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Pressure mounting for B.C. to start rapid testing health care workers for COVID-19

FILE: Seniors Advocate Isobel Mackenzie is photographed at her office in Victoria on December 15, 2017. THE CANADIAN PRESS/Chad Hipolito

VICTORIA (NEWS 1130) — The province’s advocate for seniors continues to demand more testing to keep the coronavirus from spreading in long-term care homes where people are most at risk of dying.

Isobel Mackenzie says it’s frustrating to see rapid tests allowed for hockey players in the NHL and film crews working in and around Vancouver, but not in places where that due diligence is needed most.

“With each layer, we diminish the risk. We’ll never get it to zero, but we’ll diminish it. More frequent testing of care staff is another layer we can add. We have the capacity. We have the tools. We can be doing it now,” she says.

Mackenzie has been asking for improvements since the summer when it became clear the pandemic is far from over and when more people started dying in October.

“We really need to recognize that this virus, in many people, does not present symptoms or presents symptoms that the person isn’t recognizing. That’s the role that testing can play and I think that most of us recognize we can’t mass test every British Columbian every day or every other day. But when we look at high-risk environments like long-term care –given the level of community transmission we have, the high positivity rates we have, the high number of outbreaks we have– there is a very compelling argument in favour of looking at redesigning our testing strategy.”

She says the same tests being used now in the film industry could be used in care homes, but concerns have also been raised about the proper use of personal protective equipment (PPE).

“The PPE is not perfect. That is also clear. If the PPE protocols were perfect, we wouldn’t be seeing the spread within the care homes that we’re seeing. We might still see outbreaks because somebody gets it in the community.”

Mackenzie tells NEWS 1130 she doesn’t know why health authorities have been reluctant to boost testing because Health Minister Adrian Dix has repeatedly said daily capacity allows for 20,000, but most days, fewer than 10,000 tests are being processed.

“The Health Canada guidelines are very clear. These rapid tests have been approved for use in Canada. They have been approved as a screening tool for asymptomatic people in high-risk environments like long-term care. That’s very clear in the guidelines.  They’re not approved as a testing tool for asymptomatic people.”

She says that requires staff and visitors to continue wearing PPE and following other safety protocols around residents.

“Our testing strategy from the beginning has been we don’t test you if don’t have symptoms. You still can’t get a test if you don’t have symptoms.”

Mackenzie says it’s disappointing to see that strategy hasn’t changed since rapid tests were approved by Health Canada in November.

“They could make different choices and decisions around who to test and when to test. It’s not uniform throughout the province.”

She also says she’s frustrated by a lack of transparency from the Vancouver Coastal Health Authority when she’s reached out for more details about what’s happened at Little Mountain Place where at least 41 residents of that East Vancouver care home have died –making that B.C.’s deadliest outbreak so far.

“They aren’t responding. We have placed a high priority –and rightly so– on getting the vaccine out there and I do actually think we’re doing that very well. So, the ability for people to find the time to give the answers is time-consuming and what you hear is ‘You’re distracting us from our ability to get the vaccine out there.'”

Mackenzie adds she’s concerned about the Vancouver Coastal Health Authority possibly changing what qualifies as an outbreak because since the pandemic started, an outbreak is declared as soon as one patient or staff member in health care tests positive for COVID-19.

“They won’t declare an outbreak until there’s more cases and I’m sort of puzzled. Well, suddenly, one health authority is changing the goalposts around what’s the criteria for declaring an outbreak.”

Mackenzie now plans to investigate numerous outbreaks in care homes where several residents have died.

“What we’re going to be doing is looking at those outbreaks that were prolific. It’s not just Little Mountain. Tabor Village, Langley Lodge, Holy Family, New Vista. There’s a few out there. Why did they get so out of control? It’s not sufficient to just say once it gets away from you, it’s difficult to control. Little Mountain is all single rooms. No shared rooms there.”

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BC’s seniors advocate also has questions about how soon action was taken to contain an outbreak after the first case was identified and what contact tracing was immediately done.

“It is going to matter who we tested within 24 hours, 48 hours and 72 hours. What did we learn from this? We were so taken by our success in wave one, it may have blinded us to possible shortcomings in our response to wave two.”

Mackenzie goes on to say she sees this more as a fact-finding mission rather than an exercise in assigning blame.

“I do believe that everybody is doing what they think is the best thing. I don’t believe that there’s any prevailing culture or attitude of dismissiveness or diminishment or minimizing. I don’t think that is what we are seeing here. Back in March, we said we will make mistakes, but we’ve got to have the ability to acknowledge those and sometimes it takes the distance to really see we should have done this. If we don’t do that digging, it’s going to be easy to dismiss any thoughts that we could have been doing better testing.”

In some cases, Mackenzie says it took four or five weeks into an outbreak for administrators to order everyone get tested.

“Those tests are picking up cases.”

Mackenzie is also looking forward to learning from care home operators who’ve managed to keep COVID-19 from killing anyone or at least containing it to one case.

“How rigorous they were on screening people every day. Did they do temperature checks? How many people did they send home? Did they have paid sick leave?”