Testing for COVID-19: Roles and responsibilities across Canada
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- Collaboration
- At the federal level
- At the provincial and territorial level
- Progress on Safe Restart Agreement commitments
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:
- test specimens received from provinces and territories
- develop accurate tests
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:
- testing
- contact tracing
- 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. We have purchased and shipped hundreds of millions of tests 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:
- working with industry associations, non-profit and other organizations to distribute rapid tests in the workplace, to help make critical workplaces safer
- making key resource materials, such as guidance and best practices, available to employers to help them with their workplace screening initiatives
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 adopted the COVID Alert app, which is now retired. COVID Alert was launched in July 2020 and was one of the many tools provided to Canadians to help them fight against COVID-19. This voluntary mobile app was designed to notify users who came in close contact with another user who had tested positive for COVID-19 and entered a one-time key. Provinces and territories were responsible for issuing keys to people in their jurisdiction who tested positive. Once the key was entered into the app, it notified others who were in close contact of a possible exposure, so they could follow their local public health guidance.
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:
- holding bilateral meetings with all jurisdictions to discuss solutions
- developing data-sharing principles to improve clarity on data sharing, governance and use
- sharing monthly completeness reports that highlight reporting over time for all jurisdictions, through the Special Advisory Committee on COVID-19
- working with provinces and territories to develop a pan-Canadian Health Data Strategy to address long-standing issues affecting Canada's ability to best collect, share and use health data.
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