The new Provincial Antigen Screening Program was announced by the Ministry of Health on February 17, 2021. Through the program, rapid antigen tests are being distributed to organizations in priority settings, to enhance existing routine screening measures for asymptomatic employees and other identified groups entering the workplace.
Rapid antigen tests may allow for workplaces to proactively identify cases of COVID-19 that may have otherwise been missed through routine workplace screening, supporting employee safety and business continuity in a variety of workplaces.
Retirement homes are identified as a priority sector for the new program. Participation is voluntary.
Rapid antigen screening does not replace existing workplace infection prevention and control (IPAC) measures. Like all surveillance tests, antigen screening is not considered to be an effective preventive measure for COVID-19 on its own and does not replace public health strategies such as symptom screening, physical distancing, personal protective equipment and hand hygiene. Large scale asymptomatic testing does not serve as an early warning signal for COVID-19.
Testing Frequencies for Retirement Homes
Since June 2020, all retirement home staff, home and community care staff and personal care service providers are required to receive bi-weekly testing through PCR tests. For more information on the surveillance testing policy for retirement homes, please visit:
- Ministry for Seniors and Accessibility (MSAA) Deputy Minister’s Memo, issued June 9, 2020
- Ontario Retirement Home COVID-19 Visiting Policy, last updated December 11, 2020
Retirement homes co-located with long-term care homes are expected to follow the more restrictive visiting policy, including any testing requirements, if the two homes are not physically and operationally independent. Operationally and physically independent means that there are separate entrances and no mixing of residents or staff between the retirement home and long-term care home.
For more information about surveillance testing in long-term care homes, please visit:
In accordance with the Ministry of Health’s guidance, retirement homes using rapid antigen screening should ensure that staff, volunteers and essential visitors receive screening:
- 2-3 times per week in grey, red, orange and yellow zones.
- 1-2 times per week in green zones.
Individuals entering retirement homes at a lesser frequency should complete an antigen test upon entry to the retirement home.
If recommended frequencies are met, antigen screening can be used as an alternative to bi-weekly PCR-based surveillance testing. If retirement homes are not using antigen screening or are unable to meet the prescribed antigen screening frequencies, surveillance testing should continue bi-weekly (i.e., once every 14 days) through a PCR test.
Retirement homes must continue to adhere to other applicable screening and testing requirements, including those in Directive #3 for Long-Term Care Homes issued by the Chief Medical Officer of Health.
Current Guidance on Antigen Testing
Provincial guidance on the use of antigen screening continues to be updated. The most recent guidance is outlined in the following links:
- COVID-19 Provincial Testing Guidance
- COVID-19 Guidance: Considerations for Antigen Point-of-Care Testing
- Management of Individuals with Point-of-Care Testing Results
Guidance includes the following recent updates:
Effective February 17, 2021, to participate in the program, participants must complete a program agreement with the Province of Ontario through their sponsoring ministry. The program agreement has now been integrated into the online ordering system for participating retirement homes. Retirement homes will attest to the following terms and conditions:
- Using test kits for intended purpose and not reselling;
- Reporting data weekly;
- Ensuring compliance with all applicable laws, provincial or federal directives, and provincial or federal guidance, including provincial Guidance on Antigen Screening and IPAC guidelines;
- Providing all other human resources and equipment/supplies (other than the test kits) at the participant’s own cost; and
- Ensuring that the person performing COVID-19 point-of-care antigen screening using the Test Kits at the participant’s site is a health professional or trained individual that has the appropriate knowledge, skills, judgment, and oversight to perform the test correctly.
Effective March 3, 2021, all COVID-19 tests that are approved by Health Canada for point-of-care use are exempt from Regulation 682 and Regulation 683 under the Laboratory and Specimen Collection Centre Licensing Act.
- This change will allow for a broader range of health professionals to perform rapid antigen screening as part of the Provincial Antigen Screening Program. For example, health professionals may include both regulated health professionals and non-regulated health workers, such as personal support workers.
- Retirement homes are responsible for ensuring individuals administering antigen tests have the knowledge, skills, and judgement to perform the test.
Effective March 3, 2021, any person who performs a COVID-19 point-of-care test (including antigen tests), who is not otherwise already required to report under the Health Protection and Promotion Act (HPPA), must report to the Medical Officer of Health of the public health unit within which the person being tested resides:
- Preliminary positive results from a COVID-19 antigen point-of-care test.
- Positive results from a COVID-19 molecular (nucleic acid) point-of-care test.
- The amendment requires that, where possible, results from COVID-19 molecular (nucleic acid) point-of-care tests be entered into the Ontario Laboratories Information System (OLIS) as the mechanism for reporting positive results to public health.
- Otherwise, positive results from molecular (nucleic acid) point-of-care tests must be reported to the Medical Officer of Health by other secure means.
Effective March 3, 2021, specimen collection for point-of-care antigen tests may also be done by the person being tested (‘self-swabbing’). Self-swabbing for point-of-care antigen tests is not currently approved by Health Canada, but the Ministry of Health is of the opinion that it is appropriate, from a clinical perspective, to do self-collection for antigen point-of-care tests under the following specific circumstances:
- If a trained individual, including a health professional (regulated or unregulated) is supervising the self-swabbing.
- Any individual supervising self-swabbing must consult the self-swabbing training resource developed by Ontario Health in collaboration with Public Health Ontario and ensure that they have the appropriate knowledge, skills, and judgment to provide appropriate self-swabbing oversight, including how to operate the device, personal protective equipment (PPE) requirements, and how to safely dispose of waste.
Nasopharyngeal swab (NPS) is the specimen collection type with the highest sensitivity. NPS is a restricted act, and this specimen type may only be collected by physicians, nurse practitioners, or their delegate despite the exemptions noted above. Alternate specimen collection types are also acceptable, including a combined swab of throat and both nares, a nasal swab, or a deep nasal swab.
Ontario’s current inventory of PanbioTM rapid antigen test kits come with either nasopharyngeal (NP) swabs, or nasal swabs.
- NP swabs can be used for NP, combined throat + both nares, deep nasal (both sides) and nasal (both sides) specimen collections.
- Nasal swabs can be used for combined throat + both nares, deep nasal (both sides) and nasal (both sides) specimen collections.
The BD VeritorTM rapid antigen test kits come with a nasal swab that can be used to collect combined throat + both nares, deep nasal, and nasal specimens.
For more information, please see:
Informational Webinars and Training Materials
On February 25, 2021, Ontario Health hosted a webinar targeted to the retirement homes sector, featuring an update on the Provincial Antigen Screening Program, the clinical guidance for use, and concrete steps for how to get started with antigen testing. It also featured feedback from a retirement home that has implemented on-site rapid antigen testing. A recording of the webinar is available at the following link: Feb 25 Webinar – Provincial Antigen Screening Program. A copy of the presentation is also available by clicking here.
Ontario Health provides training materials including key information on how to collect the appropriate specimens for rapid antigen screening, how to order and store test kits, how to set up and run an antigen screening clinic, and how to interpret, communicate and document results.
For more information, please see:
Participating retirement homes are required to report testing data through the Health Data Collection Service. Training on data collection and entry is available. For more information see the Ministry of Health’s Data Collection Information Sheet.
Login information for the online data entry portal will be sent to approved participants. Data should be tracked manually until login information is received.