing, which has already proven successful. The Ontario General Contractors Association has recommended “large site with more than 100 tradespersons to consider implementing non-symptomatic testing to keep COCID -19 from spreading in their workplace”.

Across Canada at our land border entry sites (117), Canadians returning to Canada and not in the exempt essential worker class, are handed a Pan Bio Nasal kit and asked to self-administer the test and to report back to Canadian officials the results. If positive they are to get a PCR test at a Provincial facility.

Cost Implications
The Canadian Business Council is advocating for larger Canadian companies to initiate rapid COVID 19 antigen testing. It with this leadership that a major pilot project was initiated through the University of Toronto’s Creative Destruction Lab for mass screening at Canada’s largest companies. Key to this pilot is developing a shared up-dateable “playbook” to address lessons learned and the shared data platform. They bought their tests, initially a bulk but at $9.55 a test, with the expectation that the next buy will be at $6.00 and eventually $3.00.

The Canadian Government and ON bought their tests for $6.00 each. Commercial purchases are available but at much higher prices. Spectrum sells the Pan Bio Nasal test from between $19.99- $17.49 per test, based upon volume. Shoppers Drug Mart sells DIY test kits a $25 per test in minimum shipments of 100 test kits. The BD Veritor sells for between $39.99 – $37.50 based on volume, plus $500 for an analyzer. For cost reasons it makes sense to apply to use the Pan Bio Nasal tests purchased as part of the Federal stockpile or through Provincial bulk purposes.

Recommended Frequency of Testing
The recommended frequency of Antigen POCT is 2-3 time of week in high prevalence area and 1-2 times a week in low prevalence areas. Without Fed/Prov subsidy this could become very expensive, not including administration.

Conclusion
While we continue to await an official Guidance Documents from BC. The BCCDC has published a User Manual for administering the Pan Bio Antigen Test, including a training and competence documents for the Pan Bio tests (http://www.bccdc.ca/Health-Info-Site/Documents/COVID-19_Tests/POC_screening/Abbott_Panbio_User_Manual.pdf). This is quite extensive or much more highly regulated than the Ontario, revised March Guidance. Dr Henry has been hesitant about wide -spread testing, other than authorized by Public Health officials and in circumstances approved by the College of Physicians and Surgeons of BC the “diagnostic accreditation program (DAP). There are also Saline Mouth Rinse tests being administered a Public Health Clinics but not available for sale.  Informal discussions with MOH officials suggest that the BC Guidance documents will come out somewhere between ON and PQ.

Key Contacts

Dr. Blake Giliks, Chief Medical Officer, Provincial Laboratory Medicine Services

blake.giliks@vch.ca 604-789-7157

Gayle Downey, Director of Patient and Client Relations BC MOH

gayle.downey@gov.bc.ca

Lacy Hizartzids, Abbott Laboratory, Western Canada Marketing Manager

Lacey.hizartzids@abbott.com 604-352-1047

Sara Menard. Director of Business Development, Shopper Drug Mart

Sara.menard@shpooersdrugmart.ca 437-219-5287

Sharmin Sriram, CEO Spectrum Medical Diagnostics

sharmin@spectrummdz.com 416-305-6829

Michael Mackillop, Creative Destruction Lab

Michael.mcakillop@creativedestructionlab.com

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