N.B. to end COVID-19 PCR testing for most people April 1, memo reveals

COVID-19 PCR testing for most New Brunswickers will end April 1, CBC has learned.

In a memo to all medical practitioners, Dr. Yves Léger, deputy chief medical officer of health, cites the "very low demand for testing and the need to eventually transition back to routine testing practices."

People will no longer be able to self-schedule an appointment for a PCR (polymerase chain reaction) test at an assessment centre, according to the March 20 memo obtained by CBC, entitled, "NEW DIRECTION on COVID-19 PCR testing."

"Patients with COVID-19 compatible symptoms where the outcome of PCR testing will directly influence treatment or care," will still be able to get a lab-based PCR test, Léger advised.

But they will require a referral from a health-care provider, he said.

The move comes as New Brunswick continues to add several deaths to its pandemic death toll each week, as dozens of people continue to be hospitalized for or with the virus, and as the Omicron subvariant XBB.1.5, deemed immune evasive and "the most transmissible" yet, has become the dominant strain in the province.

It also comes as New Brunswick recorded its highest PCR test positivity rate in about a year — the highest in the country — which indicates a high level of community transmission, and as the federal government has stopped supplying rapid tests.

Future of weekly COVIDWatch reports unclear

The Department of Health did not respond to questions Friday about what this will mean for the future of the weekly COVIDWatch reports, which include positivity rates and breakdowns of which variants are circulating in the province, based on PCR tests.

But in an interview, Dr. Jennifer Russell, chief medical officer of health, suggested Public Health will still be able to "track" the virus through rapid tests.

People will continue to have access to rapid tests, also known as point-of-care testing (POCT) kits, by appointment through a variety of community-based sites, including public libraries, municipal buildings and health centres.

"The POCT test results are are very, very good," said Russell.

She has previously said rapid tests are useful for screening, but they're not diagnostic. PCR tests are considered the gold standard.

"And please don't forget that when you do a POCT, you should register your results online so we can keep track of it."

The province stopped including self-reported results in its COVIDWatch reports months ago, saying they are "an inaccurate indicator of how many people may be positive." The numbers are still available on the COVIDWatch landing page, however, because they are "an indicator of virus spread and potential impact."

"We have millions of POCT tests available in our inventory," Russell said.

The federal government's website, however, indicates New Brunswick has an estimated 544,162 rapid tests in stock, as of March 8. The Department of Health has not said when the tests are due to expire.

When CBC inquired last week about the future of PCR testing in the province, department spokesperson Sean Hatchard replied, "Multiple COVID-19 testing options will be available to New Brunswickers for the foreseeable future. Those include both rapid tests and polymerase chain reaction (PCR) tests, which are used for other ailments as well, and those options will exist well beyond June 2023."

Asked Friday what prompted the change now and whether it's to save money, Russell said Public Health routinely reassesses.

"I think it's always wise to reconsider our strategy and evolve because that's what we've been doing throughout the pandemic."

She noted the number of people requesting PCR tests dropped to 370 in February, compared to about 8,000 in March 2022.

Self-referral for PCR testing has been limited since Jan. 4, 2022, to people with COVID symptoms who are vulnerable or in high-risk settings.

These include people who:

• Are over 50 or are under age two.

• Live or work in a hospital, extra mural and Ambulance New Brunswick, long-term care facility, correctional facility or shelter, or are "precariously housed."

• Are immunocompromised.

• Are pregnant.

• Require a PCR test for international travel.

This change will allow the regional health authorities to move staff from assessment centres back into the jobs they were doing before the pandemic, Russell said.

The key message now, she said, is for people to stay home when they have symptoms.

"To protect ourselves and to protect others, you need to stay home when you're sick."

'COVID-19 is still very much present'

As for who will qualify for PCR testing now, Russell said the same limited groups are eligible, but it will be be at the discretion of their health-care providers.

People who don't have a family doctor or nurse practitioner can be referred through an after-hours or walk-in clinic, through a virtual appointment with eVisitNB or by contacting Telecare 811, she said.

CBC asked the New Brunswick Medical Society how the province's stretched doctors feel about PCR referrals being added to their plates. In a statement, president Dr. Michèle Michaud did not respond directly.

"COVID-19 is still very much present in the province and its impact on the health system cannot be overlooked," she said.

"However, as the pandemic has evolved, so too have many of the procedures we have adopted along the way, including testing."

The society is pleased that rapid tests will continue to be available for people to test at home, and that people whose care could be influenced by PCR testing results will still have access to testing with a referral from a health-care provider, Michaud said.

Test centre staff to be reassigned

Horizon and Vitalité health networks, which operate the assessment centres, did not respond to a request for comment.

But on Friday afternoon, after CBC posted this story, Horizon issued a news release confirming that PCR testing at its assessment centres will only be available for those who receive a referral through a family physician or primary care provider, "the same as other viruses and diseases."

"These changes are being implemented in light of updated testing guidance from New Brunswick Public Health," it says.

All of Horizon's COVID-19 assessment centres will remain operational, but the hours of operation will be reduced to five days a week, Monday to Friday, from seven.

"In light of these changes, Horizon will be reassigning 26 of the 40 staff members of its COVID-19 assessment centres — a mix of registered nurses, licensed practical nurses, respiratory technicians and administrative support — back to roles in our hospitals or in primary health care," the release says.

Vitalité issued a similar news release.

Testing helps reduce spread, track variants

CBC asked Health Canada about its guidance to provinces on continuing PCR testing. Spokesperson Joshua Cooke did not answer directly.

"Molecular testing is the responsibility of the provinces and territories. Please contact them for further information," he said in an emailed statement.

The national microbiology laboratory in Winnipeg will continue to provide reference-level testing to support provinces and territories "and no end to this support is being considered at present," Cooke added.

The Public Health Agency of Canada's website says testing is "important" because it's the only way to confirm if someone has COVID-19 and PCR tests are "the gold standard" to diagnose active COVID-19 infection in people with symptoms.

Testing helps reduce the spread of the virus because when people test positive, they can isolate.

It also indicates where the virus is spreading and how much the virus may be circulating in certain communities, which helps people and authorities understand the level of risk.