B.C., Manitoba, Nova Scotia to prioritize access to COVID-19 lab tests for at-risk groups as demand strains capacity

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British Columbia, Manitoba and Nova Scotia are the latest provinces to try to limit access to some types of COVID-19 testing as laboratory systems across the country buckle under record cases driven by the Omicron variant.

In B.C. and Manitoba, health officials on Friday asked young people with mild COVID-19 symptoms, but who are otherwise healthy, to forgo the gold-standard polymerase chain reaction (PCR) lab test and simply assume they have Omicron, self-isolate and notify close contacts. Nova Scotia on Friday said people who have symptoms or are a close contact to a positive case will now have to complete an online self-assessment before receiving a PCR test.

The new instructions were made in an effort to ensure high-risk individuals and critical front-line workers can still access PCR tests when they need them.

The most accurate are molecular tests like the PCR test. But that test requires more resources to process. A rapid test can be self-administered at home, with results available within minutes. While it reliably detects cases with a high viral load, it is less reliable with asymptomatic cases or those with low viral load.

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Officials in those provinces didn’t announce new COVID-19 restrictions on Friday, but urged people to limit their contacts and make cautious decisions that go beyond public-health orders ahead of Christmas Day. In Nunavut, the government announced an eight-day “circuit breaker” lockdown by putting an end to indoor gatherings and requiring all non-essential businesses to close.

As the fifth wave of COVID-19 sweeps the country, unvaccinated individuals are at much higher risk of hospitalizaiton and death.

In his Christmas Day message, Prime Minister Justin Trudeau urged eligible Canadians to get their shots. This week, the Public Health Agency of Canada said more than seven million people still need to get their first or second dose of vaccine.

Ontario and Quebec each marked another record in reported cases on Friday. Ontario reported 9,571 cases, while Quebec media outlets reported more than 10,000 cases. Quebec did not provide official numbers on Christmas Eve.

International studies show that Omicron is less severe than other COVID-19 variants. But scientists and public-health officials say there is still much uncertainty because of how new the variant is, and the sheer number of overall cases means that even if there is a smaller percentage of severe cases, the health care system could still be overwhelmed.

There is less data available because, unlike past waves that hit Canada weeks after arriving in other countries, Omicron’s impact is being felt here at the same time, said Allison McGeer, an infectious disease physician at Sinai Health System in Toronto.

In Ontario, she said, the province is quickly moving to administer third doses and substantial restrictions are already in place.

“Looking at what people are doing, I do think that a lot of people have changed their behavior and reduced their contacts,” Dr. McGeer said. “I’m really hoping it’s enough, we’re going to find out.”

She said data on the link between Omicron infection and case severity will be clearer in the next week or two.

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“It was only eight days ago that Omicron became more common than Delta in the specimens in our lab,” Dr. McGeer said. “And so, in terms of hospital admissions, we’re just at the point where hospital admissions are going to start to climb, if they’re going to climb from Omicron.”

In the last week, hospitalizations in Ontario and Quebec have climbed by 23 per cent and 52 per cent, respectively. But in Ontario, intensive care admissions are relatively stable. Across the country, hospitalizations were up 15 per cent in the last week.

Both Ontario and Quebec have imposed restrictions to try and arrest the growth. The strictest are in Quebec, which has closed bars, gyms and movie theatres while tightly limiting restaurant capacity and opening hours. Starting on Boxing Day, the province will further cut private-gathering limits to six people.

Quebec Premier François Legault on Friday warned of tough weeks to come. “The Omicron variant is more contagious than anything seen since the start of the pandemic,” Mr. Legault wrote in a Christmas message posted to Facebook. “I count on your judgment to respect the instructions and to be careful.”

Last week, Ontario imposed 50-per-cent capacity limits, which apply to many indoor businesses, including restaurants, bars, retailers, gyms and malls.

On the West Coast, B.C. Provincial Health Officer Bonnie Henry implored people to consider themselves infectious with the Omicron variant if they had even mild symptoms, and asked younger people to consider isolating for seven days without getting a test if they have symptoms. Rapid testing, which is being deployed in Alberta, Ontario and Quebec, is not yet available to most of B.C.’s population.

Dr. Henry said the province reached its limit of 20,000 tests per day on Thursday, and reported a record high 2,046 new cases on Christmas Eve.

“Our testing centres are at their maximum capacity,” Dr. Henry said. “If you have any symptoms, you must assume you have COVID.”

PCR tests need to be reserved for people over 65, those with underlying illnesses and people who have more severe symptoms where it makes a difference in how they get treated, Dr. Henry said.

In Manitoba, Health Minister Audrey Gordon was pressed by reporters Friday to explain why the province wasn’t imposing harsher restrictions as it marked a record case count, elevated ICU numbers and a 10,000-test backlog.

At the press conference, Chief Provincial Public Health Officer Brent Roussin said to expect 10 per cent of those cases to be positive, meaning the number of cases tested but not yet confirmed is higher than the “all-time record” of 742 cases reported on Friday.

“We need to do whatever we can to decrease our contacts,” he said.

Both Dr. Roussin and Ms. Gordon signalled more restrictions were coming and that large gatherings won’t be happening in Manitoba next week. But they left it unclear whether those changes would come before shoppers flock to the malls for Boxing Day.

Nova Scotia announced new testing rules after reporting 611 new cases on Friday, slightly down from Thursday’s record of 689.

People who have COVID-19 symptoms or were a close contact to a positive case will now have to complete an online self-assessment before receiving a PCR test.

“We need to use those resources wisely given the current epidemiology ... our priority for PCR testing has to be on people who are most vulnerable to disease and people who are needed to keep our health-care system running,” the province’s Chief Medical Officer of Health Robert Strang said. “But everyone who needs a COVID-19 test will get one.”

Meanwhile, in Nunavut, which has eight active cases, travel in and out of certain communities in the territory has been restricted to essential purposes only.

“With introductions of COVID-19 in multiple communities over the past week, we must move to the strictest public health restrictions across the entire territory,” Chief Public Health Officer Michael Patterson said in a news release Friday.

“I understand this will make the holiday season harder for many, but it is necessary for the health and safety of our communities and loved ones.”

With reports from The Canadian Press