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Canada has approved a 15-minute COVID test. But the lineups will still go on for hours

Health Canada has given the green light to a rapid test for , but experts say people shouldn’t expect the testing backlog — and lineups — will disappear anytime soon.

“It’s sort of sold as reducing the backlog,” Dr. Zain Chagla, an infectious disease specialist with McMaster University, said about the newly approved ID Now test. “I’m uncomfortable with this. I don’t think this is going to significantly reduce the backlog by any means.

“It is nice to have another tool to get people tested, but this is probably not the test that’s going to change the provincial testing queues altogether.”

Ottawa announced Wednesday it approved the test developed by Abbott Laboratories, which can deliver results in less than 15 minutes of a patient being swabbed, without having to first send the sample to a lab for processing.

Neither the company nor the federal government will be more specific about when the test kits will start arriving, other than “the coming weeks.”

The approval came a day after the federal government announced it had signed a deal to buy nearly eight million of the tests from the U.S.-based company, pending Health Canada approval, as well as 3,800 of the analyzer machines that process the results.

The ID Now test has been approved and used in the United States since the end of March under an emergency authorization, but not without controversy. Several clinical studies have since raised concerns over its accuracy, though others concluded with more favourable results.

“If you look at some of the literature that has come out around this machine, it does miss some positives,” noted Chagla. “From reading the U.S. experiences, people who are still having symptoms after a negative test are recommended to get another test.

“There’s limitation with this machine but it’s better than nothing at this point.”

According to an Abbott spokesperson, the test needs to be administered by a trained health-care provider.

A swab is taken either from the nose or the back of the throat, and then mixed with a chemical solution that can “recognize a unique section of the Coronavirus genome, while ignoring other viruses even if they’re similar strains,” the spokesperson told the Star in an email.

“ID NOW delivers reliable results in minutes, rather than hours or days, on the frontlines of the COVID-19 pandemic with accuracy rates as high as 94.7% compared to lab-based PCR reference tests in the acute phase of illness.”

Dr. Andrew Morris, an infectious disease specialist at Sinai Health and University Health Network, called the approval of the rapid test “welcome” but not a surprise. The test “has been approved in almost every jurisdiction where there’s been an application,” he said.

The question now is when these tests are going to arrive.

Other countries and the World Health Organization have also purchased them, and it’s not clear “where we are in the pecking order,” Morris said.

“Inevitably it’s going to help us but we really needed it several weeks ago to avoid our backlog,” he said.

The province also needs to figure out how the new tests will be used as part of a larger strategy, which should include “surveillance, screening and diagnostic testing.”

That’s something “we’ve been really challenged by,” Morris said. “This will expand our capacity for testing, it probably won’t be used in the highest stakes, because almost certainly its quality is not going to be as good as the gold-standard PCR test.”

While the rapid test can relieve the pressure on the back end of the testing process at labs, Chagla said people still need to go through the same registration at COVID assessment centres and line up to get tested.

Local health authorities need to take a look at what their testing needs are and how the test can meet those needs.

The rapid test works best in remote areas where test centres and labs are far and apart, for asymptomatic people and at high-risk workplaces where routine testing is called for, said Chagla.

“We need to develop a system to determine who is best for what test,” Chagla said.

Dr. Isaac Bogoch, an infectious disease specialist at the University Health Network, said the approval will “provide incremental help” and is “an excellent move” but “not a silver bullet.”

It might be particularly helpful in remote or northern communities that are far from labs, for some workplace outbreaks, or even in underserved urban neighbourhoods that have been hard hit by COVID, to “remove barriers” to testing.

The newly approved rapid ID NOW test is not to be confused with antigen tests, which test proteins on the surface of the virus. Health Canada said Tuesday it’s still reviewing those.

The goal, said Bogoch, would be a rapid antigen test that you could do at home, before heading to work or school, similar to a pregnancy test.

If it was positive, he said, it would trigger a more formal test at the centre. But in the meantime it would let you know not to go to work and to isolate, to avoid infecting others.

Nicholas Keung is a Toronto-based reporter covering immigration for the Star. Follow him on Twitter:

May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter:

Ontario is proposing ‘sneaky’ changes to child care

Ontario’s Ministry of Education is proposing changes to child-care regulations that would allow operators to group infants and toddlers together, reduce staff-to-child ratios for some age groups and lower qualification requirements for staff.

Child-care advocates said the proposed changes would make child care worse, not better, and they criticized the government for releasing the proposal in the middle of a pandemic, when parents are stressed and many operators are just trying to stay afloat.

“People are pushed to the limit and very distracted,” said Carolyn Ferns, a spokesperson for the Ontario Coalition for Better Child Care. “To have something like this come along at a time when the sector is very vulnerable, very distracted and not able to mobilize … I think it’s opportunistic and sneaky.”

The proposed amendments to the Child Care and Early Years Act, , arose as a result of a scheduled five-year review of the Act. The ministry is soliciting feedback from “all interested parties” by Nov. 20.

Among the is combining infants and toddlers into one group. Infants and toddlers are currently grouped by 0-to-18-months and 18-to-30-months, respectively; the new combined group would be 0-to-24-months.

The biggest impact would be for children between 24 and 30 months old. Under the current system, they’re considered toddlers, and required to have a 1-to-5 staff-to-child ratio and a maximum group size of 15.

Under the proposed changes these children would be bumped up into the preschool category with children up to five years old, and they would have a 1-to-8 staff ratio and a maximum group size of 24. “That’s a pretty big change for those two-year-olds,” Ferns said.

Don Giesbrecht, CEO of the Canadian Child Care Federation, said any reduction in staff ratios is concerning.

“Best practice is always going to say that we want more staff for fewer children, not more children for fewer staff,” he said, adding that grouping two-year-olds with children up to five is “not the norm” in Canada. “Typically a two-year-old is very much considered a toddler.”

In a written response to questions for this story, Ingrid Anderson, a spokesperson for the Ministry of Education, said the changes to age categories were proposed because “greater continuity of care during (a child’s) first years is associated with reduced stress and stronger relationships between educators, children and parents.”

A child’s “developmental progression” varies widely, Anderson said. “Allowing educators and parents to make decisions on when children are ready to progress to the next age group is beneficial for children’s learning and development.”

The proposed changes do not seem to allow children to progress to the next age group based on their development, rather than their age, so it’s not clear what Anderson meant by this. She did not respond to a request for clarification. The ministry is soliciting feedback on possibly allowing overlapping age categories in the future, but that is not one of the proposed amendments.

Anderson said findings from an industry survey and conversations with “sector partners” indicated the need for “more flexibility in (staffing) ratios so that licensees could move children between programs based on their developmental needs.”

The Association of Day Care Operators of Ontario, which represents both for-profit and non-profit child-care centres, declined to comment.

This marks the fourth time in the last decade that the province has proposed changes to age categories and staff ratios. The previous Liberal government under Kathleen Wynne , but when it was met with widespread backlash from parents, advocates and academics.

One difference with the current proposal is that it would be optional for operators to adopt the new age categories, and they would have to apply to the ministry to do so.

Ferns said that since it would be cheaper for child-care operators to use the new age categories and staffing ratios, many would.

“Because we’re in this situation where we have this market model and centres have this financial pressure on them, decisions are made for the wrong reasons,” she said. “We’re not doing it because that’s what’s in the best interests of the child. Is it good for a toddler to be put into a larger group with fewer staff? No, of course not, and we wouldn’t be making that decision if it wasn’t for financial reasons.”

The ministry’s proposed changes also include removing the requirement that staff working with kindergarten-age children be members of the College of Early Educators; allowing non-qualified staff to temporarily fill in for qualified staff for up to two weeks; and requiring that a supervisor have two years’ experience in “general children’s programming,” rather than licensed child care specifically.

Alana Powell, who represents the Association of Early Childhood Educators Ontario, said the proposed changes collectively “undermine” the value of early childhood educators and don’t address the long-standing problems of staff recruitment and retention.

“We understand that operators are in a very tough position, but this isn’t the way to solve those problems,” she said. “We really have to get at the root of the issues, which is the wages and working conditions in the sector.”

Coming little more than a week after a throne speech in which the federal government signalled its intention to build a national child-care system, the province’s proposal is deflating, Ferns said.

“They’re not speaking to the moment that we’re in,” she said. “We’re actually at a place in Canada now where we’re talking about making substantial changes to child care. We could be moving forward in a really positive way to expanding licensed child care, to building a system that would be more affordable for families, that would provide some stability for centres, not through tweaking how many kids they can shoehorn into a room, but by actually building a quality, publicly funded child-care system.”

Brendan Kennedy is a Toronto-based social justice reporter for the Star. Follow him on Twitter: