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Seniors advocate says rapid testing of staff in care homes makes sense

As COVID-19 cases continue to surge amid a second wave of the pandemic, B.C.’s seniors watchdog is suggesting rapid testing of all staff at long-term care homes.
Isobel Mackenzie, B.C.’s seniors advocate, presents the Staying Apart to Stay Safe survey report on Nov. 3, 2020. DON CRAIG, PROVINCE OF B.C.

As COVID-19 cases continue to surge amid a second wave of the pandemic, B.C.’s seniors watchdog is suggesting rapid testing of all staff at long-term care homes.

Isobel Mackenzie says rapid tests — which yield results in 15 to 30 minutes — could be an added layer to help catch infected staff who are pre-symptomatic or asymptomatic and unknowingly bringing the virus into long-term care facilities.

“The question is: What is the harm in using them?” Mackenzie said.

About 3.8 million rapid COVID-19 tests, which can be processed where the patient is tested, rather than in a lab, arrived in Canada last week and are now in the hands of provincial health authorities, many of which are still evaluating how to use them.

Among the challenges, said B.C. provincial health officer Dr. Bonnie Henry, is that the rapid tests are not as sensitive.

However, they can play an important role if a cluster of people have an illness and a rapid diagnosis is needed, she said. “If several people are tested and they’re all negative, that’s reassuring; if one of them is positive, that tells you that this is probably an outbreak that you’re dealing with.”

The province is looking at the protocols for the rapid tests, using them now in some remote communities and in Vancouver’s Downtown Eastside. “The lab team is still working [on] about where and how we can best use them,” Henry said.

According to data from the B.C. Centre for Disease Control, there had been 162 outbreaks and 1,570 COVID-19 cases in long-term care facilities as of Friday. Of the 331 deaths linked to the virus across B.C., 205 have been residents of care facilities.

Outbreaks were declared this week in two Island care homes: Discovery Harbour, operated by Park Place Seniors Living, in Campbell River and Tsawaayuus Rainbow Gardens in Port Alberni. One staff member has tested positive in Discovery Harbour. At Tsawaayuus Rainbow Gardens, a residents tested positive a few days after a staff member did.

Island Health said the outbreaks in those homes remained contained on Saturday.

Concern about workers transmitting the virus between facilities led the province to limit staff to working at just one site. Other measures have included increased cleaning and a restriction on outside visitors, along with screening, masks, and temperature checks for staff.

Mackenzie said she thinks rapid tests could provide another layer of protection.

“My concern at the moment is while we have made tremendous efforts and tremendous investments to make things safe in long-term care, I think we have not really fully realized the potential of testing in our care homes as an effective approach to catching potentially pre-symptomatic, asymptomatic either residents or more particularly staff,” she said. “And I think we could be doing more.”

The seniors advocate acknowledges the rapid tests are less sensitive than lab tests. But using them in conjunction with gold-standard lab tests, which give results in 24 hours, could help prevent outbreaks in seniors homes, she said.

“We’re going to catch some of those people, maybe not all of them, but some of them,” Mackenzie said, noting people in the movie industry and NHL teams are being tested regularly. “We have nothing right now.”

Earlier this month, the seniors advocate released the results of a survey on the impacts of visitor restrictions in B.C. care homes. The survey, taken by more than 13,000 care home residents and family members, showed residents had a greater fear of death from loneliness than COVID-19 because of pandemic rules that limit visits. One spouse called them “inhumane.”

Residents are currently allowed one designated visitor, and Henry and Health Minister Adrian Dix said they were working toward “expanding” that — something Mackenzie would like to see in time for Christmas.

As the number of new cases grows and more restrictions are put in place, there is a need for outside caregivers, she said.

“Some of these family members are absolutely essential care partners to their loved one and we need them as part of the care team now more than ever,” she said.

“The system is stretched, we’re just at the beginning of when we’re going to start to see staff staying home more … due to isolating requirements.”

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