Hey, Where’s My Rapid Test?

B.C. has received at least one rapid antigen COVID test for each of its five million residents.

But finding them has been a big challenge.

In recent months the tests, which can be used at home to diagnose COVID-19 within minutes, were swapped more than holiday cards. The quest to obtain them has been part sleuthing, part scavenging and part smuggling operation.

“I’m getting a reputation as the neighbourhood rapid test hookup,” says Kerri Coombs, a Vancouver-based documentary film producer who had extras after securing a supply from the U.S. to screen a production crew. “I literally do the handoffs in the back alley like a criminal.”

Provincial health officials announced an accelerated rollout of rapid tests in December, a year after pilot test programs began in the province. Since then, the number of tests shipped to B.C. by the federal government has doubled.

But some say the tests — which add another layer of pandemic protection — should have been embraced sooner, a move they say could have saved lives.

“We missed the boat in B.C. because public health was comparing the rapid antigen test to the PCR [test] and, really, they’re not the same. They answer two different questions and they both have their weaknesses,” says Dr. Lyne Filiatrault, a former emergency physician who helped prevent a SARS epidemic in Vancouver in 2003. The PCR tests are more accurate, but can only be administered by trained technicians, take longer to produce results and are more expensive.

Filiatrault says the rapid tests are useful for indicating if a person is infectious at the moment the test is taken and are most effective in a vaccinated person when used two or three days after developing symptoms.

“I caution people that it’s not a free pass. It’s one additional tool in your toolkit,” Filiatrault adds.

When The Tyee asked Twitter users about procuring rapid tests — which the province has begun providing to those with COVID-19 symptoms but remain notoriously hard to find — they reported swapping with friends, tracking them down on social media and getting packages from loved ones in other provinces or even overseas.

“I went to get tested and wasn’t qualified. Someone on Twitter generously offered me a test. This is my only way to prove that I have COVID, which is critical as per longhauler folks,” Justinne Ramirez says, adding: “I have a couple of antigens if anyone wants one.” People fear that the lack of a positive test will lead to them being denied treatment and supports if they develop long-lasting COVID effects.

But while social media groups, like BC School Rapid Test Swap & Shop, have popped up in an effort to funnel tests where they are needed, many B.C. residents have resorted to ordering online, where they experience high prices, delays and even competition with large government orders.

Including shipping, a five-test kit can cost more than $100. If you can get one at all.

Alberta-based Rapid Test & Trace has a notice on its website letting customers know that “government has the right to appropriate COVID-19 antigen tests from manufacturers” and that “stock availability may be delayed due to allotments being unexpectedly taken by the government.”

In addition, Ontario-based supplier the Canadian Shield recently sent a notice to customers that shipments would be delayed due to “the unfortunate news that our supply chain of rapid tests has been interrupted by a government purchase from our manufacturing partner.”

But those shipments of test kits from the federal government aren’t making their way to many B.C. residents.

That’s partly because the provincial government has been slow to share the tests.

But the federal government had provided five million tests to B.C. as of Jan. 16, roughly one per resident, a lower rate than any other province.

Newfoundland and Nunavut have received between two and three tests per resident; Nova Scotia, New Brunswick and the Yukon have all received more than 10 tests per resident; and Saskatchewan has received almost 15 tests for each person in the province.

Filiatrault says that’s because other provinces have made more use of the tests. And British Columbians are paying a price for the decision to limit testing, she said.

“It’s prevented the population from having access to them as an added layer to get together safely with people,” she says. “They refused to allow innovation and, basically, it handicapped our response across the province.”

Rapid antigen tests were first approved by the federal government in late 2020 and B.C. began piloting them in high-risk settings like long-term care and rural and remote communities in early 2021.

By early December, the province had received 3.2 million tests. That doubled by Jan. 21 to 6.5 million as B.C. ramped up their use, including providing tests for visitors at long-term care homes and symptomatic K-12 school staff. The province expects to receive another 16 million rapid tests in the coming weeks.

Of the five million tests that had been received in B.C. by mid-January, the BC Centre for Disease Control had deployed 3.5 million by Jan. 16, a spokesperson said.

When asked for a breakdown, the spokesperson said almost 500,000 had gone to rural and remote communities, including First Nations, and another one million were divided between hospital health-care workers, K-12 schools, long-term care facilities and assisted living.

The province also caused frustration by keeping 1.3 million unused tests in a warehouse as the Omicron variant surged.

It’s not clear where the remaining two million tests delivered up until last month were allocated. When asked, the BCCDC directed The Tyee to the province’s Jan. 21 COVID-19 briefing. While Health Minister Adrian Dix provided an update at that time about test distribution during the week of Jan. 17, he did not mention distribution prior to mid-January.

Not all tests received by the province are suitable for at-home use. Of the tests received by mid-January, 70 per cent were the Abbott Panbio test, which can be used without special training or equipment. The rest are used “at the discretion of medical health officers,” the BCCDC says.

When asked where the tests that are not suitable for self-administered use were distributed, the BCCDC said, “they are used in settings with those trained to administer these kinds of tests.”

Other provinces have been more forthcoming with rapid test information.

In an email to The Tyee, Alberta Health Services provided a breakdown of where it had distributed the 7.5 million tests it had received by Jan. 19. That included roughly 1.5 million to care homes, almost three million for a variety of industries including construction, oil and gas, food processing and forestry, and more than one million to settings like offices, education, hospitality, retail and gyms.

Starting in December, Albertans could also collect, free of charge, a five-test kit every two weeks, although supplies have become limited in recent weeks. Other provinces, including Nova Scotia, New Brunswick, Saskatchewan and Quebec, have similar programs.

Dr. Dalia Hasan is an Ontario-based physician who started COVID Test Finders, which connects tests with people who need them. She says distribution in Ontario has been “a bit of a roller coaster,” with initial grassroots efforts to get tests into high-risk settings like schools being short-lived.

“In October, the premier made it clear that he wanted rapid tests only to be going to businesses and select organizations,” she says.

In November, Ontario began supplying take-home PCR kits to public school students and the following month it announced a “holiday testing blitz” with tests offered free at pop-up locations. Ontarians found themselves waiting in long lineups as supplies quickly ran out.

Still, Hasan says Ontario’s efforts to distribute rapid tests far surpass those in B.C. A petition started by COVID Test Finders calling on B.C. Premier John Horgan to provide free rapid antigen tests to B.C. households has gathered more than 15,000 signatures since early December.

“In B.C., they are probably the last province to acknowledge the utility of rapid tests, unfortunately. The science has been there for a while,” she says. “Right now, there’s enough rapid tests for each person in Canada to have access to four rapid tests for a month, and it would be critical to be distributing the rapid tests right now with the surge of Omicron.”

At least some of B.C.’s rapid test supply has been allocated to industry, with the Provincial Health Services Authority’ point-of-care rapid testing program launching last March. It looked to rapid testing as another tool for contact tracing and outbreak response “in rural and remote communities and at some worksites and community living locations.”

The program provides rapid tests at no charge to approved organizations and businesses. Under an agreement with the province, accredited businesses are required to have trained staff to administer the tests, implement appropriate COVID-19 measures and report positive test results back to the province.

Filiatrault doesn’t believe that’s keeping with the spirit of the federal government program that provides tests to provinces.

“These were given to the province for the people. They were never given for industries. Industries, as far as I’m concerned, they have the financial capacity to absorb the safety of their worker,” she says. “Instead, the province gave them away to industry, and they should have gone to the people.”

In January, the Yukon government disclosed that it had given 60 per cent of its Abbott Panbio rapid tests to four private mining companies. Of the 11,250 tests provided to the mining industry, the territory told Yukon News that about half, or 5,600 tests, were sent to Silvertip mine, which is located in northern B.C. just south of the Yukon border and operated by Chicago-based Coeur Mining.

When asked how many tests had gone to work camps in B.C.’s natural resource sector, the BCCDC said the camps fall under several categories, including “accommodation and food services; agriculture, forestry, fishing and hunting; and mining, quarrying and oil/gas extraction.”

It added that more than 200,000 tests had been sent to those sectors since May, but declined to break down the number further. In total, more than 750,000 tests have been deployed through the Provincial Health Services Authority program and a second program, Safe Screen BC, which provide free tests to industry and organizations, the BCCDC said.

While several hundred organizations have received test kits through the programs, the BCCDC declined to provide a list of accredited companies, citing privacy concerns.

Information posted to the BCCDC’s website highlights farms with communal housing and work camps in the natural resource sector as priorities for test distribution and says, “priority will be given to industries and organizations whose settings or activities are associated with an increased risk of transmission of COVID-19 or outbreaks due to high-contact between workers.”

Safe Screen BC launched in September and is administered by the Business Council of BC in partnership with the with the Ministry of Health and the Provincial Health Services Authority.

While it also provides free tests, it charges a fee for support services like training, reporting and distribution of the tests and helping businesses without in-house medical support navigate the system. Logistical work is contracted to firms like KPMG and TriHealth, says business council president Greg D’Avignon.

The Business Council of BC advocates on behalf of B.C. businesses — its executive committee and board of governors include representatives from some of the province’s largest industries, like mining, oil and gas, and forestry — and D’Avignon says he saw the benefits of rapid tests early in the pandemic and began advocating for their use as soon as they became available.

“I was on the premier’s advisory group early on during COVID, around trying to manage the challenges we were having,” D’Avignon says. “We were seeing the utility of testing, tracking and tracing, both from a population health benefit but also for keeping employees safe and businesses open.”

By the new year, Safe Screen BC had administered about 200,000 tests. It currently has 451 participating businesses and almost as many on a waiting list. D’Avignon says he expects the remaining companies will be added to the program as rapid tests become more available in the coming weeks.

Two-thirds of businesses using the service have fewer than 12 employees, D’Avignon says. Almost 30 percent are medium-sized businesses with up to 100 employees and four per cent are large businesses.

Most large industrial projects already have in-house medical services that source and administer tests independently, he adds.

“Ultimately, we want to make sure people are safe and that the economy continues to operate in the best way as possible,” he says.

For many industries operating in rural and remote locations, there’s little separation between workforce and local communities.

The Tahltan Nation in northwest B.C. is home to more than 40 per cent of the province’s mining exploration and several large mining operations provide much of the local employment.

Although rapid tests provided by the province have been slow to arrive on the territory, with tests just beginning to trickle into Iskut and Telegraph Creek, Tahltan emergency operations director Feddie Louie says a partnership between the nation and local mining operations has provided tests since last spring.

Jared Moe, health and safety superintendent at Red Chris, a mine owned by Australia-based Newcrest Mining and operated just south of Iskut, says the company has been administering an average 1,400 rapid tests a week to employees since last March. The company has also provided 2,000 tests to local communities over the same period.

He adds that the tests, which are sourced through the mine’s medical services provider, are independently purchased and not part of the publicly funded supply provided by the federal government.

“We have formed a strong working relationship with the Tahltan [emergency management committee] leads and work together to overcome challenges/situations as they arrive in a true collaborative partnership,” Moe said in an email, adding that several mining companies that operate on the territory have worked together to provide tests to local communities.

In addition to keeping the workforce safe, he says testing has provided valuable information to communities about local case counts.

It’s that same general information about clusters and outbreaks that the provincial government cited as it moved to implement more widespread rapid testing in early January, as B.C.’s existing testing capacity was overwhelmed by the Omicron variant.

Over the past month, the province has announced tests for symptomatic K-12 school staff, government-funded child-care centres and students in rural and remote areas.

When The Tyee talked to B.C. elementary school teacher Jennifer Heighton, her two take-home tests had just arrived. She says she would have appreciated having the preventative measures sooner.

“Definitely, more rapid tests would be great, just to be sure,” she says. “This is the beginning of the fourth week of in-person learning and there have been staff away sick in many schools. It would have been nice if they’d had the rapid tests earlier.”

Mike Klassen, vice-president of public affairs with the BC Care Providers Association, also questions the province’s slow rollout of rapid testing in long-term care and assisted living facilities.

“We had these tests come into British Columbia early in November 2020,” he says. “That was before we had the outbreak where we lost over 40 residents at Little Mountain Place. I mean, to think if we had actually started using them as soon as we got them.”

He says the use of rapid tests in long-term care began with a two-month pilot in early 2021, with guidelines for their use determined last spring. But their application is still far from widespread.

In October, the tests were used as a transition tool as B.C. implemented a mandatory vaccination policy for staff working in long-term care.

Focus then shifted away from staff to testing essential visitors starting in January. While the policy has been to test every visitor, he says tests have been in short supply. “The actual supplies of these were not in high enough quantities that we did start to see some sites that were running out,” he says.

There has been no direction to test vaccinated staff, he says, which creates anxiety for some employees who are in regular contact with vulnerable residents. While provincial health officials have indicated that schools are the current priority, he says long-term care and assisted living are expected to begin staff testing later this month or in early March.

“That’s a long time. We may be through the Omicron wave by that time,” he says. “These are tests that were bought and paid for by the Government of Canada.”

As for whether testing of visitors is catching cases of COVID-19 before they enter long-term care, Klassen doesn’t hesitate.

“Yes, they are,” he says. “Without question.”