Supporting Innovation in Pharmacy for a Healthier Canada

The evolving journey of COVID-19 testing in Alberta


OCTOBER 2020 - In a little over three months, Alberta pharmacists had tested more than 150,000 asymptomatic Albertans for COVID-19 by the time the province paused the programs in pharmacies until further notice.

In its October Pharmacy Benefact bulletin for pharmacies, Alberta Blue Cross explained that “this is a strategic move to help prioritize testing” due to the fact that active cases of COVID-19 and symptomatic tests are rising steadily. The bulletin also stated that Alberta Health thanks all participating community pharmacists. “They stepped up when we needed them as they always do.”

Pharmacists across Alberta have worked really hard to support the COVID-19 detection efforts through asymptomatic testing," says Margaret Wing, CEO of the Alberta Pharmacists’ Association (RxA). "With this pause, pharmacists will continue to protect Albertans by shifting efforts towards providing flu shots and remain well positioned to re-engage with COVID-19 testing when the province needs them again.” 

Margaret_Wing
Margaret Wing, RxA

The “Pharmacy-based Asymptomatic COVID-19 Testing program” launched as a pilot with 20 pharmacies on June 25. It quickly scaled up to include pharmacies across the province after the voluntary program became available to all pharmacies on July 30. By October 20, when the province’s Chief Medical Officer of Health announced a pause on all asymptomatic testing of individuals with no exposure to COVID-19, more than 600 community pharmacies in the province had joined the program.

The program was a two-step process, with two billable events. Step one was the “Assessment to Screen for Asymptomatic Testing for COVID-19,” which was billed at $20. If the patient remains eligible (i.e., meeting the criteria for being asymptomatic, no international travel within 14 days and no recent exposure with a confirmed case of COVID-19), step two was the “COVID-19 Asymptomatic Testing Sample Collection.” Its fee of $22 included $2 to offset the costs for personal protective equipment.

Initially, any Albertan could request the service. “It was clear that Alberta Health was looking to increase surveillance and build testing capacity,” says Wing.

On September 17, the Chief Medical Officer announced a targeted approach for asymptomatic testing, with recommendations that it be conducted for certain groups of individuals (such as school teachers or healthcare workers, or those in congregated living facilities). The move aimed to reduce test waiting times and speed access to results; as well, test results to date showed that asymptomatic individuals were not significantly driving the spread of the virus.

“The move to a targeted approach was in part due to laboratories being unable to keep up with the volume of test samples and individuals were sometimes waiting seven to nine days for results, making the results less meaningful,” says Wing. She adds that testing levels dropped by about half in some pharmacies, based on anecdotal reports from members.

The targeted approach did not reduce the volume of test samples enough to alleviate laboratories capacity issues and on October 20 the province suspended all testing of asymptomatic individuals. Pharmacists were advised that existing appointments could be honoured until November 4. They were also advised to keep testing supplies on hand until further direction.