Author: Tim Holman

The Ontario Association of Cardiologists (OAC) supports a draft recommendation issued by Ontario Health (OH) calling for public funding of the use of natriuretic peptide (BNP or NT-proBNP) testing for the diagnosis of people with suspected heart failure in the community and emergency department settings.

At the present time, Ontario patients pay directly for this testing unless  it is performed as an inpatient or outpatient hospital service.  “The measurement of BNP or NT-proBNP is an accepted biomarker for the diagnosis and management of patients with heart failure.  The current lack of public funding for this testing in the community in Ontario is a major limitation to clinicians and their patients and requires adjustment”, states the OAC’s letter.

The draft recommendation is based on guidance from the Ontario Health Technology Advisory Committee, which has been studying the issue since 2019.  More information on the health technology assessment can be found at OH’s website: https://hqontario.ca/…/Use-of-B-Type-Natriuretic….

The OAC is calling on the Ministry of Health to accept and implement the recommendation immediately.  “The evidence is unequivocal that natriuretic peptide testing has clinical benefit, and is in accordance with patient preferences, patient care equity and cost effectiveness.  We urge the Ministry of Health to act on this recommendation and extend public funding for the expanded use of this important diagnostic and therapeutic decision-making tool in the interest of Ontario patients.”

To read the the OAC’s letter, click here: OAC Letter – Natriuretic Peptide (BNP or NT-proBNP) Testing (Feb. 9, 2021).

OH is requesting public and stakeholder feedback on the draft recommendation by February 24, 2021, which can be provided online here: https://survey.alchemer.com/s3/6148237/B-Type-Eng.

For more information, contact:

Ontario Association of Cardiologists
34 Eglinton Ave. West, Suite 410
Toronto, Ontario M4R 2H6
Tel: 416-487-0054
Toll-Free: 1-877-504-1239
E-mail: [email protected]
Web: www.ontarioheartdoctors.ca

TORONTO — The Ontario government has deployed new COVID-19 rapid tests to provide faster results in regions of high transmission and rural and remote areas. As an additional tool to help keep essential workers safe, rapid tests will also be used to screen staff in long-term care homes and select workplaces. These new tests will provide Ontarians with more access to innovative testing options and will help to quickly identify and manage outbreaks to stop the spread of COVID-19.

Details were released today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, and Dr. Merrilee Fullerton, Minister of Long-Term Care.

“These new rapid tests are gamechangers in the fight against COVID-19,” said Premier Ford. “This new technology can provide test results in hours, even minutes, instead of days. We’re deploying them as quickly as possible to protect patients, long-term care residents, and the frontline heroes who care for them. These new tools will ensure that Ontario remains the leader in testing in Canada to help stop the spread of this deadly virus.”

Ontario has received approximately 98,000 ID NOW tests that are initially being used in hospitals and assessment centres in rural and remote communities, as well as to test people as part of early outbreak investigations in hotspot regions where there are high concentrations of COVID-19 cases. Two hospitals are using ID NOW, with 20 additional hospitals preparing to launch rapid testing. Hospitals will be able to test people, such as staff and patients, who are either symptomatic or have been in close contact with someone who has COVID-19.

“Our government strongly advocated for the approval of these rapid tests to help provide timely access to testing for Ontarians who need it the most,” said Minister Elliott. “These tests are helping to improve access to testing in our most underserved communities and allow us to better detect and contain any outbreaks. We are continuously working to expand our testing capacity and evaluate new and emerging technologies to provide safe testing options for a greater number of people.”

ID NOW tests continue to be distributed in Simcoe Muskoka, Southwestern Ontario and Eastern Ontario, and the program will be expanded to other areas of the province beginning in December. Continued rollout of this test is planned for in Toronto and Peel and work is underway with Ontario Health and local public health units to support rapid testing deployment across the province. Ontario also continues to work closely with Toronto Public Health and Peel Regional Health Unit to bring rapid testing into the regions’ outbreak response, using rapid testing to help with early identification and investigation of outbreaks.

The province has also received 1.2 million Panbio rapid antigen tests that will support a screening program for long-term care homes and other workplaces. To date, Panbio tests have been deployed to six long-term care operators for potential deployment in over 30 long-term care homes, 27 retirement homes, eight hospitals, and 11 industry partners such as Ontario Power Generation, Air Canada and Magna, with plans to expand further across province. Ontario is expecting to receive up to 1.5 million more Panbio tests by the end of December.

Over the next number of weeks, select long-term care homes will use the Abbott Panbio rapid antigen tests to help inform future deployment across the sector.

“Since day one of COVID-19, our top priority has been to protect the health and well-being of Ontarians, including long-term care residents,” said Minister Fullerton. “These rapid tests can help long-term care homes get results immediately allowing them to act faster to prevent COVID-19 from entering the home.”

Panbio tests will also be used in a broader eight-week pilot for participating employers in the private, public and non-profit sectors, prioritizing access for health care settings, essential frontline settings, and congregate settings. This pilot program is an important opportunity to learn about the value of antigen screening for asymptomatic workers in a range of workplace settings and will inform future decisions about safely and fully re-opening the economy. Participating employers would cover associated costs of delivering antigen rapid tests including human resource expenses and ensure testing follows guidelines as set by the Chief Medical Officer of Health.

The province continues to ensure that anyone who needs a test can get a test and receive their results as quickly as possible. Anyone who falls within the current Provincial Testing Guidance should continue to seek publicly funded testing, available at participating pharmacies and assessment centres. If you have COVID-19 symptoms, you should get tested at an assessment centre.

As both ID NOW and Panbio tests are new, they will be carefully evaluated and used in alignment with guidance from Health Canada.

Quick Facts

• The ID NOW test uses molecular testing with a nasal, nasopharyngeal or throat swab. Molecular testing detects genetic material of COVID-19 to diagnose people with symptoms.
• The Panbio test uses antigen testing with a nasopharyngeal swab only. Antigen testing detects specific proteins from the virus to screen and identify people who need further testing.
• Rapid tests must be performed at a laboratory or specimen collection centre licensed under the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA) or by certain regulated health professionals that are specifically exempt from the licensing requirements of the LSCCLA. Ontario has also released guidance for individuals or organizations that choose to participate in COVID-19 testing that falls outside of the public health care system, to ensure there is appropriate oversight and consumer protection and that public resources are supporting public health initiatives.
• The launch of rapid testing is part of the province’s fall preparedness plan, Keeping Ontarians Safe: Preparing for Future Waves of COVID-19, to enhance and expand efforts to quickly test and identify new cases of COVID-19.
• Ontario has completed over 5.8 million tests to date, more tests than all Canadian provinces and territories combined.
• Testing is available by appointment for those within provincial testing guidance at assessment centres, participating pharmacies and specimen collection centres. Please visit Ontario.ca/covidtest to find a testing location and for eligibility criteria to be tested.
• It is still critically important for all Ontarians to follow public health measures to stay safe and stop the spread of COVID-19—wear a mask when required, stay two metres apart from people outside of your household, wash your hands frequently, stay home if you are not feeling well, and download the COVID Alert mobile app.

Details were provided today by Premier Doug Ford and Christine Elliott, Deputy Premier and Minister of Health.

“The last thing patients and families should have to worry about right now is the cancellation of their surgery or procedure due to the second wave of COVID-19,” said Premier Ford. “We are moving mountains to make sure all patients get the top-notch care they deserve, while clearing the backlog of surgeries. At the same time, we are preparing for any future surge or outbreak in order to keep everyone safe and healthy.”

“Expanding access to care to help reduce health service backlogs is part of our plan to ensure that we are ready for future waves of COVID-19,” said Minister Elliott. “This investment is essential to help more patients waiting for surgeries and other procedures get the care they need faster and help reduce the burden on our system.To ensure that the health system is prepared to respond to any surges of COVID-19 without interrupting routine health services, we are also increasing capacity inhome and community care and expanding digital and virtual health care services.”

Accelerate Efforts to Reduce Health Service Backlogs

To support the health care system as it works to reduce surgical backlogs and improve access to care during the COVID-19 pandemic, Ontario has already taken the following actions:

• Released A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic, a comprehensive framework to help hospitals assess their readiness and begin planning for the gradual resumption of scheduled surgeries and procedures, while maintaining their ability to respond to COVID-19 and the upcoming flu season; and
• Invested in virtual care providing alternatives to in-person care that limit the transmission of COVID-19, while maintaining access to care.

Ontario is making the necessary investments to expand access to services and surgical and procedural backlogs by:

• Investing up to $283.7 million to support additional priority surgeries including cancer, cardiac, cataract, and orthopaedic procedures;
• Extending diagnostic imaging hours at health care facilities forMRIs, CT scans, and other critical procedures;
• Adding an additional 139 critical care beds and 1,349 additional hospital beds in hospitals and alternate health facilities across the province to support more surgical procedures; and
• Working to initiate a centralized waitlist and a program to optimize the use of the operating roomsto improve the use of existing resources and increase the number of surgical procedures in hospitals by hundreds on average per year, and improve patient flow by leveraging available surgical capacity in each region.

Prepare for Surges in COVID-19 Cases

Ontario is also preparing to respond to any potential surges of COVID-19 without interrupting the delivery of routine health care services. For this reason, the government is investing $457.5 million to increase community capacity, including home and community care, to help reduce pressure on the health care system and expand the delivery of care.

Since the beginning of the COVID-19 outbreak, the government has already taken necessary action to provide easier and faster access to care:

• Enhanced access to virtual care so more patients can see their doctor by phone or video through the creation of temporary fee schedule codes;
• Provided over 240,000 virtual visits for nursing and rehab home care services since the COVID-19 outbreak began;
• Invested $26.75 million to address further demand for mental health and addictions services by enhancing community-based services for vulnerable populations, expanding virtual mental health and addictions services, and supporting Indigenous communities to meet the growing needs in their communities in a culturally safe way;
• Secured sufficient critical supplies and equipment, including personal protective equipment (PPE) to support current projected demands by purchasing PPE, and maintaining a provincial pandemic stockpile, and pursued Ontario-made solutions to build domestic manufacturing capacity across the province; and
• Announced five new Ontario Health Teams (OHTs) that will support better coordinated care, with 17 more in approval. This is in addition to the existing 24 OHTs already delivering care across the province.

Ontario will continue to protect the health and wellbeing of all Ontarians and ensure they can access the routine health services they need by:

• Expanding access to virtual emergency department services and giving patients the option of virtual pre- and post-surgery appointments, to support surgical care transitions when appropriate to do so;
• Helping up to 850 alternate levels of care patients access the right level of care in a home or community setting to help add more capacity in hospitals; and
• Increasing home and community care service volumes by investing $100 million to add an additional 484,000 nursing and therapy visits and 1.4 million personal support worker hours.

The province’s COVID-19 fall preparedness plan, Keeping Ontarians Safe: Preparing for Future Waves of COVID-19, is based on six pillars, which will:

• Maintain strong public health measures, including continued expansion of testing and case and contact management;
• Quickly identify, manage and prevent COVID-19 outbreaks;
• Accelerate efforts to reduce health service backlogs;
• Prepare for surges in COVID-19 cases;
• Recruit, retain, train and support health care workers, while also continuing to engage families and caregivers; and
• Implement the largest flu immunization campaign in Ontario’s history.

Quick Facts

• In 2020-21, the Ministry of Health will invest an additional $594 million in the hospital sector to accelerate progress on the government’s commitment to end hallway health care.
• Ontario Health will be releasing guidelines for proposals to support virtual care models and eligible hospitals will be selected based on their capacity and readiness.
• Patients requiring non-emergency care can access physician care through telephone and video services. Patients can contact their physician for details or Telehealth Ontario if they do not have a family doctor.
• For added protection, download the COVID Alert app from the Apple and Google Play app stores.

Additional Resources

• Ontario Set to Launch Largest Flu Immunization Campaign in Province’s History
• Ontario Expands COVID-19 Testing to Pharmacies
• Ontario Investing More Than $1 Billion to Expand COVID-19 Testing and Contact Tracing
• Ontario Releases Plan to Resume Scheduled Surgeries and Procedures
• Ontario Expanding Digital and Virtual Health Care
• Visit Ontario’s website to learn more about how the province continues to protect Ontarians from COVID-19.
• For public inquiries call ServiceOntario, INFOline at 1-866-532-3161 (Toll-free in Ontario only).