Rapid tests are pricey, and that means many people 'just won't test,' expert warns

A public health expert says Newfoundland and Labrador's decision to reduce PCR testing makes sense, but she's concerned about access to rapid COVID-19 tests for people who can't afford them.

Rapid tests are available to buy online or in some retail stores, but Dr. Brenda Wilson, a public health physician in St. John's, noted they can be expensive — especially if someone is on a low income or needs to be tested frequently.

"Unless they're made available in some other way, either extremely cheaply or, you know, for free, then I think people just won't test," Wilson, an associate dean in Memorial University's faculty of medicine, said Monday in an interview with The St. John's Morning Show.

Last week, the province's Department of Health and Community Services announced only the most vulnerable populations, people with symptoms who are at increased risk, or people who are essential to keeping the health-care system working would be eligible for PCR tests, which had previously been provided to anyone for free. The main requirement had been symptoms for COVID-19.

While some other provinces have given out unlimited COVID-19 rapid tests for free, Newfoundland and Labrador has restricted distribution through schools, health-care centres, congregate living facilities, corrections services and other facilities.

In a media release last week, the Department of Health said people who can't access rapid tests have to self-isolate for 24 hours or until symptoms subside.

'Black market' possible, critic says

While speaking with reporters Monday, PC MHA Paul Dinn said he's already heard of people selling rapid tests on a "black market" of sorts.

He said for low-income individuals, staying home from work often isn't an option, especially for those without paid sick leave.

"These are people falling through the cracks," he said.

"It's putting unnecessary stress on individuals and putting unnecessary stress on their bank accounts."

He said the government's COVID-19 strategy has been mostly successful, but called for better access to rapid tests for people who can't afford them.

Back to normal

On Friday, Chief Medical Officer of Health Dr. Janice Fitzgerald explained the decision was made to free up health-care system capacity and to help it return to normal.

Wilson agreed that the decision to stop COVID-19 PCR testing for most residents fits an overall strategy by public health to change the way people think about the virus and get society back to normal.

"[It is taking] us through a transition to treating this much more like it's flu or any other viral disease where we really don't give it that kind of attention and we leave it to people to to handle it for themselves," Wilson said.

Wilson said the lack of access to testing will make it especially difficult to diagnose people who have developed long COVID because they won't have a medical record of having had COVID-19. While the initial phase of COVID-19 is like the flu for many, she said, some feel more severe effects later.

"For those who get long COVID, it has effects on the heart, on the brain and other body systems that are actually quite significant," she said.

"With this pandemic, what we've seen right across the board is those who are most at risk and most susceptible are often those who are in the least position to be able to access what they need."

Wilson said it's difficult to know if the decision to end restrictions and reduce testing was the right one.

"We don't have a playbook for this. Nowhere in the world yet has gone through the transition out of the pandemic, and I think one thing we're all clear about: this is not the end of the pandemic," she said.

In the weeks to come, Wilson said, she'll be keeping an eye on deaths and hospitalizations, which hit a new record high Monday.

Confusion about availability

Confusion about the availability of rapid tests have forced some organizations to clarify.

Over the weekend, Newfoundland and Labrador Public Libraries released a statement on social media to confirm that rapid tests are not available at libraries.

On Monday, the Newfoundland and Labrador English School District released a statement to clarify that students will receive a pack of 10 rapid tests but unlimited rapid tests are not available.

"The [school district] will be receiving shipments of rapid test kits from Public Health on a regular basis, which will be equitably distributed to students as they are made available to the school," said the statement.

Fitzgerald has said students who receive the packs are encouraged to share their tests with friends, family and neighbours.

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