Recently, Toronto-based infectious disease specialist Dr. Anna Banerji saw a patient who “clearly” had COVID-19, despite a negative test result. The woman’s daughter also exhibited some symptoms, Banerji said, but her test also came back negative so she went back to school.
“The problem is, even in adults, people with (COVID-19), a third of the time their tests are going to be negative,” said Banerji, an associate professor of pediatrics at the University of Toronto.
“So we have problems with our current tests as it is; we don’t need a whole bunch of unregulated or unlicensed tests of known effectiveness to be out in the market because that affects people’s behaviour.”
Banerji is referring to a number of private COVID-19 testing services that have been publicized lately, as Ontario struggles with hourslong lineups at public testing centres amid the “second wave”; the province reported 700 new daily cases Monday, a record high, though testing capacity was much lower in the spring. The upwards trend is also taking place in Quebec, which reported 896 new daily cases Sunday and 750 Monday. B.C.’s caseload went up in August and early September but is back down to under 100.
In an effort to cope with the backlog, Ontario is allowing testing at select pharmacies for high-risk individuals, and is advising asymptomatic people not to go to testing assessment centres unless they have a risk of exposure or work with vulnerable people.
Meanwhile, some private companies are now offering testing, for hundreds of dollars in fees. The issue has once again raised concerns over creating a two-tier health care system in a country with universal health care.
When asked about private testing, Premier Doug Ford said it’s a “free market.” Ontario NDP Leader Andrea Horwath later said it’s “shocking that the premier acknowledged that he doesn’t believe in public health care, that he thinks it’s OK for people to be able to pay their way to the front of the line.”
Doctors who spoke to VICE News also expressed reservations about the trend of private testing, describing it as predatory and dubious in terms of the accuracy and usefulness of the tests.
Toronto-based company HCP Diagnostics offered to do at-home COVID-19 testing for $399, with the company’s website stating that nurses would travel to a person’s home in a mobile clinic to collect samples and ship them off a lab. The company did not respond to VICE News’ request for comment. As of September 25, following criticism from the Ontario NDP and doctors speaking to the media, its website had been taken down.
As reported by Healthing.ca, it’s not clear if HCP Diagnostics had the proper licence required to collect samples and operate a lab. But the company is not alone in its endeavour.
MedCan, a “corporate wellness and executive health clinic” in Toronto is offering COVID-19 antibody tests for $295; similar services have popped up in Calgary and Winnipeg. In the earlier days of the pandemic, U.S. start-ups offered at-home testing kits when there were severe shortages. Despite private labs processing most tests in the U.S., NBC News reported that there was a huge backlog, in part because of a lack of prioritization of urgent cases. VICE previously reported on at-home care packages being offered by private hospitals in India, where the Supreme Court ordered tests to be free for poor people.
Dr. Andrew Boozary, executive director of health and social policy for Toronto's University Health Network, said while it may seem like getting a private test would alleviate overall wait times, it could actually cause a backlog if the tests are sent to same labs handling public testing.
“You may not actually be diverting the system at large from more tests. You may actually be burdening it for tests that didn’t need to be done,” he said.
Boozary said the pandemic has already exposed major inequities in society—and that people who can’t afford to take time off work or get childcare are already less likely to get tested. He said these “predatory models” for private testing only exacerbate the problem.
MedCan’s website said its test is approved by Health Canada and can detect the COVID-19 antibody that is “developed 14 days after the onset of COVID-19 symptoms with 100 percent accuracy and, if the antibody has not been developed, with 99.63 percent accuracy.”
In an email to VICE News, a spokesperson said the clinic tells patients “there is not enough evidence at this time to confirm that people who have antibodies against COVID-19 are protected from future infections and, if so, for how long.”
The spokesperson said the company arrived at the $295 fee “by considering costs in combination with what the market would be willing to pay.”
Dr. David Naylor, co-chair of the federal government’s COVID-19 Immunity Task Force, said the reason antibody tests aren’t regularly being offered to the public right now is because they have limited value for people outside of a clinical setting.
Naylor said even if everyone was given an antibody test, the proportion of Canadians who have COVID-19 is only 1 percent, so the level of potential immunity is “way too small to allow any change in operations for worksites or schools. Nor would that information allow mass changes in behaviour.”
He said the strongest argument for individual antibody testing is for people who had symptoms but were never diagnosed. But even then, an antibody test could come back with a false negative if the person was sick months earlier.
“If the test is positive, it’s indeed likely the individual has some immunity. Then again, we don’t know how long that lasts, and that individual would be ill-advised to abandon basic public health precautions,” he said.
Banerji said she thinks an antibody test needs to be available in Canada because it could be useful in certain circumstances. For example, if she was running a COVID-19 ward, she might want people on staff who have antibodies.
But she’s wary of private companies offering such a test rather than it coming from the public system.
Boozary said now is the time to double down on our commitment to a publicly funded health care system.
“You have to look no further than south of the border where we've seen for profit systems that are highly fragmented that have consistently failed people at a really expensive cost,” he said.