Step by step: How testing for COVID-19 works in Manitoba

By | March 26, 2020

As cases of COVID-19, the disease caused by the new coronavirus, increase in Manitoba and across Canada, testing has emerged as a focal point for public health workers and the public.

Thousands of Manitobans have been tested since the global pandemic began, although the province is not currently offering mass testing.

Here’s a look at how testing works in the province, for those who meet the criteria.

Step 1: Self-screening

This is where all testing in Manitoba has to start. Right now, Manitoba is not conducting mass testing — which means you’ll need a referral before you’ll be tested.

Testing was initially offered to symptomatic people who have travelled internationally or have been exposed to someone known to have COVID-19. On Thursday, the province announced expanded criteria to include symptomatic health-care workers and symptomatic people living in remote communities, First Nations or group settings (like jails, shelters, long-term care homes and remote work camps).

Tests are also being done on ICU patients with respiratory issues and any samples collected from patients for respiratory concerns.

For now, the referral needs to come from Health Links — Info Santé. But before you call them, you can do an assessment on your own to see if you should.

You can self-assess in two ways: online (find that tool here) or over the phone with an automated voice response tool (call 1-877-308-9038).

Both tools will ask you a series of questions about your symptoms and exposure/travel history. At the end, they’ll tell you if you need to contact Health Links.

Step 2: Health Links

Once you’ve self-assessed, you can call Health Links at 204-788-8200 or toll-free at 1-888-315-9257. The service is open 24/7.

Health Links has quadrupled its staffing in recent weeks to respond to the huge spike in calls since the pandemic began, including bringing in nursing students to help staff the lines. Once you get through to them, you’re likely to face a wait —but the increased staffing, along with the introduction of coronavirus-only lines, have brought the wait down significantly since the outbreak began.

Once you get through, a screener on the other end of the phone will ask you a series of questions similar to what’s included in the online self-screening tool. At the end, they’ll tell you if you need to get tested at your local testing site (there are 12 in Manitoba, as of Wednesday) or self-monitor for symptoms.

If you do need to be tested, the screeners at Health Links inform Manitoba Public Health and phone or fax test sites to let them know to expect you.

Step 3: Test sites

When you get your referral, Health Links will use your postal code to figure out exactly where you need to go. If you show up at a test site but don’t meet the criteria for testing, you’ll be sent home.

As of Wednesday, there are 12 dedicated testing sites in Manitoba: five in Winnipeg and one each in Thompson, Flin Flon, The Pas, Steinbach, Selkirk, Brandon and Winkler with plans for more in the works.

Five of the sites are drive-thru, and you can get swabbed without leaving the car.

Vehicles line up Thursday at the COVID-19 drive-thru test site in Selkirk, Man. (Ron Boileau/Radio-Canada )

If you go to one that’s not a drive-thru, you’ll be asked to wait in a separate waiting room from any non-COVID-19 clientele at the centre.

Here are the testing sites in Winnipeg:

  • Access Winnipeg West (280 Booth Dr.).
  • Access Fort Garry (135 Plaza Dr.).
  • Access Transcona (845 Regent Ave. W.).
  • Mount Carmel Clinic (886 Main St.).
  • Manitoba Public Insurance Bison Drive Service Centre (15 Barnes St.) — drive-thru site.

And the ones outside the city:

  • Thompson: Thompson Clinic in Thompson Plaza Mall at 50 Selkirk Ave.
  • Flin Flon: Channing Auditorium in the Flin Flon Community Hall, 2 North Ave.
  • The Pas: Wescana Inn, 439 Fischer Ave. (new address after relocation).
  • Brandon: Nurses’ Residence Gym in the Brandon Regional Health Centre at 150 McTavish Ave E.
  • Selkirk: 622 Superior Ave. — drive-thru site.
  • Steinbach: Steinbach Community Services building at 365 Reimer Ave. — drive-thru site.
  • Winkler: Winkler Centennial Arena at 600 Park St. — drive-thru site.

If you live far away from any testing site, you’ll be instructed to call ahead to your nearest health-care centre so staff there can prepare for your arrival and test you.

Waits were long, at first, according to a spokesperson for Shared Health, but have dropped since. Now, most patients are told to expect to wait under an hour — but that varies based on where you are and when you go.

Waiting rooms have been redesigned so people can social distance while in there. They get cleaned regularly and you’ll be given a mask to wear until you’re called to get swabbed.

Step 4: Swab

In general, you’re going to be in the testing room for about 15 minutes. Only roughly 30 seconds of that will be spent on the actual test itself. The rest is a brief assessment from the nurse, nurse practitioner or doctor who will administer the test, followed by instructions on how to self-isolate.

The test works like this: a health-care worker will use a nasopharyngeal swab (picture a very long, skinny Q-tip) deep into your nose.

A Manitoba health-care worker performs a nasopharyngeal swab as part of testing for COVID-19, the disease caused by the novel coronavirus. (Shared Health/Province of Manitoba)

Once that’s done, the swab gets put into a “viral medium” in a small tube and labelled. It’s kept cool — between 0 and 4 C — and drivers come by testing sites twice per day to pick up swabs and bring them to Cadham Provincial Laboratory to be processed.

Nasopharyngeal swabs penetrate deep into the nose of the subject. (Shared Health/Province of Manitoba)

For the patient, the waiting game begins now: You’ll be sent home and asked to self-isolate until you hear back about your results.

Step 5: Testing at Cadham, self-isolation

After your swab is sealed up and sent off, it gets delivered to the Cadham lab, where scientists will test it for COVID-19.

In addition to swabs taken from patients with symptoms and travel or exposure history, scientists there are also testing samples collected from intensive care unit patients with respiratory symptoms, and all samples collected from patients to be tested for other respiratory issues.

Once your swab gets to the lab, it usually takes between 24 and 48 hours to get tested, said chief public health officer Dr. Brent Roussin.

Cadham has more than 100 staff in total and handles testing and surveillance for communicable diseases ranging from influenza and salmonella to HIV and syphilis. A lot of that work still has to get done during a pandemic, the spokesperson for Shared Health said, although much of it has been moved to other locations.

The lab can handle a capacity of roughly 500 COVID-19 tests per day, Health Minister Cameron Friesen has said, although actual testing has dropped in recent days due to a shortage of a reagent used to complete the test.

But the lab has found a “workaround” for the reagent shortage and has successfully made its own viral transport medium for swabs, Roussin said Wednesday.

While waiting for your swab to be tested, you’ll have to stay in isolation. (Austin Grabish/CBC)

While you’re waiting for your results, the province says you have to stay in self-isolation. It encourages you to reach out to your social support network by phone or email to keep your mental health up, and keeping yourself distracted with tasks or hobbies in the meantime.

If your test comes out negative at Cadham, you will get contacted, said Manitoba Shared Health chief nursing officer Lanette Siragusa. But it might take longer than if you had tested positively, because health-care workers are prioritizing contacting those people first, she said. Remember that a negative result doesn’t get you out of any self-isolation required by travel: If you’ve been ordered to self-isolate for 14 days after returning from somewhere, you don’t get to end it early.

For now, if your test comes out positive, you’re what’s called a “probable positive” case — currently, your swab needs to be tested again at the National Microbiology Lab before you can be a “confirmed positive” case. But Roussin said Thursday the province expects to be able to confirm cases on its own in the coming days, eliminating the need for second testing at the national lab.

If it’s positive at Cadham, you’ll get contacted immediately, public health officials say, and health-care workers will get started on “contact tracing.” That means they’ll work to figure out everyone you may have come into contact with and infected.

While all that is happening, the swab will get sent to the national lab to get officially confirmed.

Step 6: National Microbiology Laboratory

When the swab gets here, it will be tested for COVID-19 one more time, although Roussin said it’s likely to be the same result as at Cadham.

If it comes out positive then you are officially a “confirmed” case of COVID-19 in the province.

Step 7: Follow up

If you test positive, you’ll be contacted daily by public health workers to follow up with you, including daily monitoring of your symptoms. 

No Manitoba cases have been officially marked as “resolved” yet, but other jurisdictions like Ontario have cleared patients as recovered from the illness once they test negative twice, 24 hours apart.

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