Ontario to expand use of rapid COVID-19 antigen tests amid surge in Omicron cases

The Ontario government has announced it will expand the use of rapid COVID-19 antigen tests as the provincial diagnostic testing network faces sustained pressure under the spread of the Omicron variant.

In documents released by the government on Thursday, rapid antigen tests (RATs) for the most vulnerable sectors are now being recommended for three purposes, including the practice of testing-to-work, testing people without symptoms as screening, and for people who are displaying COVID-19 symptoms.

TEST-TO-WORK

The province says its test-to-work strategy will be used to support what it calls “work-self” isolation in critical work shortages in the highest risk settings, where staff are able to return to work instead of self-isolating at home.

Last month, the Ministry of Health recommended that asymptomatic health-care workers, who are deemed a close contact of someone with COVID-19, should return to work immediately so long as they undergo a PCR test “as soon as possible” and partake in a daily rapid testing program for a period of 10 days following the exposure.

Ontario’s Chief Medical Officer of Health Dr. Kieran Moore said at the time that the new guidance was necessary to keep the “health system functioning” amid soaring case counts brought about by the spread of the Omicron variant.

TESTING PEOPLE WITHOUT SYMPTOMS AS SCREENING

In an effort to identify cases of COVID-19 that are in pre-symptomatic or asymptomatic individuals, the government is now recommending the “repeated rapid antigen testing” of people who are asymptomatic and without known exposure to someone with COVID-19 in the highest risk settings.

The new recommendation includes health-care workers who are subject to what the province is calling Directive 6, which requires unvaccinated staff in high-risk settings like hospitals and long-term care homes to undertake more regular rapid antigen testing at a minimum of twice weekly.

The tests are not recommended for what the government calls “one-off use” before things like social events due to the risk of false negatives.

TESTING PEOPLE WITH SYMPTOMS

If someone has COVID-19 symptoms and tests negative on two consecutive rapid antigen tests – separated by 24 to 48 hours -- the individual is less likely to be infected with COVID-19 and is advised to self-isolate until symptoms improve for at least 24 hours or 48 hours if the symptoms are gastrointestinal.

Health officials have said that a positive RAT likely means a symptomatic individual has COVID-19 and should self-isolate.

Currently, only settings that the province considers “high priority” are eligible to use the RATs, including long-term care and retirement homes, hospitals, paramedics, shelters and other congregate care settings, as well as First Nation and Indigenous communities and organizations.

Dr. Moore emphasised that COVID-19 tests in Ontario have become a “luxury” given the scarce supply and advised those not working or living in a high-risk setting against seeking out testing.

“If I come down with symptoms of COVID-19, so I get a fever and a cough, I’m not going to seek any confirmatory testing. I’m going to stay at home for the five days and hopefully my symptoms are resolved,” Moore said.

“Given the high community prevalence of COVID-19 [in Ontario], testing is a luxury. Monitoring your symptoms is what every Ontarian should be doing.”

The government said it plans to use RATs in education settings for symptomatic testing and screening while also sending kits to sectors with mandatory vaccination policies or testing mandates.

MORE THAN 54 MILLION RATS EARMARKED FOR ONTARIO

The new recommendations on rapid antigen testing in Ontario come after the federal government announced on Wednesday that 140 million additional rapid tests will be delivered to provinces and territories.

Of those tests, Ontario will receive 54.3 million which is 14 million fewer than what the province said it requested of the federal government. As of Jan. 6, the Ontario government said it had received 150,000 tests from Ottawa that it will deploy to the aforementioned settings designated as a priority by the province.

Moreover, Ontario said it has procured an additional 65 million RATs in December and January to ensure continued access.

The government said that RATs will eventually be more widely distributed to the public pending supply.  

With files from CP24's Chris Fox and Joshua Freeman