Province ramps up testing protocol
People urged to get checked even if experiencing mild issues such as sore throat, nausea, pink eye Guidelines expanded to capture more at-risk groups as assessment centres see drop in visits last weekend
Officials are now urging people to go to COVID-19 assessment centres for testing even if they have mild symptoms of the disease — from loss of taste or smell to pink eye — as more of Ontario’s economy starts to reopen.
This comes on the heels of a big drop in testing over the long weekend, with labs using one-third of their capacity, Tuesday, and processing only 7,382 tests. That’s down from17,768 at the end of last week.
Health Minister Christine Elliott said Wednesday at Queen’s Park that not enough people have been going to assessment centres. They were directed last week to start testing individuals with an expanded list of symptoms as blanket testing of long-term-care homes wrapped up.
“People did not come to assessment centres over the weekend,” Elliott said. “If you have symptoms of COVID-19, please go to an assessment centre to be tested.”
After criticism from opposition parties and epidemiologists on the testing strategy, Elliott also said the province will work with the business community on wider testing for employees returning to work.
“We can’t open things up to stage two until we can fully assess what the effects of stage one are on the community, so testing becomes all the more important,” she added, referring to the gradual stages of reopening the economy. “And we do have a plan to ramp it up considerably.”
It’s a different approach from the beginning of the pandemic, when people with mild symptoms were urged to stay home and self-isolate and constraints on testing capacity meant not everyone was able to get a test.
The list of updated symptoms goes beyond just the classic markers of COVID-19, like cough and shortness of breath, as scientists learn more about the range of impacts of the new disease, and how it can affect organs other than the lungs.
It includes sore throat, nausea, vomiting, diarrhea and abdominal pain, as well as a runny nose or congestion unrelated to seasonal allergies.
It also lists several “atypical” symptoms that can particularly appear in older people, and those with developmental disabilities, such as delirium and unexplained falls or fatigue.
And it includes multi-system inflammatory vasculitis in children, a rare condition seen in the United States and Europe in kids and teens who’ve tested positive for COVID-19.
This can look similar to Kawasaki Syndrome — a rare inflammatory disease — and can show up as persistent fever, abdominal pain, nausea, vomiting, diarrhea and rash.
Ministry of Health spokesperson Hayley Chazan added in an email that the previous testing guidelines relied on individual clinicians’ assessments of patients at the centres. With the new guidelines, “we expect everyone with mild symptoms to be tested, regardless of their exposure,” she wrote.
“While prioritizing certain vulnerable groups, as we open the economy, guidelines will allow for expanded testing of those with symptoms,” she wrote. “Our expectation is that assessment centres will abide by the province’s expanded testing guidance.”
People without symptoms may be tested in special circumstances, “typically” when they are part of an outbreak, said Chazan, in addition to the “proactive” testing of all nursing home residents and staff in the province.
The vulnerable groups include, among others, hospital patients, residents of retirement homes and other communal settings like homeless shelters, health-care workers, first responders and other essential workers such as grocery store clerks.
There are129 assessment centres across the province, Chazan said, and each one has its own policies and procedures.
Ontario’s chief medical officer of health, Dr. David Williams, said at a news conference Wednesday that the province has the capacity to “enhance” testing “considerably,” as a crucial part of moving toward the next steps of the recovery.
He’s aware there “may be some further barriers” for people, such as where to go and how to get there, and they’re “trying to look at removing those barriers.”
In Toronto, the assessment centres at St. Joseph’s and St. Michael’s hospitals have not seen any increase in people seeking testing, as more head back to work.
“In fact, volumes were a bit lower than typical at St. Michael’s assessment centre over the long weekend,” said Unity Health Toronto spokesperson Jennifer Stranges.
“With the broader criteria for testing now in place, we encourage those with symptoms of COVID-19 to get tested.”
At Michael Garron Hospital’s assessment centre, staff noticed a slight increase on Friday and Tuesday but “there wasn’t a noticeable change on the weekend,” wrote spokesperson Andrea Nameth in an email.
In Ottawa, public health officials urged employers to remember that employees without symptoms don’t need to be cleared with a test to go back to work. That message came in a tweet prompted by reports of “some individuals without symptoms” who “were presenting for assessment at the assessment centre” wrote a spokesperson.
The province recommends that people use the online selfassessment tool to determine next steps, and depending on the outcome, contact Telehealth, their physician or their public health unit to determine whether they should proceed with testing.
But whether or not a referral is mandatory seems to depend on where you live.
In Toronto, for example, “it is recommended that people call ahead before going to an assessment centre,” wrote Toronto Public Health spokesperson
Keisha Mair.
“They can also call their health-care provider, Telehealth Ontario, or Toronto Public Health.”
Mississauga’s Trillium Health Partners assessment centres at Mississauga Hospital (Clinical Administration Building) and Credit Valley Hospital (Valley House), are “currently available to the community by referral from Peel Public Health, a family physician, or a THP specialist,” said spokesperson Lyndsay Carter in an email.