As school year approaches, some warn Canada overdue in approving COVID-19 saliva tests

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Giving a school-aged child an invasive and uncomfortable nasal swab test for COVID-19 can be tricky.Ask them to spit in a cup? It could be a simpler approach.

It is the thought process behind calls by researchers and public health officials to initiate saliva tests in schools. But despite international efforts to make this option a reality, it remains unclear when saliva-based COVID-19 testing will be permitted in Canada.

“School is just around the corner and I feel like we’re falling behind,” said researcher Michael Glogauer, a professor in the faculty of dentistry at the University of Toronto who focused on saliva as a diagnostic tool for the past two decades. “We’re further behind than we should be on this point. ”

So why is it not yet available?

South of the border, five saliva tests have been approved so far by the U.S. Food and Drug Administration (FDA) – including, most recently, a headline test for COVID-19 developed by researchers at Yale University with financial support from the National Basketball Association.

Major League Baseball is already using saliva tests for players, and some U.S. universities have also started offering saliva-based options for testing returning students to campus this fall.

Much like current tests that return nasal swab specimens to a lab, these tests – and others similar in development in Canada – involve sending saliva samples to a lab for processing, with results in about 24 hours.

But no such saliva-based test has yet been authorized by Health Canada.

“Health Canada is reviewing all applications related to COVID-19 as quickly as possible without compromising patient safety,” spokesman Eric Morrissette said in a statement provided to CBC News.

A single company, DiaCarta, based in the United States, submitted a COVID-19 saliva test to Health Canada for review to date.

Canada is “always catching up”

Glogauer, who is also head of dental oncology at the Princess Margaret Cancer Center, said Canada “is still catching up.”

Dozens of research teams at the University of Toronto and across the country are exploring saliva-based tests, he said, and are making continuous “back and forths” with government officials.

Glogauer’s team is focusing on one of the FDA-approved saliva-based lab tests already in use in the United States and now seeking approval from Health Canada.

“It’s efficient, it works, it can be used in the lab system. It’s plug and play, ”he says.

“It’s just a matter of Health Canada approving these tests and getting down to business. ”

In Toronto, the city with Canada’s largest public school board, public health officials urgently want a pilot saliva test and call on the federal and provincial governments to give the green light for local schools can explore how to collect saliva.

WATCH | Saliva testing for COVID-19 could make schools safer, supporters say:

Spitting into a cup may soon be an alternative to the standard COVID-19 test that goes through the nose, but saliva tests have not yet been approved for use in Canada. 2:00 p.m.

“It’s less awkward, a little easier,” said Joe Cressy, president of the Toronto Board of Health, who works closely with Toronto public health officials recommending this approach.

“Since we have to be so proactive in testing collective schools, this could be a really important and useful way to help us prevent the spread of COVID-19. ”

Parents often refuse current swab tests because they don’t want their children to have the experience, noted the city’s deputy medical officer of health, Dr Vinita Dubey.

Provincial health workers take a nasal swab to test for COVID-19 on Raymond Robins from the remote First Nations community of Gull Bay, Ont., April 21. Proponents of saliva-based tests say it’s easier to administer – and less uncomfortable. (David Jackson / Reuters)

She said research shows that saliva-based tests may be slightly less accurate, “but they may have some advantages in its ease of use. ”

Provincial officials say they are also asking Health Canada to approve a saliva test.

“If and when a saliva-based collection kit has been approved for use in Canada, recommendations for use in Ontario will be provided by the province,” said a spokesperson for the Ontario Ministry of Health in a press release.

Concerns about delays in results

As calls for new testing options may grow, Dr Zain Chagla, an infectious disease specialist based in Hamilton, Ont., Said any possible deployment of saliva testing in schools or elsewhere must be done “thoughtfully”.

Since the current models under study would require existing lab facilities, he said widespread testing could consume crucial resources, especially as the regular cold and flu season approaches.

“You may run into issues with slowdowns and delayed turnaround times,” Chagla said.

It’s the impetus for some teams who are also exploring how to create near-instant saliva-based test kits, which could work like a pregnancy test – delivering a quick result, without requiring a lab at all.

A student in California provides saliva for an experimental COVID-19 coronavirus test for asymptomatic people. Some American universities have also started offering saliva-based options for testing students. (Irene Yi / UC Berkeley via AP)

Researchers at the University of Saskatchewan, for example, are currently developing a saliva-based COVID-19 home test kit that would provide results in minutes, but the technology is not expected to be available until spring 2021.

Glogauer said his team was exploring similar options and pointed out that even lab tests of saliva samples could be useful for schools.

Although the samples have yet to be processed off-site, he said collection could be done easily at home by parents or in schools by existing staff, without requiring medical teams in full protective gear.

“This would be an ideal test to use on high school students, for example, as a means of screening, detecting asymptomatic spreaders – giving the system assurance that students who test positive can be isolated,” he said. .

Glogauer said several private schools in the Toronto area have already expressed interest.

All it takes now, he says, is a “rubber stamp.”

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