Ontario’s COVID testing nightmare

Back in may, Ontario Premier doug Ford said that anyone who wanted a COVID-19 test could get a test: “you will not be turned away, you don’t need an appointment, just show up.” To which he should now add: “As long as you can afford to take a whole day off work and hold your bladder for upwards of six and a half hours.”

That’s how long news reports have indicated some people have been forced to wait, as demand for testing has increased by 30 per cent in recent weeks, amid a sharp spike in confirmed cases and over a million children returning to class.

The province is now scrambling to find ways to increase the number of tests it performs to 50,000 a day, up from the more than 25,000 currently being performed daily, within the next month. And while testing supplies and laboratory capacity are certainly issues, it has become increasingly clear that simply getting people through the door is a serious challenge: many Ontarians have reported being turned away from testing centres that are unable to process everyone who has shown up before they close for the day.

Ontario is certainly not the only province that’s clambering to increase testing capacity as children head back to daycare and school and the respiratory virus season looms: Quebec and british Columbia have also reported spikes in demand for testing. but Ontario does seem to have the biggest problem with getting people processed right now — a stark reminder to the rest of Canada that things can turn on a dime and quickly overwhelm existing systems, if they’re not ready.

unfortunately, throughout this pandemic, Canadian governments and public health officials have too often been reactionary, rather than proactive about implementing necessary public health measures. A good case in point is the return to school. When most of them were shuttered in mid-march, many believed they would be able to reopen within a few weeks. but by may or June it was clear to practically everyone that most schools were not going to reopen until September.

This would have been a good time for ministries of education and local school boards to start planning for the fall. Instead, in much of the country, they seemed to take an extended summer vacation, leaving important negotiations over how to safely return kids to class until August.

The result was a flurry of spending announcements from the provinces and federal government at the end of August, and grandiose plans to upgrade aging ventilation systems in thousands of schools and procure off-site spaces with only weeks to go.

In the midst of all this, it should have been clear to all that there would be a huge increase in the demand for testing, given that the fall influenza season would be compounded by an expected second wave and parents who would be desperate to prove that their children were not infected, given that schools and daycares are now turning away anyone with a runny nose. yet this appears to have come as somewhat of a surprise to Ontario Health minister Christine elliott, who admitted this week that, “We did anticipate an increase in the lineups but perhaps not to this extent.”

And things are only going to get worse. Not only in terms of the number of people who are likely to seek testing over the fall and winter, but also in terms of the logistical challenges of safely testing all those people during the cold winter months. It’s one thing to make people line up outside for four hours when it’s relatively nice out; it’s quite another to expect that young children and the elderly will be able to do this when the mercury hits -30 C.

Ontario’s chief medical officer, dr. david Williams, said on monday that the province is looking at ways to address this issue, including trying to figure out how people can safely wait indoors. but even the current system, which often forces people to stand indoors alongside people who are more likely to be infected than the general population, and answer a plethora of questions before a nurse sticks a swab up their noses, seems somewhat risky. The last thing we want is for uninfected people to acquire the virus at testing centres, especially since that infection would not show up on the test they just received.

As a number of infectious-disease experts noted in these pages last week, another big problem is the number of people who are at low risk of being infected, but are nevertheless seeking tests, often so they can feel better about engaging in social activities, or disregarding social-distancing guidelines. This is certainly a problem that needs to be addressed through information campaigns. but we are still going to see a huge increase in children who have been sent home from school and need to be tested.

So now, governments are scrambling. Last week, new testing centres opened in edmonton and Laval, Que. Quebec Premier François Legault said his province is working to expand testing facilities and lab capacity, but is having trouble procuring the necessary supplies. The Northwest Territories is increasing the number of rapid tests that can be processed within the territory. Ottawa has announced it will be offering federal labs to help deal with the backlog in testing across the country. And Ontario is considering asking private pharmacies and laboratories to help take the load off public hospitals.

All of this is likely necessary to address the coming surge in demand for testing, as are other solutions like expanding drive-thru testing, possibly by using the empty parking lots of shuttered hockey arenas throughout the country, and expanding the number of centres that take reservations. One thing is certain: without the testing capacity, this country will be unable to get a handle on a potential second wave, which could allow the virus to run rampant.