Frontline healthcare workers deny BC’s claim that all patients tested for respiratory illness

BC public health leaders shared a breakdown in a Wednesday press conference, showing which viruses are circulating and causing people to get sick this season.

Provincial health officer Dr. Bonnie Henry and health minister Adrian Dix said they used data from BC hospitals to create charts that showed how the common cold and influenza are causing more severe illnesses than COVID-19 and RSV.

It is, however, unclear how the province knows the number of people who have each illness: frontline healthcare workers tell Capital Daily that patients who go to the hospital with respiratory illness symptoms are not all tested to determine what is causing their sickness.

“The only kids that are tested for what they actually have [are] kids that fall into specific categories or risks or kids that require inpatient admission,” said Dr. Sanjiv Gandhi, a pediatric heart surgeon at BC Children’s Hospital, in response to Capital Daily’s question immediately after the province’s announcement on Wednesday. “So if your kid’s immunosuppressed or your kid has pre-existing illness, or if the kid is a certain age, like a newborn baby, then they would get tested for a variety of viruses, not just COVID-19.”

Capital Daily posed the same question to the BC Ministry of Health and BCCDC: are all patients who go to the hospital with respiratory symptoms currently tested for COVID-19 using a PCR test?

The government insisted all patients are tested.

“Yes, they are tested using a multiplex PCR test that also looks for influenza A and B and RSV as well as SARS-CoV-2,” said a representative of Provincial Health Services Authority in an emailed response Thursday evening. “All hospitals are using this and testing for influenza, COVID-19 and RSV for any request for any one of these viruses.”

That answer baffled frontline healthcare workers who shared their understanding of the current guidelines with us on Friday.

“We certainly could not test everyone that comes in,” said Dr. Jeff Unger, an emergency physician in Victoria. “Those that are at risk for serious illness are tested per guidelines.”

A lab technician at BC Children’s Hospital, who requested to remain unnamed because they fear repercussions for speaking out, confirmed Dr. Gandhi’s earlier statement as well.

“There is no way that every kid coming in with respiratory symptoms is tested using the multiplex PCR respiratory panel,” they said in a message. “We only have capacity to run 4 extended panels at a time (they take about an hour each) and about 7 more limited RSV/FLU/COVID can be run at one time.”

Internal guidance leaked to Capital Daily also confirms what both doctors have said: only patients who are immunocompromised or have a pre-existing illness, or have a severe enough condition that they need to be admitted, are tested using a multiplex PCR test—the kind of test that will determine exactly what virus a patient has.

Two other frontline healthcare workers in hospitals across BC also expressed their confusion after reading the PHSA’s statement. They say the guidance definitely does not ask that all respiratory illness patients get a complete PCR test, but they did not wish to be identified publicly for fear of repercussions.

Unger explains there are good reasons why not every patient is tested: time, resources, and whether a definitive diagnosis would make a difference to their treatment plan.

“We would run out of lab capacity, supplies, and add further delays to other important testing if everyone who came to [the] hospital with respiratory symptoms were tested for exact diagnosis,” said Unger. “Most patients do not require this, as clinically [we] can largely sort out who has viral illness and are low risk so do not need specific treatment.”

However with most people not being tested for what they have, the data presented by the province is incomplete, at best.

“Putting up graphs about how many kids have ‘this’ versus ‘that’ can’t very well be accurate, if you're only testing a fraction of the population,” Dr. Gandhi said.

“It's misleading and dishonest for public health to present prevalence rates and case numbers as accurate when the majority of sick kids don't ever get tested,” added the BCCH lab technician.