While the position of the WHO related to COVID-19 identification and containment is “test, test, test,” that is currently not the practice in Canada. Nationally, there are recommendations for who should be tested, though that may vary by province. At the outset of the outbreak in Canada, the majority of provinces/territories were only testing symptomatic persons with a positive travel history, close contacts of confirmed cases, and hospitalized persons with severe illness consistent with COVID-19. Testing of those without travel history or known close contact was not widely done, though that appears to be changing, as some provinces are shifting to test community clusters. Asymptomatic individuals are not being tested, as per current recommendations.
At the time of writing, there are significant barriers to broad testing, including resource availability. Test kits, reagents and lab capacity issues are themes we are hearing across the country. These challenges mean that testing remains more conservative than we may see in other countries, and as such, the true number of cases and true rate of community transmission is not known.