Just because you can get tested for COVID-19 in Sask., doesn't mean you should, experts say

Anyone working outside the home in Saskatchewan now qualifies to get a COVID-19 test, but that doesn't mean it makes sense for most people without symptoms to do so, according to a leading infectious diseases specialist in the province.

"I don't think that's something that I would actually recommend to members of the general public at this time," said Dr. Alex Wong, a clinician and researcher at Regina General Hospital who specializes in infectious diseases. He has worked with the Saskatchewan Health Authority on its pandemic planning and response.

Wong cautioned that widespread testing of asymptomatic people isn't as useful to track and trace cases of COVID-19 in Saskatchewan, where there's a low prevalence of the novel coronavirus, because of certain limitations in testing accuracy.

Wong said people should seek testing if they feel any symptoms — even mild ones — or have had a "concerning interaction" or "concerning exposure" with someone who may be sick with COVID-19, even if asymptomatic.

He doesn't encourage most people to get tested just to get tested.

"The most important group that we need to be testing is people that do have symptoms compatible with COVID-19, and those individuals should self-isolate and get a test. And that's super important to continue to push forward," Wong said.

People who can't maintain physical distancing — such as grocery store clerks, hair stylists, or dentists — who think they've been exposed to someone with symptoms, and don't feel they were properly protected, should also seek testing, Wong added.

Limitations of asymptomatic testing

In the early days of the pandemic, the Saskatchewan Health Authority had strict testing criteria that limited diagnostic tests to people with multiple symptoms who had travelled or been in contact with someone knwon to have COVID-19. That criteria expanded in early April to include anyone with mild symptoms, no travel necessary.  

The province's testing capacity remains high for its population. It is capable of processing about 1,500 tests a day, but demand has dropped significantly.

Now, the health authority is willing to test anyone who is working and will proactively target asymptomatic hospital patients, homeless people and factory workers, among others.

At a public health level, asymptomatic testing can be useful in regions with a high prevalence of the COVID-19 virus to determine the rate of community spread, Wong said.

However, he added that the prevalence is so low in most of Saskatchewan, excluding the northwestern region, that widespread asymptomatic testing would not be that useful for catching cases or measuring the community spread.

Wong said the PCR-based test for COVID-19 has certain limitations that could turn up more false positives than real positives in a low-prevalence region.

"We have to be careful about how we use and interpret those results," Wong said.

He said that in regions where the prevalence is higher, such as Ontario, Quebec and some parts of Alberta, it makes more sense to aggressively screen asymptomatic people to get a better sense of the rate of community transmission.

Most provinces have done some testing of asymptomatic people in places that have had outbreaks, such as long-term care homes, prisons and meat-processing plants. However, widespread asymptomatic testing is controversial.

Ontario's health ministry, under pressure to increase testing numbers, has expanded its testing protocols to include anyone concerned that they've been exposed to COVID-19, even if they have no symptoms, and anyone who is at risk of exposure through their employment, such as health-care workers and grocery store clerks.

Manitoba's chief provincial health officer Brent Roussin has rejected what he calls "large, widespread, indiscriminate asymptomatic testing."

"There's really low value in that," Roussin said.

Manitoba is going to do random testing of asymptomatic people by selecting a health-care facility, such as a doctor's office, and offering anyone who shows up a test. While Roussin isn't encouraging widespread testing of people who don't have symptoms, Manitoba's testing sites won't turn people away.

Roussin noted that a negative test result in an asymptomatic person doesn't hold much weight.

"If that person develops symptoms a few days later, they can't rely that they had a negative COVID-19 test. They still need to be tested at that time. So, that's the major limitation of testing asymptomatic people," Roussin said.

Dr. Wong advises people to focus primarily on physical distancing and hand-washing as a way to stay safe.

To request a test, people in Saskatchewan must call the 811 Healthline or their doctor.