Respiratory Infectious Diseases / COVID-19 – Tips

Rapid testing:

• Can identify infected individuals who are asymptomatic (not showing any symptoms) or pre-symptomatic (not yet showing symptoms) that could otherwise go undetected. Reducing exposures to others in the workplace, keeping them safe and minimizing disruptions to the organization.
• Can be combined with other screening tools, such as a COVID-19 screening questionnaire, for an additional layer of protection.
• Can create an increased sense of protection and security in the workplace can have a positive effect on workers mental health.
• Is easy, fast, and safe to administer:
  • Testing can be performed on-site, and samples do not need to be sent to a laboratory.
  • Most rapid test kits return results quickly (within 15 to 20 minutes).
  • Most rapid tests only require a nostril swab sample, which is less intrusive and more comfortable than the nasopharyngeal swab (deep nasal cavity) required by some other test types.
• Is not required to be administered by a health care professional (in many jurisdictions).
• Is most effective at identifying those with high viral load and high transmission potential.

• Less accurate than PCR (polymerase chain reaction) molecular tests (i.e., return incorrect test results more frequently).
• May need to be confirmed with a laboratory-based PCR test, if a presumptive positive result is obtained.
• Cannot differentiate between variants of concern.
• Not a replacement for other workplace COVID-19 control measures, which should continue to be followed. Worker perception of negative test results may reduce their compliance to other control measures.
• Not a substitute for recommended public health measures such as vaccination, wearing a mask, and physical distancing.

• Make sure that the rapid test screening program is communicated to all workers in a language and format that they understand.
• Before implementing a rapid testing program, prepare workers by explaining how the program works:
  • Where tests will be administered.
  • That the tests are used to help stop the spread of the virus by identifying COVID-19 positive individuals who are not showing symptoms.
  • That results obtained through rapid tests are not diagnostic and may need to be followed up with a laboratory-based PCR test.
  • The benefits and limitations of rapid tests.
  • That test results are confidential. Only the worker and required individuals will be informed of results.
  • That rapid testing does not replace any of the health and safety controls in the workplace.
• Address any questions or concerns from workers.
• Review absence and sick leave policies, and provide information to workers on available resources, including government support.

• Always follow the rapid test kit manufacturer’s instructions for sampling procedure (i.e., where and how to swab), and how long to wait before reading the results. Not following the kits instructions can give inaccurate results (i.e., false positives or false negatives).
• Rapid testing can be administered by a health care professional or a trained individual that has the appropriate knowledge and skills to perform the test correctly and safely. Follow local jurisdictional guidance for who can administer the tests in your workplace.
• Specimen collection for rapid testing may also be done by the person being tested (i.e., self-swabbing) when supervised by a trained individual.
• If workers are required to perform a self-test at home before they come to work, make sure they are properly trained on how to safely follow the procedure.
• Make sure that the tester is wearing adequate personal protective equipment (PPE), including:
  • Gloves
  • Eye protection
  • Long-sleeved gown
  • Medical mask or respirator
• Continue following all workplace COVID-19 measures, when administering rapid tests.
• Clean and disinfect surfaces between tests.
• Have testers and test participants practice good hand hygiene and respiratory etiquette.
• Conduct the testing in a well-ventilated space.
• Maintain physical distancing between all individuals and do not crowd the testing area (e.g., front lobby or other designated room). Only the tester and individual being tested should be in close proximity while the test is being administered.
• Staggering worker start-times may help to reduce the number of workers waiting in line together. Workers who are waiting their turn should also wear a well-constructed and well-fitting mask or respirator.

• A negative result should not be interpreted as proof that the worker is not infected.
• A positive result from a rapid test is considered a presumptive positive result and may need to be followed up with a laboratory-based PCR test. The individual who received a presumptive positive result on the rapid test should isolate as recommended by local public health authorities.
• Each province and territory may have different reporting requirements. It is important to check if a presumptive positive result needs to be reported, and what follow-up actions may be required.
• Make sure that there is no stigma or punishment for workers who have received a presumptive positive result.
• Provide support to workers who need to isolate, such as financial support (e.g., paid leave) and mental health resources (employee assistance program, Government of Canada’s Wellness Together website, etc.).
• Refer to guidance from local public health authority to determine when workers with a presumptive positive test result can return to the workplace.
• A rapid test result that is indeterminate or invalid should not be considered positive or negative. Repeat the rapid test. If the individuals test continues to be inconclusive contact the test manufacturer or local public health authority for guidance.

• Test results must remain confidential. Identify who can access the results, how results will be stored, and for how long. Follow privacy laws for your jurisdiction, and consult with your local public health authority or legal representation regarding test result information.
• Develop appropriate and consistent messaging for delivering results to workers.
• Negative results – clearly state that the rapid test does not rule out COVID-19 infection and that all public and company health guidelines and control measures must still be followed.
• Presumptive Positive results – clearly state that the individual needs to immediately isolate and may need to take a laboratory-based PCR test, while continuing to follow all public health measures.

• Follow the manufacturer’s instructions for rapid test storage requirements.
• Many kits require storage above 2 ºC and must be above 15 ºC before testing. Do not allow the kits to freeze.
• Do not use and safely dispose of expired rapid test kits.
• Safely store, handle, and transport biohazardous waste according to the requirements in your jurisdiction.

The Government of Canada and provincial/territorial governments are providing free rapid tests to organizations for workplace screening. Businesses and not-for-profit organizations are eligible to apply.

Apply through the federal program or the rapid antigen test initiative for small and medium-sized organizations. Based on your organization’s location and number of workers, you will be directed to the most suitable source of rapid tests:

• directly from the federal government
• through a provincial/territorial government
• via distribution partners, including:
  • pharmacies;
  • chambers of commerce; and
  • the Canadian Red Cross.

• Test all workers who participate in the program regardless of vaccination status.
• Rapid testing should not be used when there is a suspected or confirmed outbreak in the workplace. The exception would be if rapid testing is used in addition to (not as a replacement for) laboratory-based PCR test under the guidance of the local public health authority.
• Decide how often testing should occur, based on the risk of exposure in your workplace. Considerations include the exposure risk, community transmission rates (including variants of concern), presence of an outbreak, if you have persons with vulnerabilities, and other public health requirements. The global or national test kit supply chain may also be a variable factor.
• For example, screening may be performed 2 or 3 times a week when there is a higher risk of exposure or high community transmission rates. Areas with lower exposure risk and low community transmission rates may test only 1-2 times a week.
• If unsure of testing frequency, refer to your local public health authority for recommendations.
• Workers who frequently travel for work may need to be tested more often as they may have increased exposure risks. Encourage those workers to continue to follow all local public and workplace control measures.
• Workers who have had COVID-19 within the last 3 months should not participate in the rapid testing program, as they may get a false positive result.
• Dedicate a person (or team) at each site to implement the rapid testing program.
• Create and update training procedures which include:
  • Instructions on conducting rapid testing
  • Safety precautions
  • Documenting results
  • Internal and external reporting of results, while maintaining privacy
  • Following-up with workers
  • Storing and disposing of contaminated materials
• Review onboarding and training materials associated with the rapid testing kit.
• Make sure that testing personnel are trained and scheduled.
• Chose a private space for rapid testing and ensure confidentiality.
• Limit access to and store sensitive materials (e.g., paper copies of test results, laptop for entering records, etc.) in a secure location.
• Make sure personal protective equipment (PPE), supplies and waste containers are available in the testing space.
• Identify a space where test kits can be stored securely and according to manufacturer guidelines.
• Allow more time on the first day of screening, as workers may have questions.
• When receiving tests from government programs, follow the conditions required, such as:
  • Tests must be used on workers and other authorized people only (i.e., not patrons, customers, or the general public)
  • Tests may not be sold or redistributed
  • Workers cannot be charged for the test
• Review and update your business continuity plan to address any impacts that a rapid testing program could have on your ability to provide your products or services.
• Where applicable, make sure that workplace unions are consulted while developing the rapid testing program.
• Continue to work with your health and safety committee or representative in the implementation of this and other health and safety measures.