About a month into the fall, many families with school-age children complain about the must-have of the season: rapid antigen testing.
Since the beginning of the school year, there has been an increase in the number of COVID-19 outbreaks in school and childcare settings, according to the Public Health Agency in Canada’s latest weekly COVID-19 epidemiology report.
Along with the fact that a vaccine for children under 12 years of age still not available at present, many urge students to prioritize in provincial rapid test implementations.
Rapid testing is widely seen as a useful tool to increase the safeguards used in schools during the pandemic. However, which children to test, how often, and even where to test, are among the many issues that are different, as different Canadian jurisdictions put rapid testing into play.
“During the pandemic, we have pressured the government to stop reacting and start planning ahead and be proactive,” said Kate Dupuis, a Toronto mother of two young children who joined a parent group that distributed rapid tests to families. “We all need to work together to do everything we can to try to keep our children safer.”
Extra tool ‘if we see a school that is in trouble’
In recent weeks, Ontario has seen various efforts to get quick tests for families, including parent-driven campaigns in Toronto and a doctor-led one in Ottawa.
This week, Dr. Kieran Moore, Ontario’s chief physician for health, the province’s rapid test strategy for schools: sending them to those identified as high-risk by local doctors for use by asymptomatic, unvaccinated students at home. (Those who show symptoms are still encouraged to have a laboratory-based PCR test.)
Whether it sees high transmission in a community or perhaps a high pocket with unvaccinated people in the neighborhood, “if we see a school that is in trouble, has consistent cases that are in danger of closing, this is an extra tool to to keep our kids in the classroom, “Moore said Tuesday.
However, he stressed that Ontario’s situation has been positive as of late, despite the more contagious delta variant. He praised families, educators and communities for keeping the number of COVID-19 infections down.
Targeting hotspot schools is “an important first step,” Dupuis acknowledged, though her ideal is still for all Ontario children to have access to rapid testing twice a week.
“If we do not have enough tests right now, it may be time to start considering alternative ways to get more tests out so that all children across the province eventually have access.”
An approach in school
Olivier Drouin, a father of two teenagers in Montreal, shares this desire for asymptomatic rapid testing across the country. More specifically, he would like to see it available to all Quebec students – both vaccinated and unvaccinated – and that the tests should be performed at home.
“This is the best way to reduce transmission and prevent cases before they occur in schools,” said Drouin, founder of the Covid Écoles Quebec website, which tracks coronavirus cases in provincial schools.
“I think it’s possible; it’s been done elsewhere in the United States, it’s been done in Israel and in Britain.”
He feels that Quebec’s approach, introduced in stages that began in mid-September, does not go far enough.
The province has chosen rapid testing of elementary students who begin to show symptoms at school, performed by staff. The program was first unveiled in four neighborhoods with a large number of active COVID-19 cases, and the program was quickly expanded. On Monday, Quebec announced that rapid testing would roll out to all regions by October 11th.
Quebec’s approach is based on a number of factors, including a “safety net” with high vaccination rates (89 percent with one dose, 85 percent with two) among those over 12 years of age and eligible for a shot, according to Dr. Caroline Quach, pediatric infectious disease specialist and medical microbiologist at Sainte-Justine Hospital in Montreal.
Quach completed one pilot project last winter using in-school, asymptomatic rapid testing to detect and prevent the spread of COVID-19. Despite the fact that one of the participating schools was in a community with a high COVID-19 positivity, she mourned: “We did not find so many [students or staff] there were positives ”through the quick tests.
“If you find one, then you are happy because you know that person could have been a transmitter. But the energy and human resources needed to find that case were … out of this world,” said Quach, who is also a professor at the University of Montreal.
Although she believes that in the end there will be a wider public use of rapid tests as an additional precautionary measure, she highlighted important considerations that still need to be eradicated with the process, including ensuring that tests are evenly distributed, a consistent delivery of tests and a clear reporting process of results to school and public health officials.
“Our warehouses are not full of quick tests.… There are no major restrictions right now, but it’s not that free for everyone — and not everyone can just access it if you ask for it,” she said.
Self-test at home
Last spring, Alberta ran an asymptomatic rapid test pilot for students at select schools in four cities. This week, along with the resumption of contact tracking in schools (which was dropped in the summer), the province introduced an initiative for rapid antigen testing of school-age children who have not yet been vaccinated.
From the end of October, it will distribute rapid tests as a screening tool to be used by asymptomatic staff and parents in kindergarten to grade 6 for schools with outbreak status.
Similarly, Saskatchewan now also distributes rapid antigen tests to households with students under the age of 12 as part of its newly expanded self-test home program. Starting this week, parents can contact their child’s school for test kits to be used as an asymptomatic screening tool. However, some are already reporting that consumer goods are rapidly running out.
Last week, Nova Scotia began a nationwide pilot offering preschool students for quick 6-test kits in Class 6 through their elementary schools. Parents can test if a child has a mild symptom, such as a stuffy nose or sore throat.
The kits are also likely to be welcomed by families living far from laboratory-based PCR testing if their child develops a major COVID-19 symptom, such as fever or cough, according to Dr. Lisa Barrett, an infection doctor and a researcher at Dalhousie University in Halifax.
“It’s a little different in areas around the province – and every province has them – where PCR access is really tough and runny noses are really common,” she noted.
Barrett has spearheaded several successful initiatives in Nova Scotia with rapid testing during the pandemic; she says these campaigns have emphasized the importance of public engagement and given people some autonomy.
“We know from other infections, like HIV, hep C, that people will change their behavior – even though they do not know they are – to be safer. [or] less risky if they know their status, ”she explained.
So in addition to quick tests that help with earlier detection of positive cases, “if it’s just that people who do not normally mask, wear masks anymore or avoid some very vulnerable people, it’s a secondary part, I think. [where] quick tests really help. “
‘Why don’t we use them?’
Meanwhile, educators in British Columbia — among the regions that have not yet implemented a provincial rapid testing strategy for schools — continue to call for one.
“That’s the biggest concern from parents and teachers I’ve heard: Why don’t we use them?… So many other jurisdictions have taken that step,” said Annie Ohana, a high school teacher in Surrey and organizer of the Safe Schools Coalition BC. .
A comprehensive provincial strategy would complement existing safety measures while helping parents make important decisions this fall, said BC Teachers’ Federation President Teri Mooring.
“It’s really hard for families to decide if their child’s runny nose is that they should stay home, and therefore I think quick testing can be used in a way to give people peace of mind.”