Drive-thru in the driveway: Who are the people paying for COVID test house calls?

A nurse performs a test on a patient at a drive-in COVID-19 clinic in Montreal, on Wednesday, October 21, 2020. THE CANADIAN PRESS/Paul Chiasson

Montreal — Don’t like lineups? Don’t want to leave the house? You can always get a nurse to make a COVID-testing house call—if you have about $300 to spare.

Some of Montreal’s wealthier families jumped on that bandwagon very quickly after schools reopened this fall.

“Originally, the first batch of people were from the schools… certainly a lot of them were from private schools,” said David Ohayan, a manager at a company called Canada Home Doctors.

“It seems like they came from well-off families.”

But many different types of Montrealers have their reasons for shelling out for at-home private tests, which are offered by a small handful of companies in or near Montreal.

The demand—and the various reasons behind it—wasn’t even something the tests’ providers predicted, they say.

For example, Canada Home Doctors began offering door-to-door testing in late September, around the time the second wave started.

“We got up the website and we opened our Facebook page, and we hadn’t spent a dollar in marketing,” said Ohayan.

“Just through word of mouth, we started getting requests. It kind of caught us off guard.”

There’s a new glut of requests recently from the lucky few planning ahead for Christmas flights, plus myriad others who aren’t so lucky.

DRIVE-THRU TESTS IN THE DRIVEWAY

Canada Home Doctors was established long before the pandemic and only turned to COVID-19 tests when its normal business dried up.

Before last March, the company provided door-to-door medical services for travellers covered by foreign travel insurance—for example, a German business traveller with German insurance who’s staying in a Montreal hotel.

The company had a staff of a dozen, plus about 25 nurses and doctors on contract. In March, when most travel stopped, Ohayan and his partners scrambled for a new, temporary business model to keep staff employed.

Private companies may offer paid COVID-19 tests as long as they use tests that are authorized by Health Canada, the Quebec health department confirmed.

In September, Canada Home Doctors came up with a pricing plan that offered discounts if several people got tested at once. It’s $279 for one person and the scale goes down to $209 per person if you have at least six people.

But buying group deals looks different these days—social distancing was a given.

Montrealers came up with their own ways to take advantage, often through car-based gatherings, a bit like tailgating.

“Let’s say they chose someone’s house,” said Ohayan.

“The people who lived in the house would stay in the house, but everyone else would be outside... they would still be in their own clusters, so to speak.”

Canada Home Doctors also started offering tests to companies that would gather together their employees, in a distanced way, at their offices or in office parking lots.

Since Sept. 25, the company has tested 422 people overall, in 223 visits. Only a small fraction of them were positive, Ohayan said.

LESS WEALTHY, MORE DESPERATE

Yet another group of customers weren’t necessarily well heeled—they were scheduled for surgery.

“Most surgeries now require a negative result before the surgery,” Ohayan said.

For various reasons, those customers weren’t able to, or didn’t want to, get those tests done at a public clinic.

Canada Home Doctors is one of a very few companies in Quebec that offers at-home service. Another, called Medfuture, has been doing the same since last spring.

It has a drive-thru testing site in Mirabel, northwest of Montreal, and it offers at-home tests throughout the area at $335 a pop.

It has tested “many thousands” of people in total, said Medfuture CEO Mario Tremblay, and about 15 to 20 per cent of those have been at-home tests.

Since the spring, “there is a huge demand,” said Tremblay. “A lot of people don’t want to move outside of their homes or a lot of people are sick and cannot move.”

Testing bottlenecks in other parts of the country also led to some “crazy” trends this summer, Tremblay said.

“We have people coming here from Toronto, Ottawa, Quebec [City],” he said. In one case, customers even called about the idea of flying from Vancouver because they were having trouble getting tests on the west coast.

PART OF COVID-19 VACATION PLANNING

After the original school bump, Ohayan said, much of the demand has come from people planning to travel on airlines that require proof of a negative COVID-19 test to board.

By mid-October, the company was “getting a lot of requests already for people who are going to travel in December,” Ohayan said.

This week, he said that among the company’s 75 bookings for December are many appointments advance-booked for Christmastime.

But he said that while they’ve gotten many requests for travel, fewer have come from people planning to get tested at the holidays before seeing family within Quebec.

This would likely come good news to Quebec’s Public Health Director, Dr. Horacio Arruda, who sternly warned Quebecers this month not to rely on tests in order to visit family at Christmas—false negatives are relatively common, especially in the early days after an infection, and self-isolating before a visit is much more important, Arruda said.

ELIMINATING UNCERTAINTY

Ohayan said he thinks the draw, for many people, is less about getting door-to-door service and more about eliminating an uncertain wait time. The company sends results back within a day, or two days at most.

In the public system, he said, “there’s people that go, get seen in 15 minutes and then they get their results in 24 hours. And then there’s those that have to wait an hour and a half on the phone just to get an appointment, and then they take seven days to get the results.”

In the meantime, people must stay self-isolated in many cases while they await the results, making a multi-day wait drag on.

As the tests have grown in popularity, another battle is brewing, said Ohayan—with insurers. Many private health plans do cover private COVID-19 tests, though some have begun to fight the idea, said Ohayan.

While it often counts as a diagnostic test—which is covered under most plans—some companies are arguing that “if you don't have symptoms, you're not technically trying to diagnose something,” he said.

“Another reason I’ve heard is they've said ‘Oh, the Quebec government has set up many free testing clinics for you to get tested at, so we don't cover it.”

But since most types of bloodwork and diagnostic testing are both provided publicly and are covered by private health insuraance, he said, “that reasoning, to me, doesn't make much sense.”

A common customer complaint? The price point, Ohayan said. But he says he talks them through the various expenses, including the nurse's travel time.

“The reality is that private lab services are expensive," he said.