VANCOUVER -- The province’s top doctor seems to have embraced asymptomatic testing for close contacts of confirmed COVID-19 cases, but with B.C.’s public health websites unchanged, it’s unclear what criteria testing centre staff will follow.
The BC CDC, Fraser Health and Vancouver Coastal Health websites all say that close contacts must still have at least one symptom in order to be tested, but on Monday the provincial health officer contradicted that message.
"What I've said is that if people are concerned that they've been exposed, we're doing a lot of asymptomatic testing and people who've been exposed, if people have somebody they know who's been exposed or tested positive then absolutely they should be tested," said Dr. Bonnie Henry at a press briefing.
“I’ve talked to my colleagues and the message out there is if you have any concerns, get tested. We have testing available for people everywhere.”
With the criteria still unchanged on the key websites, CTV News asked the Ministry of Health if that would be changing. Despite several follow-up attempts, they did not respond.
Henry’s comments come as numerous people have complained that despite being in close contact with people who tested positive for the virus, they were refused testing at a variety of testing sites and forums because they didn’t have any symptoms.
Near-complete rejection of asymptomatic testing
Henry and her deputy health officer have repeatedly rejected widespread asymptomatic testing, dismissing it as not accurate enough, while largely endorsing it only in outbreak situations.
“We actually have no indication that we're missing large numbers of cases or even substantial number of cases,” claimed Dr. Reka Gustafson in February when CTV News asked if the criteria would change with the emergency of coronavirus variants.
At the time, epidemiologists and infectious disease modellers alike urged the province to ramp up its testing and screening for variants, but little changed and a third wave swept over the province without a commensurate surge in testing. Some areas of the province saw 10 to 20 per cent of tests come back positive, which experts say is a red flag that not enough testing is taking place, and a significant number of cases could be going undetected with more people exposed to the virus.
Compared to other provinces, B.C. is testing at roughly half the rate of Alberta, Ontario, Quebec and Prince Edward Island. On Tuesday, B.C. performed 5,887 tests, compared to 7,570 tests in Nova Scotia (with one-fifth the population) and 24,498 in Ontario (triple the population).
Atlantic provinces have also embraced asymptomatic and rapid testing to find and isolate cases. According to the Public Health Agency of Canada, the federal government has sent 2,796,506 rapid tests to B.C., but only 405,626 have been deployed.
Last week a University of British Columbia pilot project that screened a thousand students with rapid tests found dozens of cases of COVID-19 in students without symptoms, who were confirmed positive with the “gold standard” polymerase chain reaction (PCR) test in a lab.
Several changes to testing in B.C.
In the first wave of the pandemic, as public health scrambled to arrange lab capacity and obtain testing materials, officials urged people to stay home if their symptoms were mild and only seek medical attention or testing if they were seriously ill. This raised questions as to the validity and usefulness of daily infection numbers at the time.
As lab capacity ramped up, health officials urged anyone with even mild cold and flu symptoms to be tested, promising testing capacity would grow to 20,000 per day by the fall.
While officials say they were able to accommodate that many tests with a reasonable turnaround time, the province never surpassed 15,390 tests in a single day, and as the second wave was sweeping over the province in early winter, the criteria changed again so that only four key symptoms would prompt testing; public health required least two of the other symptoms persisting more than 24 hours to approve a test.
As the third wave saw record-breaking daily infections and hospitalizations, testing peaked at 13,234 under the current schema of focussing on the four key symptoms (fever, chills, cough, trouble breathing, loss of sense of smell or taste), while waiting 24 hours and requiring combinations of secondary symptoms: sore throat, loss of appetite, headache, body ahces, extreme fatigue or tiredness, diarrhea, nausea or vomiting.