The harms of weekly COVID-19 testing in Ontario long-term care may outweigh the benefits

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The harms of weekly COVID-19 testing in Ontario long-term care may outweigh the benefits


The drawbacks and potential costs of weekly testing of long-term care home staff likely outweigh the benefits, according to experts at the Ontario COVID-19 Scientific Table in a new report.

Long-term care staff in Ontario were initially scheduled to be tested for COVID-19 twice a month as part of a pandemic policy in May 2020. In November, this policy was revised to include weekly tests in high incidence areas of the province in orange, red and gray. lockout zones.

In all other areas, testing takes place every two weeks.

According to a report released Tuesday, the science table says Ontario is the only province in Canada to require mandatory testing of all staff in long-term care homes. He also indicated that of the more than 700,000 tests performed between June 28, 2020 and March 13, 2021, the positivity rate was around 0.16%.

“Despite the theoretical advantages of routine, asymptomatic SARS-CoV-2 testing, including the detection of pre-symptomatic, asymptomatic, or very mildly symptomatic personnel infected with SARS-CoV-2, and the detection of outbreaks of COVID -19 when not identified by other surveillance systems, there is no real world evidence available to support or refute the benefits of screening tests in preventing COVID-19 outbreaks in the home of SLD ”, reads the report.

The report cites a number of potential harms associated with weekly COVID-19 testing, including pain and discomfort from nasal swabs, which could lead to more serious injuries, test fatigue, and a false sense of security with a result. negative. He also mentions the risks of a false positive test.

“In addition, a slow test run time can also make screen testing unnecessary if infected SLD personnel continue to work due to a delay in receiving a positive test result,” said the scientific table. “As of early October 2020, only 5.5% of routine asymptomatic screening tests performed by staff in Ontario were reported within 24 hours and only 32% within 48 hours.

“However, this has improved considerably in recent months.”

The report refers to the provincial government’s latest announcement that rapid antigen testing would be used in long-term care homes. These rapid tests, while less invasive than a nasal swab, also have “lower test sensitivity, requiring increased testing frequency two to three times per week” in COVID-19 hot spots.

The report acknowledges that each household would require two additional full-time employees to implement such a consistent testing strategy.

CTV News science and technology specialist Dan Riskin says while it may make sense to test as many people as possible for COVID-19, the data may prove it’s not worth it .

“What they’re saying is maybe sometimes it’s not the right approach, maybe if we have good data that shows how often these tests really pay off and we think about the cost of these tests, and we see that the benefits don’t outweigh the cost, we shouldn’t be doing it, ”Riskin said. “They just say, you know what, reality check it just doesn’t work.”

Riskin added that considering the fact that most residents and long-term care staff are now vaccinated against COVID-19, it may not be worth doing 700,000 COVID tests just to catch the incredibly proportion. low number of employees who may be asymptomatic.

“They’ve been vaccinated in a lot of these long-term care facilities so that’s a huge plus. We also have these variations which are very scary and we don’t know exactly how they’re going to play out, so it’s a balancing act and it’s not, it’s not a light decision, ”he said. -he declares. “But I think it really makes sense when you think about all the infrastructure that needs to be in place, the tasks that need to be done could be done elsewhere. They just don’t catch that many fish that way.

The COVID-19 Science Table said as of March 21, more than 68,000 residents of Ontario’s long-term care facilities had received at least one dose of the vaccine. Over 61,000 are considered vaccinated with both vaccines.

Eight weeks after the vaccine rollout began in Ontario, there has been an estimated reduction in COVID-19 in about 89% of long-term care residents, according to the report, and about 79% of healthcare workers.

A spokesperson for Long-Term Care Minister Merrilee Fullerton said there remains a “continuing need to protect residents and long-term care staff” due to their vulnerability to the disease.

“The goal of surveillance testing is to protect vulnerable Ontarians living in long-term care homes by helping to prevent the spread of COVID-19 in homes. Rapid point-of-care antigen testing ensures that people entering the home can be tested simply and quickly and that positive COVID-19 cases that might otherwise be missing are identified, ”Krystle Caputo said in a statement.

“The Ministry of Long-Term Care will continue to consult and follow the advice of the Chief Medical Officer of Health and make a decision in the best interests of residents and staff.

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