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Guidance on Rapid Testing in the Workplace

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Introduction

This document outlines the benefits and limitations of rapid testing as well as practical considerations to follow when implementing rapid testing in the workplace. Rapid testing is an additional screening tool that can help prevent the spread of COVID-19.

The Government of Canada and some provincial/territorial governments are supporting its implementation by providing free rapid tests through different channels, depending on the type of workplace.

For general COVID-19 prevention practices, employers and workers can refer to the these COVID-19 health and safety resources, including Protect Yourself and Others and Responding to Suspected or Confirmed Cases.

In all cases, guidance from local public health authorities and your jurisdictional health and safety regulator must be followed.

Making the Case for Workplace Screening

  • Workplace screening, in combination with other public health measures such as wearing a mask, physical distancing, and washing hands, is an important measure that will help protect workers from COVID-19.
  • Some studies suggest that up to 50% of COVID-19 transmission could be caused by people without symptoms. Testing and screening are important tools to quickly identify people who are asymptomatic and need to isolate.
  • Rapid tests have helped to identify and stop the transmission of over 3,300 presumptive positive cases of COVID-19 in Canada (as reported by Health Canada on July 6, 2021).
  • Findings and testimonials from workplaces, including a pilot in Ontario, where rapid testing was done found that:
    • Most employers and workers felt an increased sense of protection and security in the workplace.
    • The number of positive test results were low compared to the number of tests performed.
    • The overall disruption to workplaces was minimal.
    • Asymptomatic screening with rapid tests was able to find COVID-19 cases that otherwise would have gone undetected.

Consider the Risks

  • Employers need to take every precaution reasonable in the circumstances to protect the health and safety of their workers. These precautions include assessing the risks of COVID-19 for their specific workplace and the activities conducted by their workers.
  • Employers must then implement appropriate hazard controls using the hierarchy of controls (i.e., elimination, substitution, engineering controls, administrative policies, and the use of personal protective equipment). Employers should layer appropriate public health measures for increased protection and risk reduction to their workers. Follow the advice and restrictions of your local public health authority. Use multiple personal preventive practices in a layered approach.
  • Implement a written workplace safety plan that addresses potential exposures to COVID-19.
  • Rapid testing can be used as an additional screening tool. It is not a substitute for any existing public health measures such as vaccination, wearing a mask and physical distancing.
  • Even if a person’s test results are negative, they still need to follow all health and safety measures that are in place.

Worker Screening

  • Screen your workers and others before they enter your workplace, following the recommendations provided by your local public health authority.
  • Active screening may be legally mandated in some jurisdictions and involves asking questions about a person’s health and possible exposures. Use a checklist or questionnaire provided by your local public health authority. Active screening is not intended as a clinical assessment or to take the place of medical advice. Rather it is a way to identify people who may spread the virus so that measures can be taken to prevent further transmission. Be sure to record the names and contact information of all workers to assist with contact tracing if needed.
  • Anyone who does not pass screening should not enter the facility, should wear a medical mask (if unavailable, wear a well-constructed and well-fitting non-medical mask), go home (while avoiding public transit as much as possible), and contact their health care provider or local public health authority and follow their advice.
  • Rapid testing can be used as an additional screening tool for workers who have passed this initial screening.

Communication

  • Before implementing rapid testing prepare workers by explaining:
    • How a rapid test works.
    • Where it will be administered.
    • What to expect.
    • That it is a screening test used to help stop the spread of the virus.
    • That results obtained through rapid tests are not diagnostic and need to be followed up with more accurate tests administered by the local public health authority.
    • What are 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.
  • Consider developing a handout for workers.
  • Make sure that any information about rapid screening tests is communicated to all workers in a language and format that is easy to understand.
  • Review absence and sick leave policies and provide information to workers on available resources, including government support.

Testing Workers

  • Rapid testing can be used for workers showing no symptoms who have passed the initial screening.
  • At this time, it remains unclear whether rapid tests can detect infection in vaccinated individuals.
  • Workers who have had COVID-19 within the last 3 months should not participate in rapid testing, as they may get a false positive result.
  • 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) diagnostic testing under the guidance of the local public health authority.
  • Most workplace screening programs are voluntary for workers.

Conducting Rapid Testing

  • Asymptomatic workers should be tested at least twice per week.
  • Rapid testing can be performed by a health care professional or a trained individual that has the appropriate knowledge and skills to perform the test correctly, depending on the requirements in place for your jurisdiction.
  • Specimen collection for rapid testing may also be done by the person being tested (i.e., self-swabbing) if a trained individual is supervising them.
  • Training resources are available from your province or territory (Alberta, British Columbia, Saskatchewan, and Ontario).
  • Make sure that COVID-19 precautions are in place during rapid testing.
  • Make sure that the tester is wearing adequate personal protective equipment (PPE), including:
    • Gloves
    • Eye protection
    • Long-sleeved gown
    • Medical mask
  • Participants should properly wear a well-constructed and well-fitting mask.
  • Clean and disinfect surfaces between users.
  • Practice good hand hygiene.
  • Maintain physical distancing as much as possible (e.g., when workers are waiting for a test).
  • Conduct the testing in a well-ventilated space.

Benefits of Rapid Tests

  • Rapid tests are easy, fast and safe to administer.
  • Samples do not need to be sent to a laboratory.
  • Most rapid tests can be done with a nasal swab collection. A deep-penetrating nasopharyngeal swab is not required.
  • Rapid tests can be conducted by a health care professional or trained individual, depending on the requirements for your jurisdiction.
  • They can produce results quickly (within 15 to 20 minutes).
  • They are most effective at identifying those with high viral load and high transmission potential.

Limitations of Rapid Tests

  • If a presumptive positive result is obtained from a rapid test, the result needs to be confirmed with a laboratory-based PCR (polymerase chain reaction) test administered by the local public health authority.
  • Rapid tests cannot differentiate between variants of concern.

Responding to Test Results

  • A positive result from a rapid test is considered a “presumptive positive result” and must be followed up with a laboratory-based test, through the local public health authority, as soon as possible for confirmation. The individual who received a presumptive positive result on the rapid test should isolate until the result of the laboratory-based PCR test is known.
  • Each province has different procedures. It is important to check if a preliminary positive result needs to be reported to the province/territory and follow the reporting requirements.
  • Make sure that there is no stigma for workers who have received a presumptive positive result.
  • Provide support to workers who need to isolate. This may include financial support (e.g., paid leave) and mental health resources (employee assistance program, Government of Canada’s Wellness Together website, etc.).
  • A negative result should not be interpreted as proof that the worker does not have an infection. All public health measures and COVID-19 control measures in the workplace must continue to be followed.
  • Workers with a presumptive positive test result may return to work only if they receive a negative result after their confirmatory laboratory-based test or if the appropriate self-isolation period has passed.
  • A rapid test result that is indeterminate or invalid means that it did not register as negative or positive. The test will need to be repeated immediately, or the individual will have to have a laboratory-based test from their local public health authority.
  • Test results must remain confidential. Identify who will have access to 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 for requirements for retaining and destroying documentation.

Communicating Test Results

  • 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 health guidelines must still be followed.
  • Presumptive Positive results – clearly state that the individual needs to immediately isolate and take a laboratory-based test through the local public health authority, while continuing to follow all public health measures.

Storage and Waste Management

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

Applying for Free Rapid Test Kits

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

Based on your organization’s location and number of close-contact 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.

Additional Considerations

  • Dedicate an overall lead person from your organization to implement rapid testing.
  • Document procedures on the training required to conduct rapid testing; safety precautions; communicating and documenting results; following-up with workers; storing and disposing of contaminated materials.
  • Review onboarding and training material associated with the rapid testing kit.
  • Make sure that the appropriate testing personnel are available and trained.
  • Identify a private space for rapid testing and ensure confidentiality.
  • Identify a secure location where sensitive materials (e.g., paper copies of test results, laptop for entering records, etc.) can be stored to maintain privacy.
  • Make sure 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.
  • Develop a schedule for testing.
  • Allow more time on the first day of screening, as workers may have questions.
  • Communicate results to workers and include any follow-up actions.
  • Do not re-distribute or resell any free rapid test from the government. Charging individuals for the test is also not permitted.
  • Review and update your business continuity plan to address any impact of positive test results on your ability to provide your product or services.
  • Where applicable, consult with your union and review the collective agreement language regarding the time for required testing, sensitive medical information, and worker privacy.
  • Continue to work with your health and safety committee or representative in the implementation of this and other health and safety measures.

It is important that mental health resources and support are provided to all workers, including access to an employee assistance program, if available.

For further information on COVID-19, refer to the Public Health Agency of Canada.

Note that this guidance is just some of the adjustments organizations can make during a pandemic. Adapt this list by adding your own good practices and policies to meet your organization’s specific needs.

Disclaimer: As public and occupational health and safety information is changing rapidly, local public health authorities should be consulted for specific, regional guidance. This information is not intended to replace medical advice or legislated health and safety obligations. Although every effort is made to ensure the accuracy, currency and completeness of the information, CCOHS does not guarantee, warrant, represent or undertake that the information provided is correct, accurate or current. CCOHS is not liable for any loss, claim, or demand arising directly or indirectly from any use or reliance upon the information.

Document last updated July 29, 2021