Since the start of the COVID-19 pandemic, Ontario has trailed the rest of the country when it comes to testing people for the virus.
It’s been a fatal gap in the province’s pandemic response, since a key method of stopping the outbreak involves figuring out who has the virus, and then isolating them and their contacts. Doing public health without adequate testing is like telling the fire department to rush to a nine-alarm blaze, and then not telling them where the fire is.
Shutting down large parts of the Canadian economy may have been necessary given our failure in the early weeks of the pandemic to test and isolate, but lock-downs are incredibly blunt weapons, resulting in massive economic damage and upsetting peoples’ daily routines.
How economically damaging? On Friday, April 9, Statistics Canada reported that more than one million people in Canada lost their jobs in March and the unemployment rate climbed to 7.8 per cent (from 5.6% in February), reflecting the first wave of layoffs resulting from the COVID-19 related closures.
Ontario experienced the largest job losses in raw numbers, with the number of employed people declining by about 403,000, followed by Quebec at 264,000 and British Columbia at 132,000.
And the April job loss numbers are expected to be much worse.
In contrast to shutting down large parts of the economy, testing is a precision instrument and the more testing you do and the sooner you do it, the less you have to close things down.
In Singapore, South Korea, and other countries that have stanched the spread of the coronavirus, public-health authorities followed a simple process. First, widespread testing identified those who were infected even before they showed symptoms (which many never do). Then, aggressive contact tracing identified everyone with whom the infected person had interacted. Finally, everyone identified was subjected to a mandatory 14-day quarantine.
Why has Ontario failed to test?
Ontario is in last place among the provinces when it comes to testing.
British Columbia has tested twice as many people, relative to its population. Alberta has tested at three times Ontario’s rate. Quebec, despite having barely more than half as many people, has administered tens of thousands more tests.
As of April 9, Ontario is the province with the largest number of deaths from COVID-19 (200), yet its public health officials, hospitals and nursing homes don’t have a handle on where the coronavirus is.
Ontario Premier Doug Ford says the province has the capacity to test 13,000 people a day – more than the number of tests performed on an average day in the other nine provinces combined. He says Ontario has the kits and laboratories to achieve those numbers. But this week, between Sunday and Wednesday, the province averaged fewer than 4,000 tests a day. That means as of this writing, Ontario is using only 25% of its testing capacity.
And according to Hayley Chazan, spokesperson for Ontario Health Minister Christine Elliott, there is no plan for “widespread testing.” That, she said, would only cause a new round of lab test backlogs.
Doing fewer than 4,000 tests per day when you could be doing 13,000 tests is a disgrace. And why can’t the lab processing of tests be expanded along with the testing capacity?
There is a clear reason why Ontario’s increased capacity has failed to translate into a corresponding increase in tests. As of April 9, guidelines issued by the Ontario Ministry of Health, encourage local health authorities, assessment centres and doctors to discourage most Ontarians from getting tested and to self-isolate if they are showing symptoms. These frontline health personnel, who are used to testing kit shortages and who have been told to be stingy with a scarce resource by the Ministry of Health, have continued to stick to these outdated ministry guidelines even though Ontario now has the capacity to test at four times the rate its current testing rate.
Outdated Ontario long-term care guidelines have resulted in many unnecessary deaths
Outdated Ontario guidelines on nursing homes have also had disastrous, heart-breaking consequences. Twenty-nine deaths have occurred at the Pinecrest nursing facility in Bobcaygeon alone. There are currently over 51 outbreaks in Ontario long-terms Long-term care homes.
It was only on late Wednesday, April 8, that Ontario’s top doctor updated the nursing home guidelines to require that long-term care residents who are being transferred into homes should be tested for COVID-19, regardless of whether they have symptoms or not.
The new guidance by Ontario’s chief medical officer of health, Dr. David Williams, reverses a previous policy that said only patients with symptoms should be tested for the coronavirus. Doctors have spoken out against this policy, saying everyone should be tested before entering long-term care homes, where the virus can easily spread.
But the new long-term care guidelines still fall short in a crucial area: they don’t limit healthcare workers to working in only one facility. Contact tracing has revealed that the virus is being spread through long-term care staff working in different facilities. that is why BC Premier Horgan legislated healthcare workers to limiting themselves to working in one facility only. Ontario’s new rules do not include such a provision. That has to change.
The new guidelines focus on the province’s “vulnerable populations,” such as long-term care residents, health care workers and indigenous communities.
The new guidleines contain serious ommissions but are at least an improvemnet on the old rules – so good for Dr. Williams. But how many vulnerable lives could have been saved if he had implemented the new rules for the vulmerable in February when it was clear that the COVID-19 pandemic was coming our way?
The United States, which was doing barely any tests until late March with disastrous consequences, is now testing at a higher rate than Canada. And this is mostly because of the low testing rate in Ontario.
To fight the virus, Canada needs to be able to test tens of thousands of people a day. Ontario’s disgracefully low testing rate is making achieving such minimal numbers impossible.
When the time comes to begin loosening physical-distancing measures and opening the economy back up, testing is going to be even more vital. The more those that actually have the virus are identified and isolated, the sooner life can get back to normal.
And the more we utilize our capacity to test, trace and isolate – and confirm who has already has the virus – the less likely we are to have a renewed outbreak that necessitates a return to economic lockdown.
Canada must end the economic lockdown as soon as possible. But to do that Ontario must massively increase its testing and isolating efforts.