NWT’s faster Covid-19 tests off to a slow start

Long-awaited faster tests for Covid-19 are now available at Yellowknife’s Stanton Territorial Hospital. But the majority of tests are still sent to Alberta for results. 

In a news conference on Wednesday, Dr Sarah Cook – the Northwest Territories’ medical director – said two GeneXpert testing systems have been ready for use since May 15 in Yellowknife and have provided some results.

Cepheid, the American company behind the devices, has said they can produce test results for Covid-19 in 45 minutes.

But not everyone getting tested for Covid-19 in the NWT should expect to get their results that quickly. Cook said there’s a Canada-wide shortage of disposable cartridges the GeneXpert machine uses.  

“We are doing everything we can to advocate for more tests in the Northwest Territories,” she said. “Certainly we want to be able to test everyone rapidly if we can, sooner rather than later.” 

That includes networking with the territorial lab’s supplier and reaching out to provinces for more cartridges, Cook said. The National Microbiology Lab has also been advocating on the territory’s behalf to the manufacturer. 

Due to the shortage, the territory is prioritizing use of the GeneXpert for cases that require rapid results. That includes symptomatic people in long-term care facilities, corrections, group homes, shelters, and mining camps.

Symptomatic hospital patients without alternative diagnoses, and symptomatic people living in cabin communities – or who have been in contact with someone who has Covid-19 but can’t self-isolate – are also being prioritized. 

This will not limit testing in the territory, however, as the government says Alberta has the capacity to meet testing needs not met by the GeneXpert.

“The hope is that we’ll eventually have enough to be able to run all tests rapidly, but the majority will still be going to Alberta at this point until we have a better supply of those cartridges,” Cook said. 

Devices could be used for TB tests

The NWT government said the cartridge shortage is the result of manufacturing limits and the increased demand due to Covid-19 – something the manufacturer couldn’t have anticipated. 

According to a video from Cepheid featuring chief medical and technology officer Dr David Persing, the cartridges are manufactured at two different production facilities in California.

One in Lodi makes the plastic components and a second facility in Sunnyvale fills the cartridges with reactants, or substances used in chemical reactions.

When the cartridges are put in the GeneXpert, the substances react with material collected from a nasal swab and change colour if the virus that causes Covid-19 is present. 

The territorial government has said faster testing is key to relaxing pandemic restrictions in the NWT. Under phase three of its Emerging Wisely plan, implementation of a “robust rapid-testing strategy” is required to remove some limits on gyms, pools, theatres, festivals, and college classes, and all restrictions on outdoor gatherings.

On Wednesday, the NWT’s chief public health officer – Dr Kami Kandola – said the territory will need more rapid testing by the fall with the start of flu season and people spending more time indoors.

Rapid testing of essential workers in communities is also part of the government’s plan, she added.

The territory had previously planned on deploying Spartan Bioscience’s Cube Covid-19 system in communities, which can provide faster test results and is portable. But the Canadian manufacturer recalled the devices after Health Canada restricted their use to research.

Kandola has previously said the GeneXpert will be sufficient for expanding testing in communities for the time being. The status of future widespread rapid testing in the territory remains unclear.  

According to the territory’s latest numbers, results for 2,048 Covid-19 tests have come back and the results of 31 tests are pending. 

The territorial government said there has been no additional cost for the GeneXpert devices other than staffing to set up and use them. The National Microbiology Lab provided the devices to the territory on a loan agreement but has “stated that no future compensation will be sought.” 

The GeneXpert devices may prove useful after the pandemic. The territorial government has confirmed they could be used for tuberculosis testing in the future.