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To swab or not to swab: Here’s how three COVID experts use rapid tests in the Omicron era


To swab or not to swab: Here’s how three COVID experts use rapid tests in the Omicron era

Your throat feels scratchy and you’re sneezing; is it the start of seasonal allergies or something more worrisome?

Friends have invited you for a home-cooked dinner; you’re longing to go, but worry about keeping everyone safe.

Your stir-crazy child no longer has a fever and is bored of TV; can you send her back to school now that she is symptom-free?

The pandemic has added layers of uncertainty to what were once easy, everyday decisions. And though people no longer stand in hours-long lines to get a free box, experts say rapid antigen tests remain a valuable tool that can help bring some clarity to common COVID-19 questions.

Since January, the province has distributed 128.4 million rapid tests, according to the Ministry of Health, which confirmed free kits will be available at pharmacies and grocery stores until at least July 31.

While the province’s COVID wastewater signal is declining, Ontario is still seeing an estimated 60,000 to 85,000 new cases a day. With plenty of COVID circulating, the Star checked in with three experts about how they use rapid tests in the Omicron era.

Angela Rasmussen, virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization

There are a few ways Rasmussen has been using rapid tests this spring: Before seeing people indoors “just to make sure I’m not putting anybody in danger inadvertently”; To check whether her spring allergy symptoms are due to pollen and not COVID; And while travelling, including on her recent trip to Portugal for a microbiology conference, where she swabbed regularly to ensure she wasn’t infectious.

“I feel like that’s ethical behaviour; I don’t want to expose anybody else to COVID if I have it.”

While there are questions about whether rapid tests — which look for pieces of viral proteins in your nose or throat — work as well with Omicron subvariants, such as BA. 2, Rasmussen said she believes it’s likely the tests would remain effective. That’s because they detect the SARS-CoV-2 nucleocapsid (N) protein, which has fewer mutations than what has emerged on the spike protein in the BA sublineages.

Though she’s swabbed many times, Rasmussen has so far not tested positive. If she does, she says she’ll isolate until she gets a negative result, advice she hopes everyone will follow.

“A positive means you’re still shedding a lot of virus particles. Regardless of your symptoms, regardless of how you’re feeling, if you’re still testing positive … to be on the safe side you should continue to isolate until you see that negative line.”

Samantha Yammine, science communicator with a PhD in cell and molecular biology and neuroscience


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As someone who keeps a close eye on evidence-based pandemic advice, Yammine has been using rapid tests since they became widely available last winter. She considers them an extra layer of protection on top of other COVID precautions, and asks her friends to do a COVID swab before hanging out without a mask.

While a negative result isn’t always definitive, “it at least means we have a lower probability of being infectious,” said Yammine, adding rapid tests are now part of her beauty routine. “I curl my hair, I put my makeup on and do a quick swab before we head out.”

When asked about rapid tests — either by friends or in her role as a trusted COVID science communicator who goes by “Science Sam” on social media — Yammine reminds people to swab both inner cheeks and/or their throat, followed by their nose, according to advice by Ontario Health.

She also explains rapid tests aren’t perfect — for example, they are less sensitive in the first few days of infection — and that they’re more of a red light than a green light. “If you test positive, that means you should definitely stay home and isolate. But if you test negative, that doesn’t mean you should accelerate towards a million people.”

Before seeing vulnerable family members, Yammine, who wears a mask in public places, is mindful of avoiding crowds for a few days, in addition to rapid testing.

“If I’m seeing my parents on a Saturday, I won’t go out from Wednesday to Friday; I’ll change my plans so that they’re a little lower risk so that I’m saving up my risk budget. That means when I take a rapid test before seeing my parents, I feel a lot more confident in the results.”

Dr. Julia Orkin, medical lead of the COVID-19 outreach program at the Hospital for Sick Children

Rapid tests are a helpful tool to determine when kids can safely return to school or to ensure COVID-like symptoms are not due to the virus, Orkin said.

Her family used them when two of her children had mild symptoms and the school COVID screening tool advised them to stay home. Orkin said they went back to school after their fevers subsided and they had two negative tests, taken 48 hours apart.

“Neither of them enjoyed it very much,” she said, acknowledging it can be hard to test children. “Doing it right is important; the quality of the specimen is based on how well you do the test.”

She recommends families review the COVID school guidance on how to test and monitor symptoms to determine when kids can return to class.

She also notes public health advice is to not use rapid tests for a one-off screen before a social outing. Rather than relying on a negative test, she and her family opt to see her grandmother, who is her 90s, outdoors while wearing masks.

“Seeing my grandmother is really important for me, and it’s important for her to see me and my family. But we are going to do that in the way that’s the least risky to all of us.”

Megan Ogilvie is a Toronto-based health reporter for the Star. Follow her on Twitter: @megan_ogilvie

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