Accelerating the fight against COVID-19: Antigen rapid testing technologies and the workplace
As part of its efforts at restricting and combating the spread of COVID-19 and its effects on the health and livelihood of Canadians, the Government of Canada is making efforts to increase its testing capabilities by exploring the possibility of rapid testing mechanisms such as antigen tests. Antigen tests detect certain proteins in the virus, and results are produced within 5-20 minutes. This timing is significantly faster than the current polymerase chain reaction (PCR) test that takes more than 6 hours to produce results. The first of such rapid antigen tests was approved in October 2020 and the first tests arrived at various federal and provincial Health Authorities, and some airlines, in mid-November. The two tests currently in circulation are the ID Now and the Panbio rapid tests. Rapid tests may increase the ability of workplaces and public health officials to quickly isolate positive COVID-19 cases and keep the rest of the work population safe. However, the technology is still relatively new.
Health Canada has approved rapid testing technology for use only at the point-of-care. The Government of Canada intends that these testing mechanisms will supplement but not completely replace lab-based PCR testing (which remains the best option for confirming a negative or a positive result). Upon the approval of rapid testing technology for use in Canada, Canada’s Deputy Chief Public Health Officer expressed hope that the inexpensive and easy to use testing mechanisms could be administered in high-risk workplaces where rapid initial results could assist in quickly isolating positive cases. According to the Deputy Chief Public Health Officer, these types of workplaces may include food processing facilities, long-term care homes, homeless shelters, prisons, jails, remote worksites and other worksites where employees must work in close proximity to each other.
In Ontario, ID Now rapid tests are currently being used in hospital settings and testing centers and in early outbreak situations in regions with high COVID-19 caseloads. The Panbio test is being used in long-term care homes, retirement homes, hospitals, and workplaces such as Ontario Power Generation, Air Canada and Magna. Although this project is still in its infancy, the Government of Ontario hopes to expand such workplace testing across the province.
Similarly, on November 26th, Alberta’s Health Minister announced that the province would begin the use of rapid testing kits in early December. Like the federal guidance, these test kits are only to be administered by health professionals. Further, Alberta’s Health Minister made it clear that the use of these tests is currently limited and that they do not provide accurate results for non-symptomatic individuals.
Employers will soon be able to make use of rapid testing to manage COVID-19 in the workplace. It is likely that employers who intend to use this rapid testing technology will have to consider whether the tests are being administered at a point-of care by a qualified professional. “Point-of-care” is not a term that is defined in statute nor is there any standardized nationwide approach to point-of-care testing.
Given the uniqueness of the situation, the guidelines for COVID-19 testing could be different than the standard for other point-of-care situations. Currently, it is the practice in most of the provinces that point-of-care testing is to be provided by trained professionals or under the supervision of such professionals. Most provinces make use of nurses, paramedics or physicians to administer testing, whether in hospitals, clinics, laboratories, pharmacies, physician offices, ambulances, nursing or long-term care homes. It may be that an employer that has nurses on-site may be able to provide point-of-care testing once provinces are assured of the efficiency of such testing and the nurses have received the appropriate training to administer the specific testing technology being used.
The technology is still new. Provinces are still in the early stages of procuring the tests and testing their efficacy, and provincial health authorities currently are reluctant to rely on the results. Some airlines and workplaces have obtained rapid tests in response to their approval and they may become more readily available once health authorities are able to better assess the utility and limitations of such tests . Employers should continue to monitor Health Canada’s guidance on rapid testing for any updates to how rapid testing should be conducted.
Even with a positive test, individuals would still need to be referred to testing centers to confirm the positive result with a lab-based PCR test. Moreover, if a point-of-care test reveals that an individual is positive and others in contact test negative, all individuals should also obtain a negative PCR test before relying on the results of a rapid test. As always employers will need to consider whether testing will be voluntary and be mindful of their other obligations toward their employees, including privacy obligations. For more information on such obligations, employers should refer to our previous guidance on COVID-19 in the workplace.