BY PAMELA FAYERMAN

A physician contacted me recently to mention that surgeons are not allowed to ask prospective surgery patients about their vaccination status.

“So I’m operating in some cases on patients who have refused vaccines. And these same patients may be sitting only feet away from immunocompromised patients in waiting rooms.”

When the surgeon decided to delay a patient’s scheduled (non-urgent) operation recently because she had a cough and no one could get a straight answer about her vaccinations status, she became belligerent, threatening to complain to the government that she was being refused health care.

“We aren’t allowed to insist on testing before surgery and the provincial health officer has also decreed that only symptomatic patients are tested. I’m moments from quitting every hour this goes on,” said the understandably exasperated surgeon.

I’ve written about testing before operations as well as research that has shown the benefits of such.

None of it sways BC health minister Adrian Dix and Dr. Henry. Low yield testing on asymptomatic people is a waste of resources in their opinions.

The honeymoon the pandemic health leaders have enjoyed with the media and the public is waning and the issue with rapid tests is the final afront.

Indeed, BC is looking like a nanny state because of bureaucratic hesitation/overcaution.

On December 1, a company called DriverCheck announced its COVID-19 Antigen Rapid Test kits could be purchased online. The BTNX Rapid Response kits come in a box with five individual tests and cost $58.75. You can order the Health Canada-approved test kits online but not if you live in B.C. because, unlike a handful of other provinces, B.C. has not approved them for household use. I discovered this after I tried to buy a box for my own household.

I then asked the BC government why it hasn’t approved the sale of such home kits and I got this response from a health ministry representative who asked not to be named:

“In B.C., public health has significant testing capacity and we urge people who may be experiencing symptoms to call 811 or use the COVID-19 Self-Assessment App to find out if they need a test.

B.C.’s testing policy and work is guided by the advice of the federal COVID-19 Testing and Screening Expert Advisory Panel and Dr. Bonnie Henry. PCR tests are considered the gold standard for COVID-19 testing in B.C. and are foundational to B.C.’s approach to detecting COVID-19. B.C.’s approach to testing increases the likelihood that those most at risk of contracting or transmitting the virus are tested immediately. This approach allows public health to detect COVID-19 cases early, which reduces transmission in our communities, and helps keep all of us safer from the virus.

Public Health’s Rapid Point of Care Testing strategy was developed based on public health guidance and information, including recommendations by the federal COVID-19 Testing and Screening Expert Advisory Panel. This strategy outlines how B.C. can best utilize Point-of-Care tests to complement its foundational testing program, which utilizes PCR tests. Early in 2021, the Panel shared testing recommendations that align with B.C.’s approach, including prioritizing the gold standard lab-based PCR testing for those who exhibit symptoms or have come into contact with someone diagnosed with COVID. More information about this program can be found here: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/testing/rapid-covid-19-point-of-care-screening-program.

B.C. currently has just under two million various rapid point-of-care test kits, which are widely available to British Columbians. The kits are provided at long-term care and seniors’ assisted living facilities, and businesses can access the tests through the Safe Screen BC program. As well, non-profits, charities and Indigenous community organizations are receiving free tests through the Canadian Red Cross.

B.C. continues to maintain testing capacity in excess of 20,000 lab-based PCR tests per day. Anyone in B.C. who has symptoms of COVID-19, who is part of an outbreak or cluster, or who has otherwise been identified by a Medical Health Officer can receive a PCR test through the public system. Our approach to testing will continue to evolve based on epidemiology, testing capacity and methodology and our growing understanding of the virus.”

It is understandable that BC may have qualms about whether people who test positive on rapid tests are not then included in provincial case counts if they aren’t re-confirmed as positive by going to a provincial test centre. This could also lead to further spread of the virus if they don’t isolate. (Notice that the provincial response didn’t mention these important matters).

But rapid tests are nevertheless a vital tool in the pandemic arsenal and if they are good enough for schools, businesses, long-term care facilities and other provinces, where they are being used, then BC should stop denying individuals access to them. This is especially urgent as the rapidly multiplying and more infectious Omicron variant is about to sap all the social pleasures out of the Christmas holidays.

Ontario is now giving away two million rapid tests in subway stations, malls, libraries, and liquor stores. Quebec and Alberta are also offering residents free kits.

B.C. has only ordered the kind of kits that need trained technicians.

Today, under pressure in his news briefing, Dix said that home kits will be available in 2022. He said there are about two dozen rapid test kits approved by Health Canada but none of them were designed as home kits although some have been adapted for such purposes.

Neither Dix nor Henry mentioned they aren’t available in BC because the government here has not yet approved them for household use. Research has shown that rapid antigen tests (RATS) are a very good tool for revealing if an individual is currently infectious, even if they have no obvious symptoms. In B.C. – a province where asymptomatic individuals must lie about symptoms in order to get tested – they are a better-than-nothing tool for individuals who are hell-bent on attending social events.

Twitter account for rapid antigen test expert Dr. Victor Leung.

On Twitter, there is so much outrage over government impediments to rapid antigen tests (RATS) that you can search #FreeTheRats to see a growing number of persuasive tweets by experts such as one of BC’s leading rapid test expert/champions, Dr. Victor Leung, a medical microbiologist/infectious disease expert.

He has been using rapid tests in health care facilities since the beginning of the pandemic and is clearly perplexed by the impediments to their widespread use in B.C.

pamela@medicinematters.ca