​​​When Omicron hit British Columbia in December, testing sites were suddenly overwhelmed as people lined up for hours to get tested. To relieve the pressure, the province turned to rapid antigen tests. To get tests into the hands of British Columbians required an extraordinary effort from PHSA teams.

“The rapid antigen tests available at the time were packaged together in boxes of 25 in anticipation that trained professionals would be using them, not by members of the general public at home," said Eric Hempel, who works with the BC Centre for Disease Control (BCCDC) Public Health Laboratory. "Before they could be handed out, the boxes had to be divided up, tests repackaged, instruction sheets added, and kits shipped to front-line testing sites across the province. I was on calls at all hours of the day with people from all over the province to figure out the logistics."

Tests first became available at test collection sites in December, with an initial focus on getting them into the hands of priority populations like health care workers, and then as more supply arrived, the tests were packaged for the broad distribution we see now. 

To make it happen required Printing Services, Supply Chain, Provincial Language Services, Provincial Lab Medicine Services, and BCCDC's Knowledge Translation team to work together.

“Our testing system was overwhelmed and it became clear that we needed to get additional testing options out to people quickly so they could take action to manage their illness especially heading into the winter holiday season," said Dr. Linda Hoang, associate director of the BCCDC Public Health Laboratory.

“The whole organization came together and through their dedication and coordination, rapid tests were available in just a matter of days." - Dr. Linda Hoang

Coordinating rapid antigen test instructions

Due to varying situations, there are five different types of rapid antigen tests being used in B.C. and each kit needed a set of instructions to show users how to use the test, read their results and take the necessary measures if they tested positive or negative.

Between Dec. 20, 2021 and Jan. 4, 2022, the BCCDC Knowledge Translation team created instruction sheets for three different tests with the others coming later in January. This not only involved making the instructions clear and simple but also designing the images to accompany each step of the process.

“It was great to work with so many committed departments to begin the rapid test kit distribution over the winter holiday period,” said Lynsey Hamilton, knowledge translation specialist with BCCDC. “We worked closely with printing services, labs and the warehouse team to create materials that were clear, concise, and feasible for the short turnaround time.”​

After the initial hustle to get the first set of instructions sheets complete, the next priority was making a video to demonstrate the best technique.

“A lot of the videos out there don’t show an individual performing the test on themselves using the correct head tilt technique,” said Lynsey.

Eric, who had been coordinating between the different PHSA programs on the roll out of rapid tests, was volunteered to star in the video and walk through the steps. The video, Guide to at-home nasal swab: COVID-19 Rapid Test​, now has 15,000 views.

​Printing services

From left: Alberto Soriano, Gerry Wang, Wayne Mackey, Ramandeep Johal, Ebenezer Badewa, Craig Thompson, Wes Garnett, Jason Moore, Yong-Jun Jung from PHSA Printing Services. (Not shown: Peter Bowra, Aileen Fulgueras, Dan Hubbs)​

“The winter holidays are usually a quiet time in the printing department, but Omicron had other ideas,” said Craig Thompson, lead of PHSA Printing Services. “Around mid-December we learned that there were shipments of hundreds of thousands of rapid tests down the pipeline. We were already going full tilt printing forms and handouts for testing and vaccination sites.”

Suddenly the team had 700,000 rapid antigen instruction sheets to add to their workload while also dealing with a paper shortage. 

“We had every possible device printing instruction sheets, including the office printers,” - Craig Thompson

It took all members of the team and the help of suppliers to find paper supplies, keep the presses running, fold the instruction sheets and deliver the copies to be included in the repackaged kits throughout the holidays including on Christmas and New Year’s days.​

Translations

Each of the instruction sheets were originally developed in English but needed to be translated into 11 languages to be accessible to people who can not read in English.

That is where the Provincial Language Services (PLS) came in. They were facing a request of up to 55 different translations between 11 languages and five different kits. This all came late in December when many of the translators are taking time off of work.

“It is crucial to have COVID-19 related documents translated to ensure patients with limited proficiency in the English language are afforded the same understanding as the English-speaking patient population,” said Ming Yi Sung, manager, PLS Translation Services.

PLS helps to create equity through equitable access to knowledge and information of public health material. With multiple editors, translators, publisher and a coordinator, the team was able to translate the instructions into multiple languages on short timelines. They’ve also been keeping the translations up-to-date as information has changed.

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Supply chain

For PHSA’s Supply Chain, distribution of rapid antigen tests had to quickly pivot from a distribution model built on scarcity to one of abundance.

As of Dec. 6, 2021, Supply Chain had about 1.8 million tests in stock. By the end of February, they had received more than 24 million and distributed more than 17 million.

“We started out with the rapid antigen test kits for the testing and collection sites but have expanded significantly, shipping to acute sites, long term care and assisted living residences, industry, schools and now local pharmacies,” said Grant Hunt, provincial director, Supply Chain Warehouse Logistics.

As part of their work, Supply Chain prepared for receiving and redistributing about 3 million test each week, which is roughly 12 full truckloads.

“We worked closely with the federal team providing the rapid antigen tests to ensure delivery was planned to come in to specific sites on a schedule that allowed us to receive the large amounts needed to meet our commitments,” said Grant.

It takes a team

Making rapid antigen tests available to the public wouldn’t have been possible without the tremendous efforts and commitment from all groups involved.

“It goes to show that when times become challenging, we can count on each other and get the job done,” said Eric.

To learn more about using rapid antigen tests at home, find translations of each of the instruction sheets and watch the video, visit BCCDC’s Rapid Antigen Testing at Home page.

Rapid antigen tests are now available for pickup in many community pharmacies across BC. To find a pharmacy near you, please visit the BC Pharmacy Association website.