Manitoba is beginning to test people without symptoms for COVID-19 as part of a sentinel surveillance program tracking the circulation of the coronavirus.
Chief provincial public health officer Dr. Brent Roussin said the program is not intended to facilitate widespread asymptomatic testing; rather, public health officials are hoping to collect a random sampling of swabs from Manitobans who present at health-care facilities and community screening sites.
"All along, we’ve had people show up for testing who didn’t necessarily have the symptoms or meet the criteria, and we would often test them anyway," Roussin said in a phone interview Friday.
"As we increased our testing capacity and we opened up our testing criteria wide open to symptomatic people, we didn’t get the demand that we thought."
"We have leftover capacity, so now we feel we can start doing some targeted asymptomatic testing."
A fact sheet and guidance documents for health-care providers related to asymptomatic COVID-19 testing was published on the Shared Health website earlier this week. The documents state testing will be voluntary and offered to anyone who is asymptomatic and visits an emergency department, urgent-care location or a community testing site before they leave the facility.
Roussin said the shift in testing protocols was not announced publicly to avoid overwhelming demand on capacity and to maintain a representative, random sampling.
"Right now, we’re not advising people who aren’t showing symptoms to go get tested," he said. "For the sentinel testing we want a random allocation. We want people who are just presenting for other reasons, so we can actually get a random sampling of Manitobans; that’s what would be important.
"We don’t want to overwhelm our testing capacity with asymptomatic individuals and end up missing the opportunity to test symptomatic individuals."
Roussin said the province can test up to 2,000 people a day without becoming overwhelmed.
The province will also require people who do not have symptoms to be tested before they are admitted to acute-care or long-term care facilities.
Manitoba's top doctor has previously stated asymptomatic testing can produce unreliable results and has been reluctant to endorse widespread testing in the past. Roussin said Friday the evidence around asymptomatic testing, particularly negative results, hasn’t changed.
According to Shared Health, a person can develop symptoms and test positive for COVID-19 at any time after a nasopharyngeal swab is taken and tested.
In Alberta last week, health officials tested just over 3,400 asymptomatic Calgarians who continue to work outside of their homes. Preliminary results released this week detected more than 120 positive cases among asymptomatic patients. Most had come into close contact with a confirmed case of COVID-19. However, 43 individuals did not have contact with a known case.
"Because of our molecular test, it doesn’t necessarily tell us that those people were infectious," Roussin said. "It doesn’t necessarily tell you a whole bunch.
"I think that the take-home message is we need symptomatic people staying home and presenting for tests, and as our capacity is bigger then, we have that luxury of looking at even lower-risk people, which is the asymptomatic group."
Roussin said public health officials are developing a policy to extend asymptomatic testing to people in high-risk categories, including those who travel outside of the province for work, and will provide more information on how to access a test when it becomes available.
Danielle Da Silva
Danielle Da Silva is a general assignment reporter.
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