Rapid COVID-19 testing of Manitoba students, teachers would be costly, require more test capacity

Mass testing students and teachers for COVID-19 before and during the school year might be possible, but it would be costly, says an epidemiologist.

Given Manitoba's testing capacity and the technology currently available, a rapid testing program would require vast amounts of money and human resources, said Isaac Bogoch, an infectious diseases expert at the University of Toronto.

"If you throw enough money and brains at something, you can really make it work," Bogoch said.

Rapid testing of students is one of three key demands the Manitoba Teachers' Society made in the lead-up to the September return to school, along with mandatory masks and smaller class sizes.

Mass or widespread COVID-19 testing is when people, whether they are symptomatic or not, get tested for the illness and wait for the results from labs, while rapid testing is a method of COVID-19 testing that produces results within roughly 30 to 60 minutes. The public teachers' union is essentially asking for both to be implemented at the same time.

A true rapid COVID-19 test would act similarly to a pregnancy test and tell a person whether they are safe to go to school or work, said Bogoch. But that type of technology does not exist yet.

There is a way Manitoba could create more testing capacity and have a surveillance program for schools, though, he said: through a method called pool testing.

Pool testing is when samples are taken from each student in a classroom, for example, then thrown into one batch to be examined.

If the test comes back negative, then that class is safe. If it's positive, then "you've got to hone in like a laser beam and test every single one of [the students]," Bogoch said.

Manitoba currently does some pool testing, using six to eight samples in a single batch, Dr. Brent Roussin, chief provincial public health officer, said at a COVID-19 news conference last week. 

But the method is only efficient when the test-positivity rate hovers around five or six per cent, he said.

"Once you get above that, then it's really challenging to pool samples."

Manitoba public health officials are against rapid COVID-19 testing for students and teachers when they return to class.

"If we're not entering a bubble, then there really isn't much benefit to widespread testing, because if you're negative on Day 1, well, in fact, you'd be negative two days before Day 1," Roussin said during the COVID-19 briefing on Aug. 20, when asked about a recommendation made by his Alberta counterpart to test students and teachers.

"It doesn't mean much for Day 2 or [Day] 3, because you're not entering a bubble," he said.

"So in the Manitoba context, that's not something that we're actively looking at."

Manitoba has recently had record COVID-19 numbers and more deaths related to the illness, and flu season is on the horizon.

On Saturday, there were 426 active cases in Manitoba, with 13 people being treated in hospital, and two in intensive care.

The number of deaths related to COVID-19 has reached 16, and there are several outbreaks at personal care homes and health-care facilities, impacting residents and health-care workers alike.

But the reality is Manitoba does not have the capacity to test all of its students and teachers regularly.

On Monday, Roussin said the province could perform 2,500 COVID-19 tests per day, maybe more. The most performed in a single day in Manitoba is 2,331 on Aug. 21.

Last September, there were more than 207,000 students enrolled in kindergarten to Grade 12 in Manitoba, says the province's 2019 enrolment report, and that number does not include teachers and school staff.

"That's a lot of testing," Bogoch said.

No testing at schools at all is concerning, said Charlene Sacher, a grades 1 and 2 teacher, because people have to wait days before they know their results.

"I just feel that staff are just going to burn through a lot of their sick time. Parents may be sending in kids dosed up on Advil … because they also have to work," she said.

"That's not a slam against parents at all," said Sacher, a parent herself. "They also need to keep a roof over their heads and food on the table."

Sacher wants paid sick leave for teachers who have to take time off to get tested for COVID-19. She also wants rapid testing implemented in schools when possible.

Some places in the world are implementing the latter. The state of Massachusetts announced last month that it would provide mobile rapid testing units for its school districts this year.

The units will be sent to schools when health authorities believe transmission occurred between at least two students, or more than one staff member develops COVID-19 within two weeks in a class, cohort or grade.

Alberta's chief medical officer of health also recommended last month that all of the province's students and teachers be tested for COVID-19 before school reopens, and then periodically throughout the year.

Professional athletes, such as Winnipeg Jets players, and workers at the Maple Leaf pork processing plant in Brandon, Man., which has had 86 cases, are also getting rapid testing for COVID-19.

While there will be no mass testing in Manitoba schools, Roussin did say that plans are in the works to make testing more accessible during flu season. He did not specify what that might look like.