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Canada’s COVID-19 private evidence industry is booming, but some experts say oversight is lacking




Whether you are a traveler taking a mandatory COVID-19 test at the airport, or a worker at a job such as a film set or food processing plant requiring a negative test, chances are this is done by a private company .

Businesses offering polymerase chain reaction (PCR) tests are now an essential part of Canada’s pandemic response, allowing thousands of people to continue to travel, visit loved ones in long-term care, and stay at work.

But some doctors and health experts worry about what they say is the lack of regulation in what has become part of the fast-growing healthcare industry.

“Who is doing the tests? What are the standards? How do we know they are doing it with the same sensitivity and specificity as those done in provincial laboratories or hospital laboratories?” said Dr. AnnaBanerji, a physician and infectious disease specialist at the University of Toronto’s Dalla Lana School of Public Health.

Publicly administered PCR tests are free and are intended for people with COVID-19 symptoms. Private companies usually test people who are asymptomatic and receive a service fee. Demand is growing as many jobs require on-site testing in order to stay operational.

The federal government and the Ontario government recently added to this requirement when both internationally declared air travelers must have PCR tests when they arrive in Canada.

New entrants

A quick and non-exhaustive search by CBC News found 15 companies offering PCR tests for COVID-19 in Canada. Some, such as LifeLabs, which says it has conducted more than a million COVID-19 tests to date, and Dynacare, are well-known names in the specimen collection and diagnostic testing industry.

Others, such as Calgary’s Ichor Blood Services, centered on COVID-19 testing in the midst of the pandemic.

Clean lifestyle in fitness and medical services in Winnipeg before starting his COVID-19 testing business shortly after Christmas.

Private companies across Canada are jumping in to meet the growing demand for COVID-19 testing. (Evan Mitsui / CBC)

In Toronto, Diagnosis of HCP caught my attention last fall when it started offering COVID-19 evidence at home for $ 400 per test. One of the directors of HCP is James Blackburn, who is also the co-owner of an event company that organizes large parties, and a night club in the Toronto Amusement District.

, Told Blackburn, who declined the CBC interview request The Pal’sPodcastrecently she moved to COVID-19 testing because the pandemic had shut down his other ventures.

“If the beast destroys your business, you can also try to get into another business and try to fight the beast, right?” he said.

Blackburn partners include a registered nurse and a doctor.

HCP timing was good. The company was incorporated in October, but its website was actually launched a month earlier, the same week the Ontario government amended the Laboratory and Sample Collection Center Licensing Act in a bid to expand testing capacity.

The change allowed a wider range of people to enter the private testing business.

HCP is now offering on-site testing for film and TV production, construction sites, production and storage, as well as smaller businesses in downtown Toronto.

In fact, HCP said it is so busy that it did not have time to talk to CBC News about its growing business.

“Given the busy nature of our programs, I am informed that our team will not be available,” HCP Emily Colessaid said in an email.

CBC News compared prices for PCRtest nationwide and found that they ranged from about $ 160 at Switch Health, which is also the company that tests passengers at Pearson Airport near Toronto, to $ 400, the highest price charged by the GMF Sante Med Clinic in Toronto.

Lack of oversight, experts say

But as the role of private testing in pandemics grows, so does the concern among some that it is largely unregulated.

“When you have people working privately on no one’s land, then you really do not know, are the tests accurate? Are they doing proper infection control?” said Banerji.

“I think there should be a body that has some oversight.”

While public tests are usually done in healthcare settings such as hospitals and clinics, private tests can be done somewhere from construction sites to homes. Companies must use equipment and tests approved by Health Canada, but there is no regulatory body that regulates the cost that private companies are charging for tests, and there is no single external system beyond companies themselves to handle complaints.

Dr. Anna Banerji is a pediatric infectious disease specialist and associate professor of pediatrics at the University of Toronto Dalla Lana School of Public Health. She says there are concerns about the lack of oversight of the private testing industry. (Submitted by Mike Cooper)

There are different governing bodies in each province that regulatecollection and processing of medical samples. In Alberta, for example, the province does not license or approve COVID-19 private testing companies.

In fact, no government agency in Canada is tracking how many companies are offering services and how many tests they are conducting across the country.

A spokesman for Health Canada and the Canadian Public Health Agency said that because medical tests fall under provincial and territorial jurisdiction, the CBC should contact each province and territory individually and compile the numbers themselves.

So we did and found that the picture is still blurry.

Each province requires companies to report positive test results. But many provinces do not know how many tests have been done in general.

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Of the nine governments that responded, only Quebec and Nova Scotia provided a breakdown of the number of private individuals for the COVID-19 public tests administered.

Saskatchewan and British Columbia say private tests are included alongside public ones in a single issue released to the public each day. But no province could say how much of this daily number is private from public tests.

Newfoundland, Ontario, Manitoba and Alberta have no regard for private testing data.

With the exception of Quebec and Nova Scotia, none of the responding provinces were able to provide a positive test rate for private tests, a percentage that reflects how many of the total number of tests return positive for COVID-19.

Possible ramifications

Experts say that the lack of an accurate calculation and the degree of positivity of private tests means that we may not have an accurate picture of the overall positivity rate in Canada.

“If the government is testing, say, 50,000 people and that gives us a positivity rate of four percent, and the private sector is testing an additional 50,000 and they are not finding cases at all, then in fact our level of test positivity is actually two cents, not four percent, “said Raywat Deonandan, an epidemiologist and associate professor in the University of Ottawa School of Health Sciences.

“This is a big change. The degree of positivity of the test tells us two things: Are we testing enough? And how prevalent is the disease in our population.”

The epidemiologist of the University of Ottawa, Dr. Raywat Deonandan, presented here in Toronto, says reporting complete private test data could have an impact on COVID-19 positivity rates. (Evan Mitsui / CBC)

CBC News also approached nearly a dozen companies to ask about the number of tests they perform and the positivity rates they have observed.

Among those who responded was Quantum Genetix in Saskatchewan, which had done PCR testing on livestock before expanding into the COVID-19 human test at the end of last year. Quantum Genetix said it tested about 1,500 people and had a positivity rate of just under two cents.

Another company, Dynacare, said it conducts between 5,000 and 10,000PCRsteste per day at its Ontario lab. He said the positivity rate is falling and leaking, but over the past 30 days it has been close to seven percent.

Problems with private testing

With companies dealing with customer complaints within, it is difficult to know how the quality of private testing compares to that of the public system.

The day before Christmas, Allan Asselin was visiting his 88-year-old mother, Mary, at her nursing home in Toronto, late in the birth, when one of the staff nurses entered the room.

“She said, ‘Your mother has COVID.’ “You have to leave,” Asselin said.

“Needless to say, there were tears. She was shaking. She was just in a terrible state.”

Mary Asselin, 88, had two requests for results for a single COVID test from December, one positive and one negative. (Submitted by Allan Asselin)

Mary spent Christmas and a few days later was quarantined in her room, alone and scared.

Her COVID-19 test was developed in a private laboratory.

Three negative tests later, she was cleared. When Allen checked the Ontario government COVID-19test results page, he found two notes for the first test on December 22, one positive and one negative.

“So did he have it or not?” he said.

In another case, a 34-year-old Montreal woman who paid $ 300 two weeks to be tested to see her elderly father says she got a positive result in the mail with her name, but the date and wrong test location, wrong home address, no health insurance card number and notification came a month after her test was done.

“What good is it for me, or the public, to get this information a month later, after walking and socializing with my family, [possibly] being without positive knowledge for a month? said the woman, whom CBC News agreed not to identify for privacy reasons.

Private testing required

The fact is, however, the economy is unlikely to reopen nearly as quickly as it does without private testing, which epidemiologists say plays a vital role in Canada’s pandemic response.

“I approve of private testing, if done strategically, because it eases the strain on the public health system to be used for things like proper supervision, to be used for real symptomatic people arriving at hospitals and things like that,” he said. “said Deonandan.

Private companies, he said, should be charged with what he calls “security proof”.

“This is when you need a test to get back to work or to keep going to work or maybe to take up some other activity,” he said.

“But even then, it requires serious ethical oversight.”

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