Testing for COVID-19: Roles and responsibilities across Canada

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Collaboration

Governments at the federal, provincial and territorial levels each play important roles in COVID-19 testing.

Canada is providing billions of dollars to support provinces and territories with the cost of testing. While each province and territory decides how to test their residents, they’re guided by a common, national approach to testing.

At the federal level

The Public Health Agency of Canada (PHAC) leads Canada’s public health response to COVID-19. For testing, PHAC’s National Microbiology Laboratory works with public health laboratories nationwide to:

PHAC also publishes the number of people tested in Canada every day.

Health Canada authorizes COVID-19 testing devices that are imported or sold in Canada. For a product to be authorized by Health Canada, it must be submitted for review by a manufacturer. To date, a number of accurate and reliable COVID-19 tests have been authorized. Following authorization, Health Canada monitors the safety and effectiveness of tests and immediately takes action, if required, to protect the health and safety of Canadians. 

At the provincial and territorial level

Provinces and territories are responsible for the delivery and administration of health care services, including public and private laboratory-developed tests. They can develop their own sample collection and testing methods for COVID-19 and are responsible for ensuring that these tests provide accurate and reliable results. This includes ensuring that laboratory-developed tests and test collection methods are safe and effective. Laboratories that develop their own tests and offer testing services aren’t regulated by Health Canada.

Progress on Safe Restart Agreement commitments

The Safe Restart Agreement is a $19-billion federal initiative. Of this, $4.28 billion was dedicated to helping provinces and territories expand their testing and contact tracing capacity, and improve their data management and information sharing systems. The goal is to ensure that Canada has the resources and information it needs to reopen the economy safely while protecting the health of Canadians.

Premiers from each province and territory have outlined how they will direct this federal investment.

Working closely with the Government of Canada, the provinces and territories have made progress in each of the 3 pillars:

  1. testing
  2. contact tracing
  3. data management and information sharing systems

Testing

Under the Safe Restart Agreement, provinces and territories are increasing their diagnostic testing capacity. The national target is to ensure provinces and territories have the capacity to test up to 200,000 people per day. Collectively, provinces and territories have exceeded this testing capacity target, providing robust diagnostic and confirmatory testing capability across the country.

As the pandemic has evolved and more than 50 testing devices have been authorized, so too has Canada's testing approach.

The availability and use of rapid tests has ramped up across Canada. In support of provinces and territories, the Government of Canada has purchased nearly 40 million rapid tests from various manufacturers. Over 28 million have been shipped to provinces and territories so far.

Alongside other public health measures, we are working closely with provinces and territories to ensure that long-term care homes, schools, communities and other sectors have easy access to rapid tests.

Federal, provincial and territorial governments are also:

Contact tracing and exposure notification

Provinces and territories continue to refine their contact tracing approaches, with some using automated systems to share test results by text. Most jurisdictions have agreements in place to access federal contact tracing surge support, which can increase the capacity to 20,000 calls per day.

In addition, 8 provinces and 1 territory have adopted the COVID Alert app. This has resulted in an increasing number of app downloads and individuals entering a one-time key into the app. Provinces and territories are responsible for issuing keys to people in their jurisdiction who test positive. Once entered into the app, the key notifies others who were in close contact of a possible exposure, so they can follow their local public health guidance.

Work is under way with provincial and territorial partners to facilitate easier and direct access to one-time keys for all positive cases. This will help to maximize the benefits of the COVID Alert app. 

We're also working with provinces and territories, public health experts and private-sector organizations to add new functions to the app. This includes adding a Quick Response function (QR codes), which will notify app users of possible COVID exposure based on the venues they go to. The feature will help support mobility and the reopening of the economy.

Data management

It's crucial that health and public health data are shared quickly to enable coordinated and informed responses across Canada. In support of the Safe Restart Agreement, provincial and territorial premiers committed, in their letters to the Prime Minister, to share relevant information and data.

Federal, provincial and territorial (FPT) partners launched national public health surveillance for COVID-19 very quickly when the virus was identified internationally. Through the Special Advisory Committee on COVID-19, FPT public health officials agreed to a national dataset and what variables should be collected. For example, variables range from reason for testing, to exposure category, to race, to dwelling type.

Provinces and territories are working to provide timely and complete data submissions. Reporting of cases from provinces and territories to the Public Health Agency of Canada has been excellent, consistently at or near 100%.

Completeness of reporting, specifically ensuring that each case report is complete, continues to improve. However, there are still a number of variables, such as race/ethnicity and Indigeneity, that present a challenge to collect or share across all jurisdictions. Filling these data gaps will not only fulfill FPT commitments. It will also improve evidence-based decision-making and thus guide collective responses to COVID-19.

Work continues with provincial and territorial partners to understand better the issues affecting the ability to report fully on all variables. This includes:

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