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Is more testing behind the record numbers of COVID-19 cases in Canada? Your testing questions answered – CBC.ca

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We’re answering your questions about the pandemic. Send yours to COVID@cbc.ca, and we’ll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. So far, we’ve received more than 55,000 emails from all corners of the country.

COVID-19 testing is a crucial part of tracking and managing the pandemic. It has become a part of daily life that’s often necessary for returning to work or school or for keeping friends and family safe. 

But it also generates a lot of confusing news and advice from case counts to wait times to ever-changing instructions about who needs to get tested, when, how and why.

It’s no wonder CBC readers have lots of questions. We checked with experts to get some of the answers.

Is the present spike in COVID-19 cases in Canada related to the increase in testing?

Many provinces have been breaking daily new case records for COVID-19, including British Columbia, Alberta, SaskatchewanManitobaOntario, and Quebec. But these provinces are all running more tests now than they were at the previous peak in the spring when a shortage of tests meant even people with very typical COVID-19 symptoms couldn’t get tested. So, are the increased case counts simply due to more testing? For the most part, no. But the amount of testing does make a difference.

For Ontario, the new records are partly due to the increase in testing, said Dr. Sumon Chakrabarti, an infectious disease specialist with Trillium Health Partners in Mississauga, Ont., in an interview with CBC News Network.

Ontario completed over 48,000 tests on Oct. 7 (two days before setting a record of 949 cases in one day) — about quadruple the 12,000 it ran on April 24 when the province hit a spring peak of 640 cases. 

At that time, Chakrabarti estimates about three-quarters of cases were being missed, and there were likely closer to 2,500 cases a day in late April.

However, the real number of cases in Canada is definitely higher than it’s been since the spring peak. 

All things being equal, if you test more of the population, you will end up testing more people with COVID-19, which will cause the case counts to go up, but you will typically test even more people without COVID-19, causing the percentage of positive tests to decrease, said Cynthia Carr, founder of the Winnipeg-based epidemiology consulting firm EPI Research Inc.

But in fact, the percentage of tests that come back positive is increasing in many places, including Manitoba. In that province, the real number of cases is “definitely an increase relative to the spring.” 

And in Ottawa, SARS-CoV-2 virus levels in waste water in recent weeks are the highest they’ve been since testing began in June. That’s a measure of COVID-19 prevalence independent of the amount of testing at testing centres, said Raywat Deonandan, an associate professor of epidemiology at the University of Ottawa. 

The good news? Coronavirus levels in waste water seem to be going down since the province imposed stricter restrictions on social gatherings in the city before Thanksgiving.

WATCH | How sewage can be used to track COVID-19:

Wastewater samples from sewage are being used to determine the existence of COVID-19 in communities and could give advance warning of where a second wave is taking shape. 2:03

If we can test feces in waste water for coronavirus, why are we still doing invasive nasal swabs?

Having your nose swabbed can feel really uncomfortable, but Dr. Matthew Cheng, an assistant professor of medicine at McGill University, said there are practical reasons for it:

  • Public health doctors are more interested in knowing if the virus is in the respiratory tract, which the nose is part of, as it’s mainly spread via the respiratory tract.

  • Lab protocols are optimized to process lots of respiratory samples and having other kinds of samples could slow down analysis.

He said that there’s lots of work underway to be able to quickly analyze respiratory tract samples that are easy for people to collect themselves, such as “swish and gargle” saliva tests. Lastly, many people may not find collecting a stool sample easier than getting a swab in the nose.

WATCH | A closer look at saliva-based tests:

Instead of waiting in a long line for a COVID-19 test that involves getting a swab stuck up the nose and sometimes waiting days for results, scientists are developing saliva-based tests and produce results in minutes. Is the future of testing more comfortable and done at home? 5:58

How long are test samples good for?

With backlogs in testing in Ontario this fall, at least one local health director has complained about tests spoiling and having to be redone after they weren’t processed within 72 hours. Dr. Robert Cushman, acting medical director of Renfrew County and District Health Unit in Ontario, reported that the testing lab told him that about 10 tests had to be redone due to delays in processing.

So how long do they last?

It depends on how the swab is stored after collection, said Allison McGeer, an infectious disease specialist at Toronto’s Mount Sinai Hospital, but generally speaking, it should last weeks.

Benoît Hébert, a Quebec-based biotechnology consultant, said most biological samples including nasopharyngeal swabs can be stored at regular fridge temperatures for up to 72 hours and should be deep frozen if there is any delay in testing or shipping.

According to Public Health Ontario, tests have about a 95 per cent accuracy rate as long as the test is processed within seven days of collection, and the sample is taken using a nasopharyngeal swab.

As of mid-October, more than half the tests in Ontario were processed within two days, the Health Ministry told CBC News in an email. It said that accredited labs conducting testing must have equipment in place to keep specimens at a stable temperature before testing, and it recommends freezing samples to preserve them.

“In the event a laboratory would report a specimen as expired, they would contact the testing site to ensure that re-collection occurs,” the ministry said.

WATCH | A closer look at rapid COVID-19 testing:

Doctors answer viewer questions about COVID-19 testing in Canada, including how effective it is and who should be tested. 4:58

I got COVID-19 and isolated for the required time. But I’m still testing positive. What does that mean? 

“Many people have these lingering positive tests,” acknowledged Chakrabarti, and that can happen weeks or months after they recover. But at that point, he said, “they’re not actually contagious.”

Dr. Zain Chagla, medical director of infection control at St. Joseph’s Healthcare in Hamilton, explained that’s because COVID-19 tests detect genetic material from the virus, which can be shed from your body even when all the viruses are dead.

So how long is a COVID-19 patient contagious?

Chagla said that researchers trying to culture live virus from patients have found there are minimal amounts in most people 10 days after they experience their first symptoms and after 20 days in critically ill patients. That suggests they’re not contagious after those periods.

“There’s also been no case reports of people being infected by others who are 10+ days into their illness,” Chagla added in an email.

That’s why 10 days (instead of 14 days) is now the standard time recommended to self-isolate after your symptoms start in places such as Ontario and B.C. 

It also means long-haulers, people who are still experiencing symptoms months after they got infected, are not contagious.

WATCH | Doctors take questions and give answers about COVID-19 testing:

There is a growing push to have Canada focus on COVID-19 tests that detect who is contagious rather than who is positive for the virus. These tests are available elsewhere in the world, cheaper and can be done at home, but they aren’t approved in Canada. 6:05

I’ve recovered from COVID-19, but my boss says I need to test negative before I can return to work. Can they ask me for one?

Given that people can test positive for weeks or months after recovery and aren’t contagious, a request like this may be frustrating.

But the answer is yes.

Even if you’ve completed isolation and public health has cleared you, employment lawyer Howard Levitt said it’s within your employer’s rights to require a negative test — and they’re not obliged to pay you if you’re unable to work. 

“Safety trumps privacy. That’s the bottom line,” said Levitt, noting that employers could ask for a negative test result every two weeks, if they wanted to, needing no other reason than ensuring a safe workplace. 

So what can workers do?

You could try talking with your boss or getting a doctor’s note, said Maggie Campbell, a partner at Vancouver law firm Roper Greyell. 

Other than that, Levitt says there isn’t much you can do. You can offer to work from home, if possible, or you could take your employer to court, but he cautioned that courts may not be in workers’ favour in the current climate. 

“Employees should understand that anything an employer is doing to protect other employees of theirs will be seen very sympathetically by the courts.”

However, companies should be up-to-date with the latest public health guidelines, he said. 

If your employer sends you home without pay while awaiting a negative test result, you could apply for Canada Recovery Sickness Benefit, providing you are eligible.

WATCH | Labour lawyer answers questions about work during pandemic:

Employment lawyer Howard Levitt answers your question about work during the COVID-19 pandemic, including when it’s in your best interest to refuse to go back to work. 14:13

I have symptoms but tested negative. Do I still have to self-isolate?

It’s always best to check with your health-care provider or local public health unit for advice specific to your personal situation. But symptomatic individuals may be advised to continue isolating for the remainder of the isolation period, even if they get a negative result. 

That’s because a negative result isn’t a guarantee that you don’t have the virus.

According to Dr. Kelly MacDonald, head of the infectious disease program at the University of Manitoba, the nasal swab test is accurate 99 per cent of the time in a laboratory setting, but in a clinical setting errors can happen when the sample is taken. For example, the swabbing may not be done properly. 

A negative test could also mean that you were tested too early before viral levels are high enough to be reliably measured

Ultimately, context is important, and your doctor or local health unit would form their advice on a number of factors, including whether there was exposure to a known case, the kind of symptoms you have, how long you’ve had them and whether you’re a student, or you work with vulnerable individuals, for example.

And even if you don’t have COVID-19, you could still be contagious with something else — perhaps the flu — in which case, the same public health advice to stay home when sick would still apply.

On the other hand, if you get a positive test, you almost certainly have COVID-19 — the false positive rate is very low — less than one per cent of tests overall, estimates Dr. Philippe Lagacé-Wiens, a medical microbiologist at St. Boniface Hospital in Winnipeg.

WATCH | Why people with COVID-19 symptoms should be reassessed if they test negative:

Infectious disease physician Dr. Isaac Bogoch discusses new research on the rate of ‘false negatives’ in coronavirus tests and why people with persistent COVID-19 symptoms should be reassessed even if they test negative.  2:24

If you’re a contact of someone who tested positive, why are you supposed to get tested within 2 weeks of exposure? Wouldn’t the virus still be developing?

While it can take up to 14 days for symptoms to develop, Charkrabarti said that most people start to develop symptoms within seven days.

“And you can actually test positive a couple of days before that,” he said.

So ideally, you should wait about three to four days after exposure before getting tested, he recommends. 

However, any result could still be a false negative, so if you were exposed, you should remain in quarantine for 14 days even if you test negative.

Are tests at pharmacies as accurate as those at provincial testing centres?

Two provinces have been offering tests in pharmacies to people without COVID-19 symptoms: Alberta and Ontario.

In general, people with no symptoms are more likely to get a false negative than those with symptoms, but it’s not known by how much.

In Alberta, the tests are identical to those offered at provincial testing sites and analyzed at the same labs, the provincial Health Ministry says. That means they should have similar accuracy to tests of asymptomatic people at testing centres. However, Alberta announced on Oct. 20 that it would stop testing asymptomatic people with no known exposure to COVID-19 — the only people who could get tested in pharmacies.

In Ontario, there are some differences between pharmacy tests and those offered at provincial testing centres. Pharmacy tests use shorter nasal swabs instead of the long nasopharyngeal swabs, and they’re sent to the California lab of Quest Diagnostics instead of in-province labs, says the provincial Health Ministry.

Chagla says the sensitivity may be slightly lower with the shorter swabs, but this shouldn’t be a big risk, as the probability of asymptomatic people having COVID-19 is lower than people with symptoms, especially if they haven’t been exposed.

WATCH | How pharmacy testing works in Ontario:

CBC’s Tahmina Aziz speaks with Thibert and outlines the criteria Windsorites must meet to be tested in a pharmacy. 1:45

I think I had COVID-19, but I’m better now. Can I be tested to confirm?

The nose swabs at testing centres can only detect current or very recent infections, not whether you’ve been previously infected. To find that out, you need an antibody test. Such tests are available 14 days after active infection, with a doctor’s prescription, in some provinces. Dynacare offers the service in Ontario and Quebec. Ichor Blood Services offers it in some communities in Alberta, Ontario and New Brunswick. The fee is typically $70 to $80.

However, studies have shown that even among those infected, antibodies fade with time, and it happens far more quickly in those who never showed symptoms.

WATCH | A closer look at the 1st antibody test Health Canada approved in May:

Health Canada says it has authorized the first COVID-19 serological test for use in the country to detect antibodies specific to the virus.   3:09

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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