Provinces must triple daily coronavirus tests, top doctor says,
Chief medical officer says 60,000 tests a day must happen before reopening
Canada needs to triple its daily number of coronavirus tests and be prepared to jump on new outbreaks, tracking anyone who comes in contact with an infectious person, before provinces reopen the economy, says Canada’s chief public health officer.
The provinces and territories are now testing about 20,000 Canadians a day for the COVID-19 virus, a number that needs to ramp up to 60,000, Dr. Theresa Tam said.
The caution came as the premiers of Ontario, Alberta, B.C., Saskatchewan and Quebec talked about releasing economic relaunch plans in the next week. Tam said medical officers of health are now trying to develop national health criteria to help that effort.
So if widespread testing is key to reopening, is Canada ready? Not yet, say many experts.
Dr. Isaac Bogoch, an infectious disease specialist at University of Toronto and the University Health Network, said Canada will need the ability to do more rapid diagnostic testing, aggressive contact tracing, and quarantine and “support” of infected individuals.
Right now, Bogoch said, Canada is “pretty good, but we’re not perfect.”
While the provinces can probably find the people needed to do thorough contact tracking, Bogoch said the public will need to accept that many services and businesses, including public transit, will only be able to operate at a fraction of their usual capacity.
“It’s not going to be like in the pre-COVID-19 era.”
The Public Health Agency of Canada reported Tuesday that Canada has 38,932 cases of COVID-19, with 576,348 people tested to date, and a per capita testing rate of 15,333 per million. Worldmeter, which is tracking global data, shows Canada ranks about 38th in the world when it comes to tests per million population.
At the moment, Ontario is second to last in Canada when it comes to per capita testing rates. Premier Doug Ford again expressed his frustration, saying he’s pressing for more testing and “it might take a few weeks, but we’re going make sure that we expedite it as soon as possible.”
Dr. Samir Patel, deputy chief of microbiology at Public Health Ontario, said the province’s system of lab testing is improving. It received 11,000 samples Monday. Patel said results should be turned around within 24 to 48 hours, but he conceded it could also take from two to four days.
Dr. Peter Phillips, an infectious disease specialist at the University of British Columbia, said in an interview that testing capacity and strategies across this country vary widely.
B.C. has capacity to process about 4,000 tests a day, but is currently averaging between 1,000 and 1,500 a day, he said, adding it’s likely due changing criteria for testing, lack of easy access to testing sites — there are only two drive-through test sites compared to 43 in South Korea — and the possibility clinicians don’t realize they now have broader discretion to send someone for a test.
Phillips said Canada has to up its game not just when it comes to wider testing, but adopting the strategies that worked in the only countries have successfully managed to control the disease spread. He pointed to Taiwan, South Korea, Singapore, Hong Kong and New Zealand, which adopted aggressive contact tracing and disease surveillance tactics that include the use of GPS, cellphone and credit card data.
“These are not things that are impossible in Canada,” he said.
“If it’s done properly, it can be done anonymously. Are there possibilities they can be abused? Sure, but Canadians can make a choice,” Phillips said. “You can end up with some initiatives that raise questions about privacy and civil liberties, or you can have the scenario like Italy or New York.
“You can flatten the curve, but if you don’t have the public health components in place … then you’re probably going to see second and third waves. And the playbook’s been written by these few countries. Why would we not adopt it?”
Health Canada is also set to “imminently” approve the first serologic tests for the COVID-19 antibody to “ascertain” the broader level of immunity in the general population, Tam said.
Unlike nose and throat swabs used to detect the presence of the virus, serologic tests check for antibodies in the blood. They don’t necessarily show if a person currently has the virus, but they may signal someone was previously infected. The tests also provide results within 15 minutes.
But Bogoch cautions that the evidence is so far unclear as to whether infection produces any immunity or for how long someone may be resistant to a new infection — a warning the World Health Organization also issued this week.
He also warns that COVID-19 will be with us for a long time.
“We’re still at the peak; that’s not a good place to be. We want to get to the bottom of the curve on the other side before we start to relax some of our public health restrictions.”