How labs in Nova Scotia are dealing with a COVID-19 testing backlog

Dr. Todd Hatchette knew something had to give the day 22,000 specimens arrived for COVID-19 testing.

"Temporary surges are manageable, but lab capacity cannot be increased at the flip of a switch," he said.

Hatchette, the service chief for microbiology in the central zone of Nova Scotia's health authority, told CBC News via email that a small backlog in the microbiology labs is typical. It's the reason Nova Scotians are advised that their results might not be ready for up to 72 hours.

But that 22,000-specimen day, which came this past week, set things too far behind.

"That spike, and the potential those volumes could continue, led to the decision to refocus testing," Hatchette said.

By the time Dr. Robert Strang, the province's chief medical officer of health, alerted the public on Friday, 45,000 swabs were waiting in the queue. Adding to the bad news, Strang said many of those would likely turn out to be positive.

Now, lab testing is restricted to those who have COVID-19 symptoms or who have been told to get a test because of travel, potential exposure, close contact or upcoming surgery.

Asymptomatic Nova Scotians who just want to be sure they aren't carrying the virus are being directed to rapid testing sites.

New instrument coming

Daily lab capacity started at about 200 tests last March and tripled within a month. It grew to about 5,000 during the pandemic's second wave and then to 15,000 just last week. More than 16,500 tests were processed Friday.

Hatchette said an additional testing instrument is en route to Nova Scotia to help further increase testing capacity.

In the meantime, some specimens could be frozen until they can be processed. Hatchette said tests are typically kept in a fridge, where they're good for three days.

Some swabs are being prioritized if they require a quick turnaround time. A health authority spokesperson said those include tests from outbreaks and long-term care settings, in-patients and pre-operative patients.

Rapid testing ramping up to fill in the gap

Nova Scotia is unique in offering asymptomatic testing to anyone who wants it. Most Canadian provinces limit testing access to those who are showing symptoms, have been exposed to a confirmed case or meet some other specific criteria.

Dr. Lisa Barrett, an infectious disease specialist at Dalhousie University in Halifax, said Nova Scotia's broad testing approach has been an essential part of keeping COVID-19 under control in this province. If the strategy can be kept up, it could prevent hospitals from becoming overwhelmed in this third wave, she said.

"If we can keep the early detection system going ... then we have the ability hopefully to not end up like Alberta, Manitoba and Ontario with our ICUs full and children's hospitals housing adult patients because we're overwhelmed," she said in an interview.

Barrett, who has been one of the lead organizers in Nova Scotia's rapid and pop-up testing operations, said additional testing options are likely to become available in the coming days for those who are now being discouraged from seeking lab tests.

"Are there going to be lineups? Yes, there are.... [But] I do think we'll be able to keep up," she said.

Barrett said it was unfortunate that on Saturday, the lines were short at rapid testing sites. She thinks people are concerned about overwhelming the system, leading some to stay away.

"That's not what we want people to do. We just want you to go to the pop-up sites for a little while while we reorient the other sites. So hopefully, actually, people do come to overwhelm us a little bit at the pop-up sites."