Industry Advisory Roundtable on COVID-19 testing: Taking stock and looking forward
Organization: Health Canada
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The Government of Canada’s Workplace Screening Initiative supports business and employee safety by enabling private-sector access to rapid antigen tests. Under the Initiative, the following distribution channels were established:
- direct delivery to workplaces for larger companies
- pharmacies and chambers of commerce for small and medium-sized enterprises (SMEs)
- Canadian Red Cross for non-profits, charities and Indigenous community organizations
The collaboration of some provinces has been key to supporting several of these channels, in partnership with the federal government. Provinces where channels are active have also played a vital role in adjusting regulations to allow for flexible and cost-effective workplace screening programs (see the section on task-shifting).
The Industry Advisory Roundtable continues to advise the federal government on economic recovery in terms of workplace safety. Recently, the Roundtable consulted with business and industry stakeholders about workplace safety and economic recovery.
While the Roundtable commends governments on making progress, further action is required in some areas. Accordingly, the Roundtable recommends the following:
- Maintain support for workplace screening into the fall: although vaccination rates are increasing, COVID-19 prevalence is also increasing and may continue to do so throughout the fall and winter, making it important to maintain screening as a precautionary approach.
- Ensure consistent government messaging about the continued value of workplace screening, including alignment with public health messaging and guidelines
- Align provincial and territorial guidelines and support for home-based self-testing programs, which will decrease the cost and complexity of workplace testing programs
- Adopt a milestone-based approach (based on vaccination rates, status of variants of concern, community prevalence, test availability) for scaling back direct government support for workplace testing
Various businesses, including small, medium-sized and large enterprises, have leveraged rapid testing to keep their employees and communities safe. Industry as a whole has also helped to inform provincial and territorial regulatory guidelines and the adoption of screening in the workplace.
Industry came together through the CDL Rapid Screening Consortium
The private-led, not-for-profit CDL Rapid Screening Consortium has guided the adoption of workplace screening for businesses and provided a platform for sharing best practices.
As of the end of July 2021, the Consortium had brought 87 businesses into its workplace screening program. With experience, the program has become more efficient. Organizations are now brought onboard in as little as 3 weeks, compared to the 10 to 14 weeks at the outset.
Businesses taking part in workplace screening had 715 active test sites in 8 provinces. Of the over 395,000 tests completed, over 300 cases were positive COVID-19 cases.
Government of Canada secured supply of rapid tests and provided them to provinces and territories
In addition to providing over 34 million rapid tests to provinces and territories, the Government of Canada delivered over 1.8 million tests directly to Canadian businesses. The government also launched a portal in April 2021 that directs organizations to distribution channels for SMEs and manages orders for medium-sized to large organizations. This complements provincial web- or e-mail-based ordering systems for the private sector.
Access to rapid screening for SMEs through pharmacies and chambers of commerce
The Industry Advisory Roundtable published a report in February 2021 recommending a new distribution network to support workplace screening by SMEs.
The federal government acted on that recommendation and set up new channels for distributing rapid tests to SMEs through pharmacies and chambers of commerce. As of the week of August 11, 2021, over 825 pharmacy locations in 3 provinces and over 115 local chambers of commerce in 3 provinces had received over 4.2 million tests for distribution to participating SMEs. In addition to providing tests to businesses, pharmacies and chambers of commerce provide guidance to SMEs on how to implement workplace screening.
Significant number of tests shipped directly to larger companies and employers
By August 8, 2021, the Workplace Direct Delivery program had been in place for 22 weeks. By that point, over 1.8 million tests had been sent or were in fulfillment to 155 organizations across the country. Of those tests, over 387,000 had been reported as used by organizations conducting workplace screening.
Changes in provincial guidelines enabled task-shifting
Task-shifting from health care professionals to a broader range of individuals increases the capacity and accessibility of screening without impacting vaccination efforts. The Industry Advisory Roundtable highlighted the importance of task-shifting to workplace screening in an April 2021 report.
As of August 2021, all provinces where screening programs are established have eliminated the requirement that only health care professionals administer rapid antigen tests in the workplace. Allowing trained laypeople to administer or supervise testing has made workplace screening more accessible to a wider variety of businesses.
Industry successfully integrated screening as part of the workplace and a tool for reopening the economy
By adopting workplace screening, industry leaders have led the way in making workplace screening a familiar, normal and expected part of the workplace. Employees across Canada have welcomed screening. They report being more confident in their workplaces and employers.
Workplace screening has become, and will continue to be, an important part of the reopening of the Canadian economy.
Priority areas and recommendations
While much progress has been made since the start of the Workplace Screening Initiative, there are several areas for further action.
Priority area: Greater awareness of workplace screening and consistency of public health guidance
Adoption of workplace screening varies greatly across the country, which reflects differing levels of awareness. We need to better communicate the benefits of screening across sectors of the economy and among the public.
While there has been progress on task-shifting, there are still barriers to implementing workplace screening. Some local public health policies have resulted in organizations choosing not to adopt rapid testing.
Public health guidelines that support workplace screening will realize the following benefits:
- enable economic recovery
- maintain essential industries and services
- support the return to physical workplaces for office workers
Recommendation: Enhance government communications and clear guidance
Governments should continue to communicate that rapid antigen testing is an effective tool, along with vaccination and public health measures, in managing the pandemic.
Despite high vaccination levels, the rising cases means that clear and consistent public health guidance on the value of workplace screening will continue to be important.
Recommendation: Expand sharing of best practices within industry
The Industry Advisory Roundtable and business leaders that have already adopted screening programs are in a unique situation to act as ambassadors of workplace screening. The Roundtable encourages Canadian industry to continue and expand its sharing of best practices, emphasizing the importance of senior-level buy-in and communicating the benefits of workplace screening for employees and the community within and for its own networks.
Priority area: Greater availability and adoption of home-based self-tests
A number of organizations are piloting the use of home-based screening with rapid antigen tests and several provinces are sponsoring pilot programs. Home-based testing promises to reduce costs and improve adoption of screening.
The federal, provincial, and territorial governments should work together to fast-track approval of and guidance about home-based rapid antigen testing across Canada. Health Canada has already approved one self-test and has Interim Orders in place to accelerate approvals for new self-tests.
In an August 2021 report on priority strategies to optimize self-testing in Canada the COVID-19 Testing and Screening Expert Advisory Panel explores the implications of self-testing and what conditions could make it successful.
Recommendation: Implement consistent home-based testing policies
Most provinces have approved the self-administration of rapid antigen tests. Some have not clarified that self-administration can mean that tests may be used at home. Consistent guidelines will unlock the potential of home-based testing.
Recommendation: Continue to fast-track regulatory review
Health Canada has approved 1 home-based self-test, but more cost-effective and high-performance tests are needed.
Priority area: Increased use within the education sector
There are screening initiatives for schools and universities in some provinces. There is significant potential to increase use of screening in elementary, secondary and post-secondary institutions by staff, faculty and students.
Increased use of screening programs within the education sector could avoid the societal and economic risks associated with school closures.
The COVID-19 Testing and Screening Expert Advisory Panel released a report in March 2021 on priority strategies to optimize testing and screening for primary and secondary schools. The report considers scenarios where schools may consider implementing screening on their premises.
Recommendation: Implement a national plan for schools and universities for the 2021-22 school year
The Government of Canada, provincial and territorial governments, and universities and colleges should collaborate on a national plan for testing staff, faculty and students. Such a plan should include the use of screening in school and/or university settings, with the understanding that education falls under provincial and territorial jurisdiction.
Priority area: Continued refinement of border measures
The Government of Canada announced initial plans to refine border measures in the course of June and July 2021. Testing will continue to play an important role in the safe reopening of our borders.
Recommendation: Implement measures to facilitate the movement of people and goods
The Industry Advisory Roundtable issued recommendations in a separate June 2021 report.
The initiatives of the Government of Canada have reached many businesses and made significant progress in adopting and scaling up workplace screening. This success is due in part to the valuable advice provided by the Industry Advisory Roundtable since October 2020.
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