Rapid Tests, Rapid Return to Normal

1. COVID-19 lockdown measures are crippling our economy. Canada is liable to see closures of up to 225,000 businesses before the end of the pandemic. We need to take proactive steps to lighten lockdown measures, to protect Canadian jobs.

2. What are the differences between PCR and rapid antigen tests? PCR Tests detect COVID-19 nucleic acid to diagnose an active infection. They’re highly sensitive and accurate, but expensive and slow, and best used in circumstances with no tolerance for uncertainty (international travel, analyzing outbreaks.) Rapid Tests detect the presence of antigens expressed by the COVID-19 virus. They offer results in less than 15 minutes, are inexpensive, and can be self-administered but are less sensitive than PCR tests, with higher instances of erroneous results.

3. Why use rapid tests? They’re inexpensive, accurate, and fast. A rapid test can easily be administered on site at any business, store, workplace, or event, with results available immediately. They provide peace of mind for the young, the immunocompromised and the un-vaccinated. They prevent backed-up labs, ensuring PCR tests - when necessary - are processed quickly.

4. Why do we need tests if vaccinations are so widespread and effective? 22% of the Canadian population has yet to receive their first dose; 59% have yet to receive their second. Children are not eligible for the vaccine. The vaccinated can still asymptomatically carry and spread the virus to the vulnerable. Why take the risk when rapid testing is so inexpensive and readily available?

5. Thanks to their speed, relative accuracy, and accessibility, rapid tests are our safest, fastest, and best shot at a return to normal. 

58,000 Canadian businesses became inactive in 2020 due to COVID-19 lockdown measures. 

Experts predict upwards of 225,000 could shut down permanently before the end of the pandemic. Economic growth in Canada slowed by 5.5% in 2020, the most significant contraction since 1945. With only ~4% growth reported so far in 2021, it’s looking to be at least another year before we fully recover. The restaurant industry is now seasonally dependent, operating at partial capacity at best. The entertainment industry is on life support until further notice, with multiple landmark venues in Toronto closing their doors forever. Salons and non-medical aestheticians find themselves operating outside the bounds of the law, with stylists seeing clients at home, taking payment in cash. 

Economic anxiety and isolation have left us facing a concurrent pandemic of mental health issues. More than 43% of American surveyed by the US Census Bureau in 2020 reported symptoms of anxiety and depression, an increase of more than 11% over previous years. 50% of all Canadians claim COVID-19 has affected their mental health. For those aged 18-24 that number jumps to a staggering 72% (it’s no coincidence this is the lowest paid adult demographic, and the one statistically most employed in restaurants and retail.) 

Public opinion is still ~66% in favour of lockdown measures, but people are growing weary. The Provincial and Federal governments’ shifting goalposts, scattershot rule-making, and rule-changing have led to a widespread sensation of fatigue. 

People are desperate for normal, and with over 11% of the Canadian population fully vaccinated, 78% partially vaccinated, daily case rates at 25% of what they were in March, and testing of all types so readily available it can be brought to your front door, normal seems to be slowly, but steadily approaching. But, behind reports of nationally dropping rates of infection, there is still data to suggest that COVID-19 rates have only dropped because testing has dropped. Rapid testing is a simple, highly effective means of preventing COVID-19 transmission, and the fastest way for Canadians to return to normal.

Why Use Rapid Tests?

With multiple varieties available free of charge for all Canadians, widespread vaccination is crucial to ending the COVID-19 pandemic. With 78% of the population partially vaccinated and 41% fully vaccinated, the prognosis is optimistic. Even so, some experts suggest it’s unrealistic to expect Canada to be fully out of the woods before next summer. Yet, the sun is shining today. Patios are open for business, golf courses and athletic centres have reopened their doors, “non-essential” retail is tentatively up and running, and parks are packed.

Inexpensive, exceptionally fast, and still boasting 93% accuracy in their diagnostics, rapid tests have been unfairly maligned as less effective for their inability to distinguish between variants and their comparably higher rates of false positives and negatives. In spite of multiple government programs actively encouraging their immediate, widespread implementation, rapid tests have inexplicably found themselves the black sheep of the COVID-19 prevention world.

Rapid tests alone aren’t perfect, but neither are vaccines (Pfizer and Moderna may boast 95% efficacy rates, but only against the original variant) nor PCR tests (inefficient and themselves not immune to false negatives.) Rapid testing, PCR testing and vaccination work best when treated as a three-pronged approach. Available either free of charge for essential businesses, at reasonable prices courtesy of private healthcare providers, and (soon to be) available for personal use at home and in the office courtesy of licensed retailers, rapid testing must be incorporated as a crucial component of a robust, defense against COVID-19. 

Evolution of COVID-19 Testing

Catastrophe is the midwife of progress. In the face of unprecedented need, private healthcare providers have worked tirelessly in collaboration with Health Canada and Provincial health authorities to analyze and contain outbreaks and ensure hospitals remain focused on medical emergencies. Their efforts and innovations have helped keep Canadians healthy and essential business and travel running safely. Companies like Canadian Health Labs have helped to build an extraordinary infrastructure of COVID-19 testing services, delivering testing services directly to families and businesses, providing PCR tests at every border in Canada, offering virtual appointments for video-supervised self-testing, and (pending Health Canada approval) offering home rapid testing kits for sale to anyone in Canada.

How Do Rapid Tests Work?

Rapid antigen tests have been approved by Health Canada for use in the fight against COVID-19 since October, 2020. A simple, elegant device, your average rapid test kit contains a test cassette, a swab, and a test tube with a buffer solution inside. The test can be self-administered, but is best supervised by a healthcare professional to ensure accurate results. Using the less invasive - albeit still ticklish - anterior nasal swabbing method, the sample is collected from the patient's nose, and placed in the test tube where it is allowed to mix with the buffer solution. The resulting mixture is dripped onto the test cassette, where (provided the target antigen is present in sufficient concentrations) it will bind to antibodies fixed to a paper strip and generate a visually detectable signal within 15 minutes. 

Given that the antigens detected are expressed only when the virus is actively replicating, rapid tests are best used to identify acute or early infections, but still offer a 93% overall accuracy rate. Rapid testing is available now for essential businesses via Provincial Governments, and from private vendors. 

The PCR Test has long been considered the “gold standard” of COVID-19 tests, and for good reason. These nucleic acid-based tests are extremely precise and highly accurate, using cutting edge technology to detect viral genetic material (RNA), even at extremely low levels. These tests require CRISPR and/or LAMP machines for diagnosis, and can only be administered by a healthcare professional. They are an extraordinary tool and have been crucial to our world’s continued functioning throughout the pandemic.

But they aren’t perfect. Specialized equipment requires specialized operators and significant investment. The average cost of a PCR test on the private market is $150CAD, with some providers charging up to $280CAD for “expedited” results that still take 12 hours to arrive. Specimens occasionally become corrupted at the lab level and result in inconclusive tests. False negatives - though uncommon - are far from unheard of. 

Many of these issues can be attributed to a hard-working but dated network of labs that were never (and could never have been) prepared for COVID-19. These labs are overwhelmed and struggling to keep up with the enormous number of tests they’re required to process, leading to mistakes and occasionally lengthy delays. 

Canadian Health Labs offers COVID-19 testing across Canada and the United States, for both private businesses and the public sector. Our private sector business has seen significant uptake from essential businesses, restaurants, and events who want to advertise testing as a marketing strategy to help customers and employees feel comfortable. In the public sector, we work with the Government to help manage outbreaks among essential businesses. Over 95% of the testing we’ve done for the government is PCR testing; over 95% of the private sector has been rapid testing. Private businesses typically only request PCR tests after an employee tests positive from a rapid test. The PCR test is then used to confirm the rapid positive result before the employee goes into isolation. 

Canadian Health Labs has yet to have a case where a patient has tested positive on a rapid and not also tested positive on a PCR test. A major construction firm experienced an outbreak at one of their build sites, and contracted Canadian Health Labs to perform weekly rapid testing. They wanted to a) control the spread of the virus and b) create the perception of a safe work environment to provide comfort to trades and employees and reduce lost hours. Through screening with rapid tests, we were able to prevent an outbreak entirely within 21 days, with positive tests reducing by 33% per week until they remained consistently at 0%.

Testing the Vaccinated

Vaccines are the ticket to a COVID-19 free future, but they’re only truly effective once the percentage of a population vaccinated passes a certain tipping point. For polio, that number is 80%. For measles, 95%. 

So you’re vaccinated - that’s great! But consider the ~25% likelihood that your neighbor isn’t. Consider that children are not eligible for the vaccine, but are no less susceptible to the virus. Consider the risk that vaccinated asymptomatic carriers pose for the immunocompromised.

Consider the highly contagious and vaccine-resistant Delta variant. The Federal modelling from April/May that suggested lockdown restrictions could be eased once a minimum of 75% of eligible Canadians received the first dose of the vaccine and 20% received their second did not factor in Delta. Though two doses are still proving to be highly effective against all variants, one dose has been found to be less effective against Delta. Vaccination rates are plateauing as Health Canada strives to reach the remote and the distrustful, and the ultra-infectious Delta variant is still spreading steadily. Some experts suggest 80-90% of the Canadian population may need to be vaccinated to stop the spread of multiple variants.

As of July 7th, Ontario Health announced that its COVID-19 Assessment Centres will be suspending service, as infection rates decrease and vaccinations rise. Epidemiologist Colin Furness from University of Toronto’s Institute of Health Policy, Management and Evaluation has stated on record in an interview with QP Briefing “[in order] to avoid an autumn lockdown, the province needs an active rapid testing strategy to target people like restaurant workers, warehouse employees and bus drivers — anyone on the front lines… Rapid tests will be important, because unlike PCR tests - which test if someone has COVID-19 in their system - rapid tests flag if someone is actively shedding the virus.”

Testing is still a critical component of the fight against COVID-19, and rapid tests are still the most efficient diagnostic tool at our disposal.

How Does A Pandemic End?

The Spanish Flu was by any measure a blip in history, starting in 1918 and (having taken upwards of 50 million lives) mostly disappearing by 1919. But where did it go?

The simple answer is that it never really left. Despite our lack of medical technology, rudimentary knowledge of virology, and haphazard standards of hygiene, some people simply had powerful enough immune systems to survive. The virus - to its own benefit - mutated into a less lethal variant, allowing for more efficient transmission from living host to living host. This mutated H1N1 influenza virus has stuck around ever since, rebranded with a much more innocuous handle: the seasonal flu. 

It’s impossible to know exactly what will happen with COVID-19, but it’s unlikely it will ever go away completely. There are, however, a couple things we do know. Ontario’s case count has shrunk by 90% since March. All statistics show that our vaccines work. While an immunized world doesn’t mean a virus-free world, it does mean drastically reduced mortality rates and significantly less-burdened healthcare systems.

In the meantime, rapid testing administered by health care professionals is free for essential businesses, and an incredibly economical means of achieving peace of mind for everyone else. The results are available instantly, there’s negligible discomfort, and they flatten the curve while ensuring every other line of defense we have against the pandemic is left unencumbered. Rapid testing is the best means of expediting our return to normal, today.