People wait in line at a COVID-19 testing and vaccination site, in Montreal, on Dec. 29, 2021.Graham Hughes/The Canadian Press
The Quebec Health Department said Tuesday that members of the general public with COVID-19 symptoms will not be eligible for PCR testing and should consider themselves positive if they do not have access to self-tests.
The province will reserve PCR tests for those considered “high risk,” such as symptomatic hospital patients, people who live in congregate care and people being transferred between medical facilities, Dr. Marie-France Raynault, a senior strategic medical adviser to Quebec public health, told a technical briefing.
Raynault said testing centres are overwhelmed and supply shortages are expected as demand for tests continues to rise elsewhere.
“We have a capacity of about 30,000 tests a day, and last week, for example, we had almost 60,000 tests per day and it’s unsustainable,” she said. “So we have to keep our capacity for the ones who are more at risk, the places at risk.”
Members of the general public who have symptoms of COVID-19 are being asked to administer a rapid antigen test, Raynault said, and if one is not available, they are being asked to consider themselves positive and isolate for five days – down from the previous recommendation that people isolate for 10 days.
The Health Department said it expects to receive on Wednesday three million rapid tests purchased by the province, and those tests will be delivered to pharmacies in the following days. Quebec began distributing free rapid tests to the general public through pharmacies on Dec. 20, but many ran out of tests shortly after opening.
Health Department spokesman Robert Maranda said in an e-mail that deliveries of rapid tests from the federal government were interrupted due to the holidays.
Raynault said the recommendation to isolate for five days applies only to those who have received two doses of vaccine or are under 12. People who isolate for five days must not have a fever for at least 24 hours, and their symptoms must be improving before they leave isolation.
She said studies have shown people are most contagious in the two days before they develop symptoms and in the two to three days after symptoms appear.
With more people being asked to isolate, maintaining the 10-day isolation period would “paralyze” society, Raynault said.
“There isn’t only COVID in the life of a society,” she said. “If we don’t have firefighters to put out fires, if we don’t have police officers to ensure security, if we don’t have delivery people so there’s food, if we don’t have bus drivers, that is also a consideration that we take into account in public health.”
The five-day isolation period does not apply to health-care workers in direct contact with patients, who must isolate for seven days before returning to work.
Dr. Catherine Hankins, a professor of public and population health at McGill University, said the decision to limit access to PCR tests is a pragmatic one.
Hankins, who is also the co-chair of Canada’s COVID-19 Immunity Task Force, said in an interview that the health-care system should be focused on accelerating the vaccination campaign and preparing hospitals for more patients, rather than testing.
The shorter isolation period, which has already been implemented in several other provinces, including British Columbia and Ontario, and is recommended by the Centers for Disease Control and Prevention in the United States, makes sense because 90 per cent of transmission happens within five days of the onset of symptoms, she said.
“Yes, there’s a little bit of a risk, there’s a potential for transmission, but if you’re following all the precautions, the likelihood that you will transmit is very low,” she said.
While daily case counts regularly make headlines, she said the reason people get tested is so that they can avoid spreading the disease to others.
“From a health-care system viewpoint, the most important metrics are hospitalizations, and then from there, how many of those people require oxygen, how many of them require ventilation, how many of them end up in the ICU and how many of them end up dying,” she said.
Earlier Tuesday, Quebec reported another jump in the number of people hospitalized with COVID-19, as well as 21 more deaths linked to the pandemic. Health authorities said 1,592 people were in hospital with COVID-19, an increase of 196 over the previous day. The number of people in intensive care rose by four to 185.
Quebec reported 14,494 new cases of COVID-19, with 28.1 per cent of tests analyzed in the previous 24 hours coming back positive.
This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.
Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.