Dr. Shane B. Barclay
Sun Peaks Community Health Centre
3115 Creekside Way, Sun Peaks, BC, Canada V0E 5N0
January 17, 2022
Dear patients of SPCHC and Sun Peaks residents/guests,
Re: Covid-19 update
I realize it has been a while since I’ve written a community letter, but with Omicron
things have been developing at such a pace it is hard to keep up. I think we all feel this. And yes,
we are all exhausted by the whole situation.
First, as you are aware, Interior Health has basically stopped doing Covid testing along
with contact tracing and instead are handing out ‘Rapid Home’ test kits. Our clinic is still doing
standard PCR swabbing/testing on Monday, Wednesday and Friday, but have certain criteria.
These rapid tests have some bonuses but also limitations. First, like any test or procedure
their accuracy is dependent on how it is used. It is crucial the test be done EXACTLY as the
instructions direct. There are various tests out there, not just the IH ones, so make sure you read
the instructions or, dare I say, watch a YouTube video on how you use your specific test. When
the swab is in your nose it should feel uncomfortable and even make you feel like you may have
to sneeze or cough. You will not get an adequate sample by ‘gently’ putting the swab up
your nose and bringing it out!
(My cynical side would like to point out that many unvaccinated people seem to be
relying on these tests now. Odd that they don’t trust mRNA technology but are willing to trust
PCR technology to what end suits them best.)
Secondly, for the test to be positive, you need a certain number of viral particles in your
nose (what is called viral load or viral shedding). If you do the test too early, in some cases
within the first day of symptoms, the viral shedding may be too low for detection. If you have no
symptoms, even if you have Covid, the sensitivity of many rapid tests to show positivity is only
around 60%. If you have symptoms, the sensitivity is up in the 80 + % range.
Thirdly, if the test comes out positive, then assume you have Covid (as they are about
99% accurate or specific). What we call the ‘false positive’ rate (the test saying you are positive
when in fact you are negative) is thus extremely low. Conversely, if you have symptoms and the
test comes out negative, the ‘false negative rate’ (test says you are negative but in fact you are
positive) can be around 90 – 95%. In other words, there is a 5 – 10% chance you actually do
have Covid despite the test results. To make life simple, if you are symptomatic, assume you
have Covid and isolate. Even if you don’t have Covid, you have some infectious disease and
why would you want to spread that to co-workers and friends? There is a reason daycares
and schools recommend children stay home when they have a ‘cough and cold’.
Fourthly, if you are positive and you isolate for the recommended 5 days, the question of
doing another rapid test to ensure you are now ‘negative’ has come up. If you do test and it
comes back negative, then you likely are no longer shedding virus and thus non-infectious. If the
test comes back positive; you may just have lingering viral particles (which can last for weeks or
even months) but there is no way to know if you are infectious. So, to error on the side of caution
most authorities recommend isolating for another 5 days. So as far as ‘return to work’ is
concerned, after 5 days I personally think being without symptoms is more important than a
negative test. The caveat to that statement is that with many viral infections, including Covid,
patients will often have what is called a ‘post viral cough’ which is that nagging dry hack. This is
caused by post infectious inflammation in the airways and not from infection. That being said, if
you return to work with a cough, expect people to look at you funny!
Lastly, regarding vaccines. Yes, I am still profoundly in favor of vaccines (and still not
writing letters of exemption!). My concern is that there seems to be the public perception
developing that Omicron is not that bad so why worry. You may have had Omicron yourself or
known a friend and yes felt awful or the sniffles for a couple of days, then fine. However, across
BC, Canada and worldwide, patients intubated in ICU beds range from 80 – 100% being
unvaccinated people. If you are vaccinated, your chance of becoming seriously ill is greatly
reduced. If you are unvaccinated your risk of needing hospitalization and even dying is still
substantial. To reiterate, your risk of a serious side effect from a vaccine is much less than the
effects of Covid.
Stay safe and please continue to wear masks and socially distance. Unfortunately, we
are not out of this yet.
Shane Barclay MD
Medical Director SPCHC