Transcript: Rapid Tests: The Key to Ending the Pandemic? | Oct 08, 2021

Nam Kiwanuka sits at the Agenda news desk. She wears a bright blue blazer over a white and blue striped shirt. A monitor behind her shows a red lowercase ‘a’. Nam grips a pen as she rests her hands on the desk. Papers, a cell phone, and a glass of water sit in front of her.

Text reads, “Rapid Tests: The Key to Ending the Pandemic?”

Nam begins,
ASK ANY PARENT HOW THE
SCHOOL YEAR IS GOING, AND ODDS
ARE THEY'LL MENTION THE FEAR AND
HASSLE AROUND COVID SCREENING
AND TESTING.
COULD RAPID OR AT-HOME TESTING
MAKE LIFE BOTH SAFER AND EASIER?
WITH US ON THAT, IN HALIFAX,
NOVA SCOTIA, DR. LISA BARRETT.
CLINICIAN, SCIENTIST AND
INFECTIOUS DISEASE PHYSICIAN AT
DALHOUSIE UNIVERSITY AND THE
NOVA SCOTIA HEALTH AUTHORITY.
AND HERE IN ONTARIO'S CAPITAL
CITY, DR. ISAAC BOGOCH.
INFECTIOUS DISEASES PHYSICIAN AT
THE UNIVERSITY HEALTH NETWORK
AND A SCIENTIST BASED OUT OF
TORONTO GENERAL HOSPITAL AND THE
UNIVERSITY OF TORONTO.
HI TO YOU BOTH.

Dr. Bogoch replies, GREAT TO SEE YOU AGAIN.

Dr. Barrett nods as she smiles widely.

Nam continues,
LOOKING FORWARD TO THIS
CONVERSATION.
I DON'T WANT TO START OFF BY
COMPLAINING BECAUSE I THINK
WE'RE VERY LUCKY TO LIVE IN
A PROVINCE WHERE WE HAVE ACCESS
TO HEALTH CARE.
BUT I THINK A LOT OF US WHO'VE
HAD THE COVID TEST, YOU KNOW THE
ONE WHERE THEY STICK IT UP YOUR
NOSE AND IT FEELS LIKE THEY'RE
TICKLING YOUR BRAIN IT'S VERY
UNCOMFORTABLE BUT THAT TEST,
I GUESS, WOULD BE CONSIDERED
THE GOLD STANDARD TEST IN COVID
TESTING. HOW ARE TAKE-HOME
RAPID TESTS DIFFERENT FROM PCR
TESTING, DR. BARRETT?

Text reads, “Rapid Tests: The Key to Ending the Pandemic? In the Comfort of Your Home”

Dr. Lisa Barrett sits in a hospital hallway. Sunlight shines through a window and reflects off the wood panels on the ceiling. Dr. Barrett’s blonde hair rests on her green scrubs.

Text reads, “Lisa Barrett, Dalhousie University”

Dr. Barrett replies,
WELL, IT ACTUALLY DEPENDS ON
EXACTLY THE FORMAT THAT YOU'RE
USING. THERE ARE MANY TESTS
THAT ARE OR WILL BE APPROVED IN
CANADA FOR AT-HOME USE.
BUT ACROSS ALL OF THOSE IS A
DIFFERENCE FROM THE NOSE TICKLE
YOU WERE TALKING ABOUT IN THAT
THIS IS A MUCH MORE SHALLOW OR
FRONT OF THE NOSE TYPE OF TEST.
THE SWAB GOES IN.
A COUPLE OF CENTIMETRES INTO THE
FRONT OF THE NOSE.
YOU SWIRL IT AROUND YOURSELF.
IT DOESN'T REQUIRE AN ADDITIONAL
PERSON.
THAT CAN HAPPEN IN INDIVIDUALS
WHO ARE SMALLER KIDS RIGHT ON UP
TO VERY MUCH OLDER FOLKS.
AND THAT TEST THEN GOES INTO
WHATEVER FORMAT THE DOWNSTREAM
PART IS.
BUT THE SWABS ARE ALL VERY
SIMILAR.
FRONT OF THE NOSE.
NO BRAIN TICKLING.

Nam raises her hands as she laughs.

She responds,
IT DOES FEEL LIKE IT. BUT DR. BOGOCH,
HOW EFFECTIVE ARE THESE
RAPID TESTS?

Text reads, “Isaac Bogoch, University of Toronto”

Dr. Isaac Bogoch sits in a doctor’s office. Plaques and degrees hang from the walls. Dr. Bogoch wears a white lab coat over a patterned blue dress shirt. His dark hair is cut short and parted to one side. White earphone wires dangle from his ears.

Dr. Bogoch states,
SO THE SHORT ANSWER IS
THEY'RE VERY EFFECTIVE.
THE MORE NUANCED ANSWER IS IT
DEPENDS WHAT QUESTION YOU ARE
TRYING TO ASK.
THE PCR TESTS ARE EXQUISITELY
SENSITIVE IN THE SENSE THAT THEY
WILL DETECT SHREDS OF GENETIC
MATERIAL THAT'S IN THE BACK OF
YOUR NOSE.
THAT COULD INCLUDE SOMEONE WHO'S
GOT A RIP-ROARING INFECTION.
THAT COULD INCLUDE SOMEONE WHO'S
RECOVERED FROM A RIP-ROARING
INFECTION AND STILL HAS GENETIC
SHREDS IN THE BACK OF THEIR NOSE.
THAT COULD BE SOMEONE BEFORE
THEY EVEN START TO DEVELOP
SYMPTOMS AND THEY'RE STARTING TO
BUILD UP THEIR VIRAL LOAD.
THE PCR TEST IS VERY, VERY
SENSITIVE IN PICKING UP GENETIC
MATERIAL.
THE RAPID TESTS REALLY ADDRESS
THE QUESTION: AM I CONTAGIOUS
TO OTHER PEOPLE RIGHT NOW, YES
OR NUMBER YOU TYPICALLY HAVE TO
HAVE MORE VIRUS PRESENT FOR
THOSE RAPID TESTS.
BUT YOU CAN IMAGINE IF YOU ARE
ADDRESSING THAT QUESTION: AM I
CONTAGIOUS TO OTHER PEOPLE NOT
DO I HAVE SHREDS OF GENETIC
MATERIAL IN THE BACK OF MY NOSE.
YOU CAN STILL MAKE SOME VERY VERY
WELL INFORMED DECISIONS BASED ON
YOUR BEHAVIOUR AND I AM SURE
WE'LL GET INTO THAT LATER ON IN
THIS CHAT.

Nam says,
YOU KNOW THERE'S BEEN FRUSTRATION
IN THE PROVINCE FROM PARENTS WHO
WANT ACCESS TO THESE RAPID TESTS
AND THEN HEARING BACK FROM THE
CHIEF MEDICAL OFFICER DR. KIERAN
MOORE ABOUT WHY WE MIGHT
NOT BE USING THEM RIGHT NOW.
ARE THERE ANY BENEFITS TO THESE
RAPID TESTS OVER THE PCR TEST?
DR. BARRETT?

Dr. Barrett replies,
WELL, AGAIN, I THINK IT
REALLY DOES DEPEND ON THE
QUESTION YOU'RE TRYING TO ASK
AND WHAT YOU'RE TRYING TO DO IN
A GIVEN JURISDICTION.
HERE IN THIS PROVINCE, IN NOVA
SCOTIA, WE HAVE A COUPLE OF
AREAS WHERE THERE IS A FAIR
AMOUNT OF COMMUNITY SPREAD.
AND I WOULD SAY MOST PLACES IN
THE COUNTRY RIGHT NOW HAVE AREAS
WITH COMMUNITY SPREAD.
AND WE RECOGNIZE THAT WHEN
UNVACCINATED KIDS GO BACK TO
SCHOOL, WE HAVE A QUESTION: DO
THE PEOPLE WHO HAVE ONE OR TWO
SYMPTOMS NOT FEVER OR COUGH BUT
ONE OR TWO SYMPTOMS, DO THOSE
KIDS HAVE COVID OR NOT OR IS
THIS SOME OTHER OF THE PLETHORA
OF OTHER VIRUSES THAT IS ARE
AROUND IN THE COMMUNITY?
IN OTHER WORDS, SHOULD OUR KIDS
STAY HOME OR NOT?
SO FOR THAT KIND OF QUESTION
THESE RAPID ANTIGEN QUESTIONS
ARE PRETTY USEFUL IN THAT THEY
GET A QUICK AND EASY ANSWER AT
HOME AND IF THEY'RE NOT THE
MAJOR SYMPTOMS YOU CAN ACTUALLY
GET YOUR KIDS TO SCHOOL INSTEAD
OF HAVING TO KEEP THEM HOME
POTENTIALLY.
ALTHOUGH WE'RE ENCOURAGING
FOLKS WHO ARE SICK TO STAY
HOME. THE SECOND QUESTION
WOULD BE IN PLACES WHERE YOU'RE
IN A RURAL AREA OR SOMEWHERE
WITHOUT EASY ACCESS TO PCR
TESTING. WE WANT TO MAKE SURE
IN CANADA, I WOULD EXPECT, THAT
WE HAVE SOME GOOD EQUITY IN
TERMS OF ACCESS TO TESTING AND
THIS WOULD BE A GOOD EXAMPLE
WHERE RAPID ANTIGEN TEST MAY
ALSO AUGMENT THAT LACK OF PCR
AVAILABILITY IN THE SHORT RUN.
QUICK, EASY, FAST
ANSWERS FOR PARENTS.
ESPECIALLY IF YOU REPEAT THE
TEST A COUPLE OF DAYS LATER
WHICH GOES OVER THAT SLIGHT
DECREASE IN SENSITIVITY THAT
DR. BOGOCH IS MENTIONING.

Text reads, “Rapid Tests: The Key to Ending the Pandemic? Don’t Forget Your Test Results!”

Nam adds,
WELL EARLIER THIS WEEK
ONTARIO ANNOUNCED IT WILL OFFER
RAPID COVID-19 TESTS TO SOME
SCHOOLS AND CHILD CARE SETTINGS
IN WHAT THEY'RE CALLING HIGHER
RISK AREAS FOR UNVACCINATED AND
ASYMPTOMATIC STUDENTS.
DR. BOGOCH, WHAT DO YOU THINK
OF THIS PLAN?

Dr. Bogoch answers,
I THINK IT'S FANTASTIC
THAT THE PROVINCE IS GOING TO
START USING RAPID TESTING IN A
MANNER THAT WILL HELP CREATE A
SAFER SCHOOL ENVIRONMENT.
THAT IS GREAT.
WHEN YOU COMPARE THAT TO NOT
DOING RAPID TESTING, IT'S
CERTAINLY A MAJOR STEP IN THE
RIGHT DIRECTION.
I THINK WE COULD DEBATE ON THE
MERITS OF VARIOUS RAPID TESTING
PROGRAMS AND HOW TO USE THEM AND
WHERE TO USE THEM.
OF COURSE A LOT OF THOSE
DECISIONS WILL DEPEND ON
RESOURCES AVAILABLE AND ALSO WHO
YOU ASK.
I MEAN LET'S JUST CALL IT HOW IT IS.
THERE'S STILL CONSIDERABLE
DEBATE WITHIN THE MEDICAL,
SCIENTIFIC, AND PUBLIC HEALTH
COMMUNITY ABOUT THE
BEST MECHANISM, THE BEST WAY
TO DEPLOY THESE RAPID
TESTS BUT THE FACT THEY'RE
DEPLOYING THEM IS ALREADY A STEP
IN THE RIGHT DIRECTION.
AND I THINK -- WE DON'T HAVE A
TON OF DETAILS AS TO HOW THEY'RE
GOING TO DO IT.
A LOT OF THIS IS AT THE
DISCRETION OF THE LOCAL MEDICAL
OFFICER OF HEALTH.
I THINK WE'LL SEE SOME
HETEROGENEITY IN HOW THESE ARE
DEPLOYED ACROSS THE PROVINCE.
CURRENTLY, WE’RE HEARING
WHISPERINGS THAT THEY’RE GOING
TO USE THESE IN MORE HIGH-BURDEN
AREAS. OKAY, THAT’S A START.
YOU KNOW, THERE’S OTHER WAYS
OF DOING THIS.
FOR EXAMPLE RAPID TESTING AT
HOME BEFORE SENDING KIDS TO
SCHOOL.
OF COURSE, YOU HAVE 2.1 MILLION
KIDS GOING TO SCHOOL.
THAT'S A LOT OF RAPID TESTING IF
YOU HAVE TO DO IT FIVE TIMES A WEEK.
AND WE’D RUN INTO SERIOUS
RESOURCE ISSUES AT THIS POINT IN
TIME. THERE ARE OTHER PROGRAMS
YOU CAN DO.
FOR EXAMPLE, IF THERE'S AN
OUTBREAK IN THE SCHOOL.
THERE'S THE TEST TO STAY
APPROACH RATHER THAN SEND
EVERYBODY HOME.
YOU HAVE PEOPLE WHO MIGHT HAVE
BEEN EXPOSED ENABLED THEM TO
COME TO SCHOOL IF THEY HAVE A
NEGATIVE TEST RESULT.
WHAT I AM TRYING TO SAY IS THERE
ARE MULTIPLE WAYS TO DEPLOY
THESE TESTS IN A MEANINGFUL
MANNER.
IT'S YET TO BE CLEAR HOW ONTARIO
WILL DEPLOY THESE.
AND I LOOK FORWARD TO THEM
ACTUALLY USING THESE BECAUSE
IT'S A LOT BETTER THAN NOT.
IF YOU DON'T USE THESE TESTS,
YOU WILL IDENTIFY ZERO PEOPLE
COMING TO SCHOOL WITH THE
POTENTIAL INFECTION.
IF YOU DO USE THESE TESTS YOU
WILL IDENTIFY AND HOPEFULLY
PREVENT SOME PEOPLE FROM COMING
INTO THE SCHOOL.

Nam responds,
I AM GLAD YOU SAID THAT.
I AM GLAD YOU SAID THAT.
BECAUSE THERE IS A LITTLE BIT OF
CONFUSION.
I'M GLAD THAT YOU SAID THAT YOU
DON'T KNOW HOW IT'S GOING TO
WORK OUT BECAUSE FOR A LOT OF
PEOPLE WERE HEARING HIGHER RISK
AREAS.
WE KNOW THE PROVINCE HAS SAID
FOR PEOPLE WHO ARE NOT
VACCINATED FOR WHATEVER REASON
THEY'RE GOING TO BE TESTED
WEEKLY. WE DO KNOW THAT THERE
ARE KIDS UNDER TWELVE ARE NOT
ELIGIBLE TO BE GETTING VACCINATED.
SO I THINK THERE'S A LITTLE BIT
OF CONFUSION ABOUT IF YOU ARE
GOING TO USE IT IN HIGH-RISK
AREAS WHY NOT USE IT EVERYWHERE.
DR. BOGOCH?

Dr. Bogoch replies,
I DON'T KNOW. I MEAN, I DON'T KNOW.
IF YOU HAD THE RESOURCES
AVAILABLE -- LIKE IF YOU HAD AN
INFINITE NUMBER OF TESTS AND THE
CAPABILITY TO DEPLOY THESE
EITHER AT THE SCHOOL OR AT THE
HOME THAT WOULD BE GREAT.
IMAGINE IF EVERY DAY SOMEONE DID
A RAPID TEST AND SAID YOU KNOW
WHAT? MY TEST IS NEGATIVE HAVE I
A GREEN LIGHT AND I CAN GO INTO
WORK OR I CAN GO INTO
SCHOOL BECAUSE I KNOW MY RISK OF
TRANSMISSION IS EXCEEDINGLY
SMALL, ALMOST NEGATIVE.
ALMOST ZERO. BUT OF COURSE
NOTHING IS ZERO OR 100%.
I DON'T THINK IT'S REASONABLE TO
SUGGEST THAT WE HAVE THOSE
RESOURCES AVAILABLE TO US.
IN FACT, IT'S BEEN PUBLICIZED IN
MANY MEDIA OUTLETS THAT THERE IS
A SHORTAGE OF RAPID TESTS.
AND ISSUES WITH SUPPLYING RAPID
TESTS BECAUSE THEY'RE IN SUCH
HIGH DEMAND IN MANY COUNTRIES
AROUND THE WORLD.
SO IT WOULD BE NICE TO KNOW WHAT
THE RESOURCES WE HAVE AVAILABLE
TO US NOW SO THAT WE CAN DEPLOY
THESE RAPID TESTS IN A
MEANINGFUL MANNER THAT'S
BASICALLY, YOU KNOW,
COMMENSURATE WITH WHAT WE HAVE
AVAILABLE.
AND, OF COURSE, WE COULD ALWAYS
PLAN FOR EXPANDING THESE
PROGRAMS IF WE HAVE MORE OF
THESE TESTS AVAILABLE MOVING
FORWARD.

Nam says,
I READ THAT WE IN ONTARIO WE
HAVE ACCESS TO FOUR
MILLION RAPID TESTS RIGHT NOW.
I COULD BE WRONG.
BUT DR. BARRETT, OTHER
JURISDICTIONS AROUND THE WORLD
ARE USING RAPID TESTING IN
SCHOOLS, INCLUDING THE U.K.
AND NOVA SCOTIA RECENTLY
INTRODUCE ADD PILOT PROGRAM.
DO WE HAVE ANY EVIDENCE FOR HOW
EFFECTIVE THESE PROGRAMS ARE?

Dr. Barrett states,
WELL AGAIN, IT COMES BACK TO
THE QUESTION THAT YOU ARE TRYING
TO ASK.
AND IF YOUR QUESTION IS: AM I
GOING TO GET AND IDENTIFY FOLKS
WHO DON'T HAVE SYMPTOMS AND
PREVENT THEM FROM GOING TO
SCHOOL?
THERE ARE SOME PROGRAMS THAT ARE
STARTING TO SHOW YES, OF COURSE.
THAT THIS DOES HAPPEN. IT DOES WORK.
PEOPLE GET INTO THE NITTY GRITTY
OF QUESTIONS AROUND TESTS THAT
WE DON'T NEED TO BE ASKING RIGHT
NOW LIKE WELL, WHAT'S THE FALSE
POSITIVE, FALSE NEGATIVE RATE.
AND THERE IS DATA OUT THERE ON
THAT THAT SAYS IF YOU HAVE A
REASONABLE AMOUNT OF VIRUS
AROUND THE COMMUNITY THE FALSE
POSITIVE RATE IS EXCEEDINGLY LOW
AND ALSO THAT THE FALSE NEGATIVE
RATE IS APPROPRIATE ESPECIALLY
FOR SERIAL TESTING.
IF THE QUESTION IS ARE YOU GOING
TO PICK UP PEOPLE WHO OTHERWISE
WOULD HAVE BEEN AROUND OTHER
UNVACCINATED PEOPLE, MEANING
KIDS AT THIS POINT HOPEFULLY,
YEAH.
WE DO FIND OUT THAT THAT IS THE
CASE.
AND I WOULD ASSERT THAT IT
DOESN'T MATTER IF THAT'S ONE
PERSON OR IF THAT IS FIFTY PEOPLE
BECAUSE THE OTHER PART THAT YOU
ARE GOING TO MANAGE TO DO IS
GIVE PEOPLE ENGAGEMENT IN
TESTING, DE-STIGMATIZE THE COVID
POSITIVITY SITUATION.
SO TAKE AWAY SOME OF THE STIGMA
OF BEING COVID POSITIVE AND
ENGAGE PEOPLE IN HEALTHY
ACTIVITIES LIKE KNOWING THEIR
STATUS UNTIL WE'RE FURTHER ALONG
IN THIS PARTICULAR PANDEMIC.
SO OTHER THAN JUST FINDING
PEOPLE THERE IS A HUGE AMOUNT OF
EVIDENCE AND EMERGING EVIDENCE
THAT ENGAGEMENT IN THIS TYPE OF
TESTING IS AN IMPORTANT PART OF
BEING COMMUNITY-ASSOCIATED AND
COMMUNITY-LED WHICH IS JUST AS
IMPORTANT ON THE BEHAVIOUR FRONT
AS EVERYTHING ELSE.

Nam responds,
DR. BOGOCH, DR. BARRETT MENTIONED
FALSE POSITIVES.
AND THAT WAS A CONCERN THAT WAS
RAISED BY DR. KIERAN MOORE
EARLIER THIS WEEK IN VERY LOW
RISK SETTINGS.
HE SAID THAT THEY CAN PRODUCE
FALSE POSITIVES.
IS THIS SOMETHING THAT WE SHOULD
BE WORRIED ABOUT?
OR IS THIS SOMETHING MAYBE JUST
ADDING ANOTHER LAYER OF
CONFUSION?

Dr. Bogoch says,
LISTEN, I THINK YOU
CAN'T IGNORE THERE WILL BE SOME
FALSE POSITIVES.
BUT I THINK THE RATE AND IMPACT
OF THESE IS MUCH LOWER THAN WHAT
MANY WOULD SUGGEST.
HERE'S THE BEAUTIFUL PART ABOUT
A RAPID TEST: IT'S RAPID.
YOU CAN ALWAYS REDO THE TEST.
OR YOU CAN FOLLOW UP, FOR
EXAMPLE, WITH A PCR TEST.
AND, I MEAN I REALLY THINK THAT
THESE CONCERNS ARE NOT ENTIRELY
OVERBLOWN BUT SOMETIMES
OVERBLOWN BECAUSE YOU CAN CREATE
POLICY TO ACCOUNT FOR THIS.
YOU CAN TEACH PEOPLE AS
DR. BARRETT SAYS YOU CAN TEACH
PEOPLE HOW AND WHEN TO USE THESE
TESTS AND WHAT TO DO WITH THE
POSITIVE OR NEGATIVE RESULT.
LIKE THESE ARE WONDERFUL
OPPORTUNITIES TO ENGAGE
COMMUNITIES IN REALLY TAKING
CONTROL AND EMPOWERING PEOPLE
AND COMMUNITIES TO REALLY ENSURE
THAT THEY CAN BE ACTIVELY A PART
OF CREATING A SAFER COMMUNITY
ENVIRONMENT, A SAFER SCHOOL
ENVIRONMENT. WE CAN DO THIS.
WE ABSOLUTELY CAN.
I REALLY THINK ONE OF THE BIGGER
LIMITATIONS NOW MIGHT AND SUPPLY
LIMITATION.
AND I THINK SUPPLY WOULD LIMIT
THE SCOPE OF A RAPID TESTING
PROGRAM.
THE OTHER IS OUR CREATIVITY.
LIKE IN A PERFECT WORLD WITH
UNLIMITED RESOURCES THESE COULD
BE UBIQUITOUS.
YOU COULD IMAGINE A SCENARIO
WHERE YOU HAVE FORMAL PROGRAMS
LIKE WHAT DR. BARRETT
DISCUSSED IN TERMS OF RAPID
TESTING AND RURAL UNDER-SERVICED
COMMUNITIES OR RAPID TESTING
LIKE WE'RE TALKING ABOUT HERE TO
CREATE SAFER SCHOOLS.
BUT YOU COULD ALSO TAKE THESE
TESTS OUT OF HAND AS THE MEDICAL
SCIENTIFIC AND PUBLIC HEALTH
WORLD AND PUT THEM IN THE
COMMUNITY.
SO HAVE THEM EASILY AVAILABLE.
AND, AGAIN, TEACH THEM HOW AND
WHEN TO USE THESE AND HOW TO
INTERPRET POSITIVE AND NEGATIVE
RESULTS MUCH LIKE PREGNANCY
TESTS ARE WIDELY AVAILABLE.
I'M NOT SAYING THROWING TESTING
AT A PROBLEM IS A SILVER BULLET
AND WILL SOLVE ALL OUR ISSUES IT
CERTAINLY WON'T BUT IT IS CERTAINLY
A HELPFUL TOOL IN A TOOLKIT TO
CREATE SAFER SPACES AND WE CAN
EMPOWER PEOPLE TO USE THESE
TESTS IN A SMART MANNER.
AND THIS WILL HELP. THIS CAN
CERTAINLY HELP.
IT'S NOT GOING TO SOLVE ALL OUR
PROBLEMS BUT IT CAN CERTAINLY
HELP TO MAKE THIS PANDEMIC A LOT
MORE BEARABLE AND CREATE SAFER
INDOOR SPACES.

Nam asks, DR. BARRETT?

Dr. Barrett adds,
WELL JUST TO FOLLOW UP ON THAT
AGAIN WE HAD A CONVERSATION, OUR
GROUP THIS MORNING WHEN DO WE
STOP TRYING TO CALM EVERYTHING
HOW TO COMMUNICATE WHEN AND IF
AND HOW AND JUST TURN THIS INTO
A VERY MUCH HERE'S THE TASK.
LIKE, FOLKS, THIS IS FOR YOU.
WE TALK ALL THE TIME IN
MEDICINE AND PUBLIC HEALTH ABOUT
WANTING PEOPLE TO OWN SOME
CONTROL OVER WHAT HAPPENS TO
THEM AND HOW THEY DO IT.
THIS IS A PERFECT EXAMPLE.
AND WE TRIED TO DO THAT IN NOVA
SCOTIA. YOU KNOW HAND THIS
TO PEOPLE. OFFER A TOOL.
HERE’S SOMETHING YOU CAN DO TO
HELP AND IT'S REALLY NOT AN
OUTDATED CONCEPT WITH TESTING.
I WOULD SAY IT'S COMING INTO ITS
OWN.
PARTICULARLY WITH HIGH RATES OF
VACCINATION UNTIL WE GET
EVERYONE UNDER TWELVE
VACCINATED AND WE HAVE ANOTHER
SEASON OF IMMUNITY DEVELOPED
THROUGH EXPOSURES, WE'RE GOING
TO NEED TO KEEP COMMUNITY VIRUS
AT A REASONABLE LEVEL WITHOUT
LOCKING DOWN.
AND BEING ABLE TO DETECT HOW
MUCH VIRUS IS AROUND IN OUR
COMMUNITIES IS AN IMPORTANT
THING AND THAT INVOLVES A HECK
OF A LOT MORE ASYMPTOMATIC
SUPER RAPID TESTING.
SO REALLY A TIME TO THINK
CREATIVELY AND COME INTO OUR
OWN.
ESPECIALLY IN CANADA WHERE WE
REALLY TALK A LOT ABOUT THIS
CONCEPT OF HAVING PEOPLE HAVE
AUTONOMY WE'RE NOW TRYING TO PUT
OUR MONEY WHERE OUR MOUTH IS
WITH RESPECT TO PUBLIC HEALTH
TESTING FOR INFECTIOUS DISEASE.

Nam replies,
I KNOW FOR PARENTS WHO ARE
WATCHING, THE WINTER SEASON
COMING UP, KIDS GET SNIFFLES
WITH EVERYTHING.
AND YOU ALWAYS GET NERVOUS IS
THIS COVID OR -- I JUST WANT TO
ADD, ANY ONE OF THOSE YOUNGER
KIDS. KIDS ARE VERY SMART.
MY KIDS ARE LIKE I'M NOT REALLY
FEELING WELL, MY THROAT HURTS.
AND YOU HAVE TO KEEP THEM HOME
BECAUSE THEY'RE MANIPULATING THE
SITUATION.
BUT THAT'S JUST AN ASIDE.

Dr. Bogoch adds, MAYBE YOUR KIDS ARE.

Nam says,
VERY SMART.
IT WOULD GIVE PEOPLE A SENSE OF
CONTROL AND PEACE OF MIND
INSTEAD OF GOING TO GET A TEST.
AND IF YOU'RE MISSING WORK TO GO
GET YOUR KIDS TESTED EVERY DAY
THIS WINTER IT WILL CREATE A LOT
OF PROBLEMS.
BUT I WANTED TO READ SOMETHING
FROM A COLUMN THAT MATT GURNEY
WROTE FOR TVO.ORG IN RESPONSE
TO WHAT DR. MOORE WAS SAYING
ABOUT FOCUSING ON HIGH-RISK
AREAS. THIS IS WHAT MATT WROTE.
AND IT'S CALLED WHAT THE HELL
TOOK SO LONG. SORRY FOR
CURSING. MATT WRITES…

Text reads, “What the Hell Took so Long? This makes sense on the face of it but also gives the government some tiny bit of cover. “Well, it doesn't make sense everywhere but it’s worth trying in high-risk areas” isn’t much of a defence for a government that could have mandated what it announced Tuesday many months ago, before school had even resumed. but it's marginally better than nothing…
So, yes, let’s celebrate today's news. Tomorrow we can get back to wondering what the hell took so long.”

Nam adds,
DR. BOGOCH, WHAT'S CHANGED
FROM THE BEGINNING OF THE SCHOOL
YEAR UNTIL NOW TO BRING IN RAPID
TESTING?

Dr. Bogoch answers,
I HONESTLY DON'T KNOW.
I TRULY DON'T KNOW.
IT MIGHT BE EXTERNAL PRESSURE.
BUT THERE MIGHT BE OTHER THINGS
THAT SOMETIMES WE'RE JUST NOT
PRIVY TO THAT ARE HAPPENING
BEHIND THE SCENES.
BUT, YEAH, I DON'T HAVE A GOOD
ANSWER TO THAT, UNFORTUNATELY.

Nam continues,
AND DR. BARRETT, THE, ONTARIO
SCHOOL PLAN, AS WE MENTIONED,
IS TARGETING HIGH-RISK AREAS
FOR RAPID TESTS. DO YOU THINK
THEY SHOULD BE WIDELY AVAILABLE
FOR ALL STUDENTS?

Dr. Barrett replies,
AGAIN, DEPENDS ON THE QUESTION.
BUT I THINK THE BEGINNING PART
HERE IS THAT IT MAKES SENSE FOR
KIDS WHO ARE NOT VACCINATED TO
HAVE ACCESS.
AND IF YOU HAVE A SUPPLY
PROBLEM, THEN YOU START WITH
SOMETHING SMALLER.
BUT I THINK ASKING THE RIGHT
QUESTION FIRST AND ANSWERING
IT -- WHICH IS PROBABLY THAT,
YEAH, EVERYONE SHOULD HAVE
ACCESS TO THIS.
THIS VIRUS -- JUST TO COME BACK
TO THE VIRUS BIT FOR A MOMENT IT
MOVES INCREDIBLY QUICKLY.
AND IF WE ALWAYS USE
HOSPITALIZATIONS AND
EPIDEMIOLOGY THAT’S A WEEK
BEHIND TO MAKE DECISIONS ABOUT
WHERE THE VIRUS IS, I MEAN THE
VIRUS LAUGHS AT THAT.
IT'S LIKE WOW, HAVE YOU FOLKS
NOT LEARNED?
SO ONLY TARGETING HIGH-RISK
AREAS SETS YOURSELF UP TO
DEVELOP MORE HIGH-RISK AREAS.
AND IF YOU CAN PREVENT THAT BY
USING WIDE-SPREAD TESTING AND
YOU HAVE THE RESOURCES TO DO
IT WHICH I WOULD ARGUE SHOULD
BE AVAILABLE, THEN THAT MAKES
THE MOST SENSE TO ME.
YESTERDAY'S LOW-RISK AREA IS
TOMORROW'S HIGH-RISK AREA.

Nam says,
I WANTED TO SHARE A
TWEET FROM HARVARD
EPIDEMIOLOGIST MICHAEL MINA.
AND THEY WROTE…

A tweet reads, “Symptoms don't mean more virus. Nope. Symptoms can actually even mean less virus sometimes, bc symptoms are often the result of
the immune response. Often ppl develop symptoms AFTER peak viral load.
This is a misperception that they are one and the same”

Nam asks,
SO DOES BEING SYMPTOMATIC OR
ASYMPTOMATIC MATTER FOR HOW
ACCURATE THESE RAPID TESTS ARE?
DR. BOGOCH?

Dr. Bogoch responds,
THERE'S A LOT TO UNPACK THERE.
WE KNOW THAT THERE'S A CONCEPT
OF PRESYMPTOMATIC TRANSMISSION.
MEANING YOU HAVE A GROWING
AMOUNT OF VIRUS IN YOUR BODY.
YOU'RE GOING TO DEVELOP SYMPTOMS
IN A DAY OR TWO DAYS.
BUT YOU'VE GOT A LOT OF VIRUS
THERE. YOU DON'T FEEL UNWELL
JUST YET. YOU SOON WILL. AND
YOU’RE TRANSMISSIBLE TO OTHERS.
THAT'S A CONCEPT THAT'S
EXTREMELY IMPORTANT AND RAPID
TESTING CAN CERTAINLY PICK UP
THAT VIRUS AT SOME POINT WHEN
YOU CROSS A CERTAIN THRESHOLD.
THERE’S PEOPLE WHO ARE
COMPLETELY ASYMPTOMATIC.
ASYMPTOMATIC. THEY'RE INFECTED.
THE VIRUS IS IN THEM.
THEY HAVE NO SYMPTOMS WHATSOEVER
FROM THE TIME THEY START WITH
THE VIRUS TO THE TIME THEY HAVE
NO VIRUS LEFT IN THEIR BODY.
AND THERE IS A GROWING BODY OF
EVIDENCE SUGGESTING THAT PEOPLE
IN THAT CATEGORY AREN'T AS
TRANSMISSIBLE AS OTHERS.
NOW, AGAIN, I WOULDN'T SAY
THE -- THAT'S CASE CLOSED.
THERE'S GROWING EVIDENCE
SUGGESTING THAT.
BUT THERE'S STILL SOME
SCIENTIFIC DEBATE OVER THAT.
I THINK THE POINT THAT
DR. BARRETT MADE EARLIER WAS
FANTASTIC IN THAT, YOU KNOW,
THESE RAPID TESTS IN
ASYMPTOMATIC, WELL PEOPLE, CAN
SERVE A PURPOSE IF THE GOAL IS
TO IDENTIFY PEOPLE WHO MIGHT
HAVE VIRUS IN THEM.
AND ESPECIALLY IN THE
PRESYMPTOMATIC PHASE.
AND PREVENT THEM FROM GOING INTO
WORK OR SCHOOL AND INFECTING
OTHERS.
THE OTHER IMPORTANT POINT, TOO,
IS THAT WE KNOW SOME PEOPLE HAVE
MILD SYMPTOMS.
SOMETIMES THAT'S REFERRED TO AS
PAUCISYMPTOMATIC. WHEN YOU DO
A CURSORY HISTORY, PEOPLE SAY NO,
NO, I'M FINE BUT IF YOU DRILL DOWN
THEY DO HAVE SYMPTOMS, THEY'RE
NOT AT THEIR BASELINE.
THAT'S CALLED PAUCISYMPTOMATIC.
AND THOSE ARE PEOPLE WHO HAVE
SYMPTOMS. IF IT'S THE BINARY
QUESTION OF ARE THEY SYMPTOMATIC,
THE ANSWER IS YES, IT'S JUST THAT
THEY ARE MILD SYMPTOMS. SOMETIMES
THOSE PEOPLE, UNFORTUNATELY
GET CATEGORIZED AS
BEING ASYMPTOMATIC WHICH IS NOT
ACCURATE.
AND THOSE ARE SYMPTOMATIC,
JUST MILDLY SYMPTOMATIC
AND CAN STILL TRANSMIT THE VIRUS
IF THEY'RE INFECTED.
THE POINT IS THESE RAPID TESTS
WILL DETECT IF THE VIRUS IS THERE.
SYMPTOMS DON'T ALWAYS TELL THE
ENTIRE PICTURE.
BROAD, RAPID TESTING WOULD
REALLY HELP IF IT'S FAST, IF THE
RESOURCES ARE THERE, IF IT'S
FAST, IF IT'S WIDELY AVAILABLE
AND YOU CAN GET AN ANSWER, AM I
CONTAGIOUS TO OTHERS, YES OR NO,
IN REAL-TIME THAT CAN CERTAINLY
DRIVE SMART BEHAVIOURS LIKE
SHOULD I SEND MY KID TO SCHOOL
OR SHOULD I GO TO WORK?

Nam replies,
I WANT TO READ QUICKLY FROM,
SOMETHING FROM THE PERSON,
FROM THE TWEET I JUST READ.
HARVARD’S MICHAEL MINA.
THIS IS SOMETHING THEY WROTE IN
THE NEW YORK TIMES OCTOBER
1ST. THEY WRITE…

Text reads, “Before rapid tests people have to assume they could be contagious from covid-19. That's why people isolated themselves, and businesses and schools closed. It is why people missed holidays with their
families. But by embracing rapid testing alongside vaccination, people can live with the virus. Workplaces can sustainably reopen. Children can stay in
school. The United States should use rapid testing as a complement to the vaccine…Our leaders must work quickly to make this a reality.

Text reads, “Rapid Tests: The Key to Ending the Pandemic? You Get One, and You Get One, and You Get One!”

Nam adds,
DR. BARRETT, YOU'VE MENTIONED
A FEW TIMES IT DEPENDS ON THE
QUESTION THAT YOU'RE ASKING.
BUT WE DO KNOW THAT WE'RE GOING
TO BE LIVING WITH THE VIRUS FOR
SOME TIME NOW.
TO WHAT EXTENT IS RAPID TESTING
ESSENTIAL TO HELPING END THIS
PANDEMIC?

Dr. Barrett answers,
SO ENDING IS NOT
THE WAY I'D PUT IT BUT WHAT I
WOULD SAY IS VACCINES ARE OUR
STAR QUARTERBACK. WE'RE NOT
GOING TO GET OUT OF THIS.
WE'RE NOT GOING TO WIN UNTIL WE
HAVE VACCINES AND WE NEED THAT
STAR QUARTERBACK.
SENDING THE STAR QUARTERBACK ON
THEIR OWN TO WIN A TEAM EVENT IS
SILLY.
AND THE TESTS, THESE RAPID TESTS, TO
FIND AND DAMPEN DOWN RAPID VIRUS
MOVEMENT IS REALLY KEY.
AND IF WE USE THOSE TWO TOOLS
TOGETHER ALONG WITH SOME BASIC
LIKE MASKING, THAT WILL GET
THROUGH FAR FASTER WITHOUT LOCK
DOWNS.
AND SO, QUESTION INDEPENDENT,
RAPID TESTS WITH RAPID VIRUS AND
THE STAR QUARTERBACK VACCINE IS
A TEAM THAT'S GOING TO WIN OVER
THE VIRUS.

Nam says,
AND DR. BOGOCH, WE'VE GOT
ABOUT THIRTY SECONDS.

Dr. Bogoch replies,
I WOULD JUST REQUEST
THAT WE USE HOCKEY ANALOGIES
INSTEAD OF FOOTBALL ON THIS
CHANNEL.

Nam laughs.

She asks, WHAT ABOUT BASKETBALL.

Dr. Bogoch responds,
THAT, TOO. WE’RE UNDERUTILIZING
THESE IN CANADIAN SETTINGS.
WE'RE STARTING TO UTILIZE THEM
MORE AND MORE. IF WE USE THEM IN
A SMART MANNER I THINK THAT
COULD DO A LOT OF GOOD WITH THESE.
IN THE EXAMPLE THAT WAS GIVEN
HERE, YOU CAN USE THIS
IN A “TEST TO STAY” APPROACH WHERE
YOU DON'T ALL HAVE TO GO HOME
AND ISOLATE FOR FOURTEEN DAYS IF
YOU HAVE A POSSIBLE EXPOSURE.
A NEGATIVE TEST CAN ENABLE
PEOPLE TO STAY IN CLASS OR
CONTINUE TO GO TO WORK.
THERE'S GOOD DATA BACKING THIS
UP AND GROWING DATA BACKING THIS
UP.
THERE ARE A LOT OF DIFFERENT
WAYS THAT RAPID TESTS CAN BE
IMPLEMENTED INTO YOUR DAY-TO-DAY
LIVES. WE'RE ONLY STARTING TO DO
THIS. WE'RE A BIT BEHIND THE
EIGHTBALL HERE.
I HOPE IF WE HAVE ACCESS TO
THESE RESOURCES WE DEPLOY THEM
BROADLY BECAUSE THEY CAN DO A
LOT OF GOOD.

Nam says,
DR. BOGOCH, DR. BARRETT,
THANK YOU SO MUCH
FOR SPARING TIME WITH US.
IF IT HASN'T BEEN SAID WE REALLY
DO APPRECIATE ALL THE WORK
THAT YOU’RE DOING TO HELP GUIDE
US IN THIS MOST UNUSUAL TIME.
THANK YOU SO MUCH FOR YOUR TIME
TONIGHT.

The guests reply, THANK YOU.

Text reads, “Rapid Tests: The Key to Ending the Pandemic? Produced by: Eric Bombicino @ebombicino”

Watch: Rapid Tests: The Key to Ending the Pandemic?