PCR testing volumes in Manitoba down 59% since early January

A large drop in the number of COVID-19 lab tests being completed in Manitoba is raising questions about resources devoted to PCR testing and whether it's time to expand eligibility.

Statistics published by Manitoba Public Health show COVID-19 test volumes are nowhere near the province's stated capacity of 4,000 PCR tests per day.

During the week ending Jan. 27, Manitoba labs completed a a daily average of 2,165 COVID tests per day.

That's a 59 per cent drop from the first week of January, when the daily average test volume was 5,251.

The province's chief public health officer says access to polymerase chain reaction, or PCR, testing has been restricted in order to ensure lab tests can be processed quickly, especially to allow treatments to begin as soon as possible for patients eligible for new COVID-19 medications.

"We're testing right now to ensure we have people diagnosed in a timely matter to receive treatment if they're eligible for that," Dr. Brent Roussin said on Wednesday.

Those treatments include Sotrovimab, a monoclonal antibody treatment manufactured by GlaxoSmithKline, and Paxlovid, a set of antiviral pills made by Pfizer.

The Sotrovimab treatments must be started within seven days of appearance of symptoms, while Paxlovid treatments are recommend to begin within five days.

Sotromivab, which must be administered intravenously, is the only monoclonal antibody treatment the province uses against the Omicron variant, which is the dominant strain in Manitoba of the coronavirus that causes COVID-19. 

It's been provided to 310 patients since Dec. 20. The province still has 210 doses.

Health Canada shipped enough Paxlovid to treat 1,100 patients to Manitoba on Jan. 19. To date, 16 Manitoba patients have received the treatment, which consists of two types of pills taken over five days. 

Dr. Philippe Lagacé-Wiens, a medical microbiologist at St. Boniface Hospital, said it would be a mistake to look at the low volumes of patients who have received COVID-19 treatments so far and conclude the province should not be making them a priority for PCR testing.

"We don't have enough doses of this stuff to give it to everybody, and that's the limiting factor," he said.

Lagacé-Wiens said Manitoba had no choice but to reduce PCR testing eligibility when Omicron overwhelmed the system.

"It's possible that it went too far," he said. "I think it's reasonable to start considering other groups without overflowing the system with tests."

Right now, most people in Manitoba who test positive for COVID-19 using a rapid antigen test are not eligible to return to receive a more sensitive PCR test.

The province limits PCR testing to certain groups, including residents of First Nation communities, people having surgery, symptomatic patients in hospital, some symptomatic immunocompromised people, and symptomatic children who can't take rapid tests.

PCR tests are also open to some people who have a positive result from a rapid test, including health-care workers who provide direct patient care and first responders, designated family caregivers for people in personal care homes, and elementary or secondary students.

People can also get PCR tests on the advice of a doctor or public health official. 

People who don't fall under any of the province's designated categories are advised to get rapid tests — or if they have symptoms, simply assume they have COVID-19 and stay at home.

NDP Leader Wab Kinew said he too believes the province ought to expand the eligibility criteria to include more symptomatic people.

"It's pretty tough to shake the idea that maybe the restriction on who can get a PCR test right now is motivated more by money and financial concerns for the provincial government," he said.

A spokesperson for Government Services Minister Reg Helwer declined to say whether the limitation is a cost-saving measure.

Helwer's spokesperson said there is no demand to warrant the expansion of PCR testing eligibility.

"PCR testing is down because Manitoba is making effective use of available rapid antigen tests," he said, adding the turnaround time for a PCR test is less than 24 hours.

Three laboratories conduct PCR testing for Manitoba: the provincially owned Cadham Laboratory and private companies Dynacare and BioScision Diagnostics.