Province restricts PCR testing to high-risk use; rapid antigen results not part of case counts

Case count changes concern Alberta experts With the province changing its methodology, some health experts are concerned about case counts. Stephanie Thomas reports

CALGARY — The province is moving away from testing all positive cases of COVID-19 with PCR tests even after a positive result from an at-home test which is worrying some Calgary doctors who say the province won't have accurate data.

However some infectious disease experts say there are ways the province can track infections and develop a public health response.

On Tuesday provincial leaders told reporters Alberta is not going to be able to do PCR testing to confirm all the positive cases that are expected with an omicron surge.

"The PCR tests that we are currently reporting as positive are just the tip of the iceberg," said Dr. Deena Hinshaw, chief medical officer of health for Alberta.

The province is reporting more than 15,000 active cases which is only a fraction of community cases in Alberta.

Alberta Health recommends those with complex medical history or workers in healthcare settings including staff or residents of long-term facilities should be given priority to provincial testing centres -- otherwise take a rapid antigen test and isolate if you have symptoms.

Dr. Hinshaw says results of at-home tests should be sent in to your family doctor if possible, though it will not be included in reported case counts.

This has some doctors concerned the province will not have reliable data for the fifth wave.

"(Without the) PCR tests, the government would not know how many cases to be had within the province and (COVID-19) will be spreading on buses, in malls and workplaces," said clinical physician Dr. Mukarram Zaidi who is also connected with the Protect Our Province medical advocacy group.

Dr. Zaidi says that government should have sufficient budgets to cover enough PCR testing capabilities, as private companies have.

Yet some infectious disease experts say the data from lab-confirmed tests that is being collected is enough for public health officials to respond to.

"In terms of kind of the public health response and even the hospital response I think that we still do have enough data to be able to put our plans in place and be ready for what we anticipate is going to be a busy time," Dr. Stephanie Smith infectious disease physician based in Edmonton.

WASTEWATER ANALYSIS HELPFUL

Wastewater analysis is another data collection tool used in Alberta with the Pan-Alberta Network for Wastewater-based SARS-CoV-2 Monitoring program.

Virus particles can be found in human waste and scientist can determine how much community infection there is.

One of the co-leads says the program has been highly accurate in previous waves and predict it will be the standard for detection going forward.

"What's great about wastewater is it's entirely objective. And it captures everybody that's contributing to that wastewater in an entire population. So that includes people with symptoms, and people without symptoms, and people who get tested and people who don't get tested," Dr. Michael Parkins who is also based out of the University of Calgary.

Drs Smith and Zaidi say Alberta's pandemic response needs to address documentation for individual cases, especially in severe cases where those who test positive with a rapid antigen test, are forced to miss long periods of work.

The concern is whether some insurance companies, workers compensation or disability programs will require the official confirmation from the province, or if there's a mechanism for the person's family doctor to submit that information after a rapid test.

Alberta's top doctor says the issue is being looked into.