Public health experts criticize Health Canada’s decision not to approve home testing

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A nurse prepares a swab at a temporary COVID-19 testing clinic in Montreal on May 15, 2020.

The canadian press

Canadians will not have access to home COVID-19 testing, a Health Canada decision that is being challenged by public health experts who say home testing could play an important role in managing the pandemic.

They argue that the benefits of home testing far outweigh the risks.

Dr Colin Furness, infection control epidemiologist and assistant professor at the University of Toronto, said home testing could be an effective way to prevent viral spread. If everyone in Canada could test themselves every day, he said, then “you wouldn’t have a pandemic.”

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“I think it’s a travesty that Health Canada opposes home testing with saliva / paper tests,” he said in an email.

Health Canada, which regulates commercially available medical and diagnostic tests, will not approve home tests for COVID-19 due to concerns about their accuracy when used by the public.

“While Health Canada recognizes that the home self-test may allow more people to get tested… we are concerned about the risks of home self-tests,” said Eric Morrissette, spokesperson for Health Canada.

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“Without the advice of a healthcare professional, there is a significant risk that a patient will misuse the home test kit or misinterpret the results.”

Mr Morrissette also said the federal ministry was concerned that health care agencies might not be able to properly track test results, preventing them from tracking the spread of the virus.

“This information is essential for important public health decisions regarding disease control during an epidemic.”

Developing a home test for COVID-19, which can be performed entirely on its own without the need for a lab, has been the goal of many companies and innovators around the world, and some have almost reached that goal. .

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In the United States, the Food and Drug Administration recently approved a stand-alone test from Abbott Laboratories that is the size of a credit card and provides results in 15 minutes, but still requires a health worker to take the sample. . The test uses lateral flow assay technology to provide a result similar to a test for strep throat; the downside is that it might not have the same accuracy as the more widely used polymerase chain reaction (PCR) test, which relies on a lab for results and is done with a swab.

A Yale University lab has also developed a test using saliva instead of a swab – it’s used by the National Basketball Association – but the sample has yet to be sent to a lab to get the results.

And in Britain home collection kits are available to the public, but samples must also be mailed to a lab, and test results become available after several days.

Dr Furness said that instead of seeing home testing as a purely diagnostic tool, Health Canada should treat it as a screening tool in which people who test positive would then go to their doctors for a test for the. to confirm.

“The objection about the follow-up again takes this as a definitive diagnostic test [ordered by a physician], rather than a drug test, which should be considered home use, ”he said.

While home tests might have less sensitivity and miss some cases, he said “it would also help detect asymptomatic cases that might otherwise have gone undetected,” which would help stop the spread of the virus.

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Dr Ashleigh Tuite, a University of Toronto epidemiologist said the decision not to approve the home test was “paternalistic” on Health Canada’s part and indicated a lack of public confidence.

“I think throughout this pandemic there has been a lot of pushback where, in terms of interventions that might help, they’ve seen from the medical community that the public won’t know how to use it properly,” he said. she declared.

Dr Tuite said the same type of reaction occurred at the start of the pandemic with regard to masks, when medical experts feared people were not going to put their masks on and take them off safely, or that they would touch their face. more. These concerns “have not been confirmed,” she said.

“I think there’s something similar going on with the idea of ​​these home tests, the concern that if you put the technology in the hands of the general public, they’re going to abuse it, or they won’t understand how to do it. ‘use,’ said Dr Tuite. “But I don’t think that’s a fair judgment.”

She said Health Canada’s concern that home testing would make it more difficult to track positive results could be addressed through public education efforts.

“You need education, so I think the message would be, ‘If you test positive you need to self-isolate immediately and you should go for a PCR test. “”

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