What Nova Scotians should know about rapid testing during Omicron

As Nova Scotia continues to deal with rising case numbers of COVID-19, questions remain around why the province's testing strategy has changed during the Omicron wave.

Premier Tim Houston said during a news conference Monday that he understands the move away from the "surveillance" philosophy of earlier waves might be frustrating. 

Nova Scotians have had the message drilled into them over the past year that asymptomatic rapid testing as often as possible is a good thing — a way of putting control into the public's hands.

But Houston and Dr. Robert Strang, Nova Scotia's chief medical officer of health, now say with so many cases of COVID-19, the new strategy of limiting PCR testing and offering rapid tests by appointment only is key to ensuring resources get to the people who need them most.

"We're at a different stage now in the pandemic. We have less of a need for the surveillance part because the reality is there's a lot of COVID around," Houston said. 

People do need to modify their behaviour, said Houston, adding that in a large group of people, everyone should expect that someone in the room "probably" has COVID-19.

The province announced 1,020 new cases on Monday. Thirty-six people were in hospital with COVID-19, including four in intensive care.

Despite record-breaking case numbers in the province, Strang said the relatively low number of hospitalizations is key.

Think you need a test?

Anyone who thinks they might need a COVID-19 test, whether they have symptoms or not, now has to complete the province's online self-assessment tool. This will tell someone whether they need a PCR test, how to pick up a rapid test by appointment, or if they don't need a test at all.

For those who have symptoms and fall into the groups listed here, they can book a PCR test right away.

All other people with COVID-like symptoms, or who are asymptomatic but a close contact of a person or an exposure site, will need to use rapid test kits at home.

There are various sites within each health zone offering appointments to pick up rapid tests, although Strang acknowledged Monday there are limited options for people in Cape Breton. He said more appointments will open in various communities on the island soon.

Anyone who needs a rapid test in the province and lives near a pop-up site can also drop in without an appointment. All pop-ups are listed here.

According to Nova Scotia Health's website, two negative tests, 48 hours apart, can be considered a negative result, unless the person being tested is not fully vaccinated and has ongoing symptoms. In that case, they will need a third negative test.

What to do with positive rapid test

Anyone who tests positive on a rapid test should report their results to Public Health. The province has asked people to do that by emailing their name and contact information to [email protected].  

Most people who test positive do not need to do a followup PCR test. They must follow self-isolation rules and notify their own close contacts — people they have been inside with, unmasked, less than six feet apart, for 15 minutes or longer.

The people who will need to confirm their rapid positive results with a PCR test are those who fall into the same groups mentioned above, like first responders and those over 50 years old.

Strang asks Nova Scotians to use tests responsibly

The province has also said that contact tracing will no longer happen for school cases, and if a student or teacher tests positive on a rapid test, their school principal should be notified.

Strang emphasized Monday that people can no longer show up regularly to testing sites to pick up boxes of rapid tests to make themselves feel more comfortable.

"That's not feasible to do that right now," Strang said. "We need Nova Scotians to ... be responsible with the supports that they're seeking."

Another reason asymptomatic Nova Scotians shouldn't rely solely on negative results from rapid tests is because the tests are much less effective at actually detecting Omicron.

Dr. Peter Jüni, scientific director of Ontario's COVID-19 Science Advisory Table, told CBC last week that data shows rapid tests only find 50 per cent of the infectious Omicron cases out there. 

Strang said Monday he is waiting for more information from the federal government on when the province could get more shipments of rapid tests. But he said even when they arrive, the strategy will likely remain focused on getting rapid tests to those who are symptomatic or close contacts.

He also said with more testing supply, Public Health will look into how the province can offer tests in schools for all grades and teachers.