Bruce Arthur: Rapid COVID tests would help in Ontario schools. Shouldn’t we at least try to get them there?

Opinion Sep 27, 2021 by Bruce Arthur Columnist

If you’re looking for rapid tests for your kids, good luck. Ontario private schools had some, until a predictable and reasonable outcry forced the province to pull them. But some parents are still hunting rapid antigen tests, and educators too. Again, good luck to them.

Rapid tests are only one small tool in the pandemic, but their use is also an artifact and a system that is still tilted toward business over most anything else. And it should be changed.

“Is there a practical and valid argument to be made that (rapid tests) can’t be distributed to every single school in every part of the province every single week? Sure,” said Joe Cressy, city councillor and the chair of the Toronto Board of Health. “But that’s not an excuse to do nothing.

“I would just say, try everything. Our whole experience with the pandemic is, try everything. And with rapid tests, if those who are looking at procurement and logistics say it can’t be done to everyone everywhere every week … then there is a better way to do it.”

The scientific argument over rapid tests has bubbled back and forth in Ontario since the tests arrived in November of last year. A lack of accuracy can mean false positives, and false negatives as well. Rapid testing can be hugely laborious to the lab and health-care system if deployed at scale, unless you can do the tests at home. Using the tests is more helpful, in theory, in high-prevalence areas. Some of these arguments are still going on.

And still, Ontario used 135,000 rapid tests last week, according to one source, almost entirely in health-care settings and businesses, and had planned for up to 120,000 a day, depending on demand. Directive 6 ordered rapid tests in health care: in a world where not every health-care worker is vaccinated, there are breakthrough cases even among the vaccinated, and they are often caring for both the immunosuppressed and the unvaccinated, that’s the right call.

But choosing businesses, which the province still refuses to name, over schools? That doesn’t sound like Ontario at all, does it?

“With Delta, where you get infectious probably one or two days before (original COVID), and because the viral load is also higher, this changes absolutely the situation for rapid tests,” says Dr. Peter Juni, the scientific director of the province’s independent volunteer science table. “And the rapid tests we have are absolutely fit to separate the wheat from the chaff. You need confirmation with PCR if someone is positive, but that’s doable, and to rule out people who are highly likely to be infectious.

“What you probably would need to focus on is where you get the most bang for the buck, and that’s high-risk areas. Elementary schools are the most important place to do something like that. And if you are a contact of a case … a test-for-staying strategy can work. And if you come in close contact with a case, if you are tested daily and test negative you can continue to go to school.”

Why wouldn’t we do this? The science table is expected to release reasonably optimistic modelling Tuesday, but there are puffs of smoke starting to come from schools. As the Star’s David Rider reported, Toronto Public health says the only age group in Toronto whose case count is rising are children 4-11, at 64 cases per 100,000, up from 57 last week. Of Ontario’s 4,800 schools, almost 800 have active COVID-19 cases. The official public health line on all this is that cases aren’t transmitted in schools, and hopefully that is true, but with students eating together, and about a million Ontarian children ineligible to be vaccinated, the virus is going to find unvaccinated people.

No, it could have been worse. Ontarians can look at Alberta and Saskatchewan and hold their breath over the unfolding tragedy of two wildly conservative governments shattering their health-care systems even in the age of mass vaccination, and still not seeming to grasp what they have done.

But in the comparative safety of Ontario, many parents — much less parents with immunosuppression, or comorbidities, or who have a pending and possibly already-delayed surgery — will go to great lengths to try to grapple back some control. And as in much of the pandemic, unless they have the sterling Michael Garron Hospital in their neighbourhood, that means the most privileged have the most advantages to secure the most protections, however well they work.

So if you can’t test every student in the province, why not direct rapid tests to the highest-risk schools? The argument against it appears to be that with false positives in a low-endemic area you actually keep more kids out of school, and between antigen testing and a confirmatory PCR test, could cost more money. The money argument is the one that shouldn’t be occurring, but this is Ontario, land of the cheap.

Still, Ontario should redirect some rapid tests toward higher-risk schools as a preventative measure as well. For all the nuance, it more or less comes down to prioritizing actual positives, rather than worrying about false ones. Like some things in the pandemic, it’s complicated, and simple.

It should go without saying that we can’t test our way out of the pandemic, and we never will; vaccination is the road, and that means the best tools are increased education and outreach to vaccine-hesitant communities, compliance from businesses and a regulatory structure for vaccine passports, and increasing mandatory vaccination settings. We’re getting there.

But if this government wanted to accelerate the end of the pandemic it would mandate vaccination in health care and long-term care, and it would make vaccinations mandatory for kids in school, and teachers. too. And it would push more protections to the largest unvaccinated community in the province, and tilt toward those kids whose educations have already been disrupted by a government that so rarely worried about community spread before it was too late.

Look, Ontario has bumbled its way to this rosy, precarious perch, and it’s an unexpected delight. But that doesn’t mean we shouldn’t use every tool to crush this thing, every chance we get.

Correction — Sept. 27, 2021: This article has been updated to clarify that Ontario used 135,000 rapid tests last week, according to one source.

Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: @bruce_arthur

Bruce Arthur: Rapid COVID tests would help in Ontario schools. Shouldn’t we at least try to get them there?

Opinion Sep 27, 2021 by Bruce Arthur Columnist

If you’re looking for rapid tests for your kids, good luck. Ontario private schools had some, until a predictable and reasonable outcry forced the province to pull them. But some parents are still hunting rapid antigen tests, and educators too. Again, good luck to them.

Rapid tests are only one small tool in the pandemic, but their use is also an artifact and a system that is still tilted toward business over most anything else. And it should be changed.

“Is there a practical and valid argument to be made that (rapid tests) can’t be distributed to every single school in every part of the province every single week? Sure,” said Joe Cressy, city councillor and the chair of the Toronto Board of Health. “But that’s not an excuse to do nothing.

“I would just say, try everything. Our whole experience with the pandemic is, try everything. And with rapid tests, if those who are looking at procurement and logistics say it can’t be done to everyone everywhere every week … then there is a better way to do it.”

The scientific argument over rapid tests has bubbled back and forth in Ontario since the tests arrived in November of last year. A lack of accuracy can mean false positives, and false negatives as well. Rapid testing can be hugely laborious to the lab and health-care system if deployed at scale, unless you can do the tests at home. Using the tests is more helpful, in theory, in high-prevalence areas. Some of these arguments are still going on.

And still, Ontario used 135,000 rapid tests last week, according to one source, almost entirely in health-care settings and businesses, and had planned for up to 120,000 a day, depending on demand. Directive 6 ordered rapid tests in health care: in a world where not every health-care worker is vaccinated, there are breakthrough cases even among the vaccinated, and they are often caring for both the immunosuppressed and the unvaccinated, that’s the right call.

But choosing businesses, which the province still refuses to name, over schools? That doesn’t sound like Ontario at all, does it?

“With Delta, where you get infectious probably one or two days before (original COVID), and because the viral load is also higher, this changes absolutely the situation for rapid tests,” says Dr. Peter Juni, the scientific director of the province’s independent volunteer science table. “And the rapid tests we have are absolutely fit to separate the wheat from the chaff. You need confirmation with PCR if someone is positive, but that’s doable, and to rule out people who are highly likely to be infectious.

“What you probably would need to focus on is where you get the most bang for the buck, and that’s high-risk areas. Elementary schools are the most important place to do something like that. And if you are a contact of a case … a test-for-staying strategy can work. And if you come in close contact with a case, if you are tested daily and test negative you can continue to go to school.”

Why wouldn’t we do this? The science table is expected to release reasonably optimistic modelling Tuesday, but there are puffs of smoke starting to come from schools. As the Star’s David Rider reported, Toronto Public health says the only age group in Toronto whose case count is rising are children 4-11, at 64 cases per 100,000, up from 57 last week. Of Ontario’s 4,800 schools, almost 800 have active COVID-19 cases. The official public health line on all this is that cases aren’t transmitted in schools, and hopefully that is true, but with students eating together, and about a million Ontarian children ineligible to be vaccinated, the virus is going to find unvaccinated people.

No, it could have been worse. Ontarians can look at Alberta and Saskatchewan and hold their breath over the unfolding tragedy of two wildly conservative governments shattering their health-care systems even in the age of mass vaccination, and still not seeming to grasp what they have done.

But in the comparative safety of Ontario, many parents — much less parents with immunosuppression, or comorbidities, or who have a pending and possibly already-delayed surgery — will go to great lengths to try to grapple back some control. And as in much of the pandemic, unless they have the sterling Michael Garron Hospital in their neighbourhood, that means the most privileged have the most advantages to secure the most protections, however well they work.

So if you can’t test every student in the province, why not direct rapid tests to the highest-risk schools? The argument against it appears to be that with false positives in a low-endemic area you actually keep more kids out of school, and between antigen testing and a confirmatory PCR test, could cost more money. The money argument is the one that shouldn’t be occurring, but this is Ontario, land of the cheap.

Still, Ontario should redirect some rapid tests toward higher-risk schools as a preventative measure as well. For all the nuance, it more or less comes down to prioritizing actual positives, rather than worrying about false ones. Like some things in the pandemic, it’s complicated, and simple.

It should go without saying that we can’t test our way out of the pandemic, and we never will; vaccination is the road, and that means the best tools are increased education and outreach to vaccine-hesitant communities, compliance from businesses and a regulatory structure for vaccine passports, and increasing mandatory vaccination settings. We’re getting there.

But if this government wanted to accelerate the end of the pandemic it would mandate vaccination in health care and long-term care, and it would make vaccinations mandatory for kids in school, and teachers. too. And it would push more protections to the largest unvaccinated community in the province, and tilt toward those kids whose educations have already been disrupted by a government that so rarely worried about community spread before it was too late.

Look, Ontario has bumbled its way to this rosy, precarious perch, and it’s an unexpected delight. But that doesn’t mean we shouldn’t use every tool to crush this thing, every chance we get.

Correction — Sept. 27, 2021: This article has been updated to clarify that Ontario used 135,000 rapid tests last week, according to one source.

Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: @bruce_arthur

Bruce Arthur: Rapid COVID tests would help in Ontario schools. Shouldn’t we at least try to get them there?

Opinion Sep 27, 2021 by Bruce Arthur Columnist

If you’re looking for rapid tests for your kids, good luck. Ontario private schools had some, until a predictable and reasonable outcry forced the province to pull them. But some parents are still hunting rapid antigen tests, and educators too. Again, good luck to them.

Rapid tests are only one small tool in the pandemic, but their use is also an artifact and a system that is still tilted toward business over most anything else. And it should be changed.

“Is there a practical and valid argument to be made that (rapid tests) can’t be distributed to every single school in every part of the province every single week? Sure,” said Joe Cressy, city councillor and the chair of the Toronto Board of Health. “But that’s not an excuse to do nothing.

“I would just say, try everything. Our whole experience with the pandemic is, try everything. And with rapid tests, if those who are looking at procurement and logistics say it can’t be done to everyone everywhere every week … then there is a better way to do it.”

The scientific argument over rapid tests has bubbled back and forth in Ontario since the tests arrived in November of last year. A lack of accuracy can mean false positives, and false negatives as well. Rapid testing can be hugely laborious to the lab and health-care system if deployed at scale, unless you can do the tests at home. Using the tests is more helpful, in theory, in high-prevalence areas. Some of these arguments are still going on.

And still, Ontario used 135,000 rapid tests last week, according to one source, almost entirely in health-care settings and businesses, and had planned for up to 120,000 a day, depending on demand. Directive 6 ordered rapid tests in health care: in a world where not every health-care worker is vaccinated, there are breakthrough cases even among the vaccinated, and they are often caring for both the immunosuppressed and the unvaccinated, that’s the right call.

But choosing businesses, which the province still refuses to name, over schools? That doesn’t sound like Ontario at all, does it?

“With Delta, where you get infectious probably one or two days before (original COVID), and because the viral load is also higher, this changes absolutely the situation for rapid tests,” says Dr. Peter Juni, the scientific director of the province’s independent volunteer science table. “And the rapid tests we have are absolutely fit to separate the wheat from the chaff. You need confirmation with PCR if someone is positive, but that’s doable, and to rule out people who are highly likely to be infectious.

“What you probably would need to focus on is where you get the most bang for the buck, and that’s high-risk areas. Elementary schools are the most important place to do something like that. And if you are a contact of a case … a test-for-staying strategy can work. And if you come in close contact with a case, if you are tested daily and test negative you can continue to go to school.”

Why wouldn’t we do this? The science table is expected to release reasonably optimistic modelling Tuesday, but there are puffs of smoke starting to come from schools. As the Star’s David Rider reported, Toronto Public health says the only age group in Toronto whose case count is rising are children 4-11, at 64 cases per 100,000, up from 57 last week. Of Ontario’s 4,800 schools, almost 800 have active COVID-19 cases. The official public health line on all this is that cases aren’t transmitted in schools, and hopefully that is true, but with students eating together, and about a million Ontarian children ineligible to be vaccinated, the virus is going to find unvaccinated people.

No, it could have been worse. Ontarians can look at Alberta and Saskatchewan and hold their breath over the unfolding tragedy of two wildly conservative governments shattering their health-care systems even in the age of mass vaccination, and still not seeming to grasp what they have done.

But in the comparative safety of Ontario, many parents — much less parents with immunosuppression, or comorbidities, or who have a pending and possibly already-delayed surgery — will go to great lengths to try to grapple back some control. And as in much of the pandemic, unless they have the sterling Michael Garron Hospital in their neighbourhood, that means the most privileged have the most advantages to secure the most protections, however well they work.

So if you can’t test every student in the province, why not direct rapid tests to the highest-risk schools? The argument against it appears to be that with false positives in a low-endemic area you actually keep more kids out of school, and between antigen testing and a confirmatory PCR test, could cost more money. The money argument is the one that shouldn’t be occurring, but this is Ontario, land of the cheap.

Still, Ontario should redirect some rapid tests toward higher-risk schools as a preventative measure as well. For all the nuance, it more or less comes down to prioritizing actual positives, rather than worrying about false ones. Like some things in the pandemic, it’s complicated, and simple.

It should go without saying that we can’t test our way out of the pandemic, and we never will; vaccination is the road, and that means the best tools are increased education and outreach to vaccine-hesitant communities, compliance from businesses and a regulatory structure for vaccine passports, and increasing mandatory vaccination settings. We’re getting there.

But if this government wanted to accelerate the end of the pandemic it would mandate vaccination in health care and long-term care, and it would make vaccinations mandatory for kids in school, and teachers. too. And it would push more protections to the largest unvaccinated community in the province, and tilt toward those kids whose educations have already been disrupted by a government that so rarely worried about community spread before it was too late.

Look, Ontario has bumbled its way to this rosy, precarious perch, and it’s an unexpected delight. But that doesn’t mean we shouldn’t use every tool to crush this thing, every chance we get.

Correction — Sept. 27, 2021: This article has been updated to clarify that Ontario used 135,000 rapid tests last week, according to one source.

Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: @bruce_arthur