Medical official advises against COVID-19 testing unless you have symptoms

As a father, I understand everyone’s concerns about having children go back to school during the COVID-19 (Coronavirus) pandemic. I want to let you know that the Grey Bruce Health Unit has been actively engaged with public and Catholic school boards, and the private and rural schools throughout Grey and Bruce counties. For the most up-to-date information, visit our website https://www.publichealthgreybruce.on.ca/ or contact your school to see its plans.

Feeling anxious, you may want to take your child or children to get tested for COVID-19, just to be sure they do not have it. I want to explain to all parents that if there are no symptoms, and no close link to a confirmed case (as decided by the health unit), then there is no practical benefit to getting your children tested. There is, however, potential harm. Let me explain.

1. Testing for COVID-19 can be a difficult event for some children. Like any other clinical test, there is the potential for complications, one of which is potential long-term anxiety that could negatively affect a child’s mental health.

2. False reassurance is another harm. Testing someone who has no symptoms only lets them know that on the day they were tested, they were not shedding the virus. It is very possible to test negative one day (while incubating the virus), and then develop symptoms and test positive in a day or so. It is not a bulletproof way to say that you or your child is COVID-19-free.

3. Testing in people who have no symptoms can result in false-positives. A false-positive may cause significant and unintended anxiety in families linked to the false-positive. Self-isolation, inability to attend work, and fear/anxiety are real outcomes of a false-positive. Imagine getting a call from the health unit letting you know that you and your family have been exposed to COVID-19, when in fact you were not? Now imagine that this happens to a number of families as their children attend the same class or school. This is not acceptable in my mind, and could cause significant harm. To that end, as the Grey Bruce medical officer of health, it is important to share that there are no practical benefits of mass testing of asymptomatic individuals and that potential harms are paramount. I made an oath based on the first principle in practising medicine - the principle of “Do no harm.”

4. Testing people with no symptoms puts undue pressure on provincial testing capacity and delays the results for people who actually do have symptoms. Delays in receiving results can pose significant risk to facilities that may be battling true outbreaks.

Getting a COVID-19 test would be appropriate and strongly recommended only in the following two scenarios:
 

• The health unit has let you know that you are a close contact to someone who has COVID-19, based on a thorough risk assessment completed only by the health unit. Deciding who is a close contact is a decision that can only be made by the health unit. This decision cannot be made by your health-care provider or school official(s).
• Your health-care provider has told you to get tested because you have COVID-19-related symptoms.

If neither of these situations exists, testing would NOT be suggested, and in fact, the health unit strongly recommends against it. If there is a case in your child’s school or class, that, in and of itself, is not a reason to get tested.

If there is potential that you were a close contact to a person with COVID-19, the health unit will call and advise you. If you do not get a call from the health unit, you DO NOT need to get tested.

I fully appreciate that if you find out there was a case in your child’s school, your anxiety may be elevated. Rest assured that we will notify you if you or your child need testing, and will do everything in our power to keep the children and staff in that school safe.

We work together with school officials before and during the school year to ensure that the safety and well-being of both the children and staff in the schools, remain our priority and that everything we do reflects that objective.

I would never have my child tested without proper cause. As a parent and medical officer of health, I would consent to testing only if my child had symptoms and had been assessed by his health-care practitioner, or was considered a close contact and directed by the health unit to do so.

Yours very truly,
Dr. Ian Arra
A father and medical officer of health