Don't just rely on rapid tests ahead of holiday gatherings: Ontario testing panel chair

A frank conversation between family members about what it means if someone has COVID-19 is a better bet than just relying on a rapid test result, says the head of Ontario's panel on COVID testing.

Dr. Jennie Johnstone, who chairs the Ontario Provincial Testing Expert Strategy Panel, says there's a margin of error with COVID-19 rapid tests, including if the self-tester is using it correctly. 

People getting together for Christmas dinner should instead talk about what would happen if one of them did have COVID. 

"Have an open and frank discussion with your family members or loved ones, and say if, in fact, somebody did have COVID in retrospect, are we OK with that?" she told CBC News.

Johnstone also talked about the testing backlog, how we're using rapid test data, and other questions around testing. The following has been edited for length.

One thing to note is that our lab testing capacity is actually excellent. The pinch point is the assessment centres, because many individuals appropriately and necessarily have been pulled away to do vaccinations. And that is where we need to have our priority. 

The province is looking at trying to improve the potential for self and drop offs for PCR testing as a means that doesn't rely necessarily on as much stuff. We do want to continue to maximize the PCR testing capacity that we do have. Once the test is in the lab, the turnaround times are excellent. 

But almost certainly, we're missing cases. Our test positivity in the province is somewhere in the realm of 10 per cent, which means for every person tested, I'm sure there are additional individuals that we're missing.

It's difficult to say. What we need to know is that there is a lot of COVID out there and we need to act accordingly. We know how this is spread. So let's think through the gatherings that we're going to have. Is it masked, or is it unmasked? Is it indoors or is it outdoors? We know that outdoors is safer. We know that masked is safer. I know that's very hard to hear at a time when individuals want to gather and have meals together.

We have evolved our testing strategy over the last two years. What we're doing now isn't what we were doing in May 2020. I think we need to continue to evolve. Every wave is different and we do have to adjust accordingly. 

So in the coming weeks, as the demand for PCR testing increases, we know that we need to preserve that capacity for hospitalized patients, residents of long-term care, staff who are working in those settings, and individuals who may benefit from treatment. Whether or not we need to pivot then … I'll leave it to the chief medical officer of health to make a decision. But we may need to do that in the coming days and weeks.

One of the challenges with pivoting to a rapid testing strategy for diagnostic purposes is that right now, we get all of our data from PCR testing. That's how we know how many cases we have, where the hot spots are, and who's getting COVID. Once you go to a self-reporting system, you're going to lose a lot of data. 

I think it is a great strategy to have people self-report so we continue to know: where the hot-spot neighbourhoods? What are the hot-spot regions? Who are the individuals that are getting COVID? Then you can target your public health measures. I expect that the province is looking at something like what Peterborough has done so we can continue to have some data if, in fact, we pivot to using rapid antigen tests for the purpose of diagnosis in lower-risk individuals.

At this moment, that is the provincial recommendation. And again, it's less about the fact that you need to confirm that it's positive. Almost certainly, it is positive.