Military must test more soldiers deployed to long-term care homes, health expert warns

Canadian troops serving in long-term care facilities are not being uniformly tested for the novel coronavirus — an omission that alarms a leading health and safety policy expert.

In response to questions from CBC News, the Department of National Defence (DND) said that soldiers, sailors and aircrew throughout the Canadian Forces are tested if they show symptoms of the virus.

Those personnel on deployment providing support to seniors homes in Quebec and Ontario are administered the test — but only in certain circumstances.

"To date, primarily symptomatic [Canadian Armed Forces] personnel are being tested for COVID-19, including [Operation] LASER deployed personnel," said Dan Le Bouthillier, DND head of media relations, in an email.

"CAF personnel deployed on Op LASER and assessed to be in close contact with active COVID-19 cases in [Long-Term Care Facilities] may be proactively tested based on recommendations of the local public health authority."

A testing patchwork

Some of the long-term care homes where troops are deployed "are also mass testing all personnel working in these facilities and therefore some of our asymptomatic CAF members are subject to these mass testing activities," said Le Bouthillier.

It all amounts to a patchwork policy that fails to recognize the extraordinary uncertainty surrounding the transmission of COVID-19, Mario Possamai, a former senior adviser to the Ontario government's SARS Commission, told CBC News.

While he acknowledged the military is following the established health protocol, he argued that the military's approach ignores mounting evidence of symptom-free transmission as a vector for the spread of the disease.

"One of the surprising characteristics of COVID-19 is the importance of asymptomatic transmission," said Possamai, an occupational health and safety expert.

"That's unlike SARS, unlike influenza. And that goes against typical public health control measures, which focus on the testing of symptomatic individuals."

Lax virus containment

Since Canadian Forces members were asked to backstop faltering seniors homes, 40 of them have tested positive for the virus — 25 in Quebec and 15 in Ontario. The figures are current as of June 1.

Military members wrote extraordinarily precise, detailed accounts of the dire conditions they found in some of the facilities. They noted lapses in the use of personal protective equipment in the long-term care homes and, in some cases, poor protocols for virus containment.

One military report noted that residents who had tested positive for COVID-19 had been allowed to wander freely in one facility.

Possamai said such accounts should have prompted alarm and a higher state of vigilance within the military establishment.

The 'Achilles heel' of pandemic response

"The military should ensure all of our personnel, whether they are symptomatic or not, are regularly tested," said Possamai, who pointed to a recent New England Journal of Medicine article that described asymptomatic transmission as "the Achilles heel of current strategies to control COVID-19."

One of the key conclusions of the SARS Commission was that health care workers were particularly vulnerable to the virus.

A debate is raging in the medical community right now over whether the novel coronavirus can be transmitted through the air through a process called "aerosolization", in addition to being carried by droplets.

The threat of airborne transmission prompted health officials in Montreal to inspect the defective ventilation system at the Vigi Mont Royal long-term care facility, where Canadian troops have been deployed.

Take no chances, says expert

Many scientists have said they're skeptical of the idea that the virus could travel further than three metres from an infected person. And at the moment, there are no studies that support one mode of transmission over any another.

Given the uncertainty over how COVID-19 gets from one person to another, Possamai said it's incumbent on health professionals to take unusual precautions, scale up protective equipment to the highest level and institute uniform testing.

"There should be testing of both symptomatic and asymptomatic individuals, especially when they're in such a high-risk environment as our military is in those long-term care facilities," he said.

CBC News requested an interview with the Canadian Forces surgeon general last week but received no response.

Without exception, troops who do test positive are isolated in the hotel rooms where they're being billeted while on deployment.

Soldiers exhibiting symptoms are required to remain in their hotel rooms for 10 days under the supervision of military medical staff. They won't be allowed to return to duty until the fever and any other symptoms are gone.

DND says that if the member shows no signs of illness after a positive test, the individual will remain isolated for 14 days from the date of the test and will be allowed to return to duty if no symptoms develop.