Huge holes appearing in province’s COVID-19 testing regime as economy reopens

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After receiving plaudits for navigating the first wave of cases, holes are beginning to appear in the province’s response to the coronavirus crisis as the economy restarts. Has the province opened too quickly? The recent spike in the number of cases seems to suggest as much.

Premier Doug Ford stood at the podium during one of his regular press briefings last week and told Ontarians that he “wouldn’t hesitate to roll things back in a heartbeat” on the province’s reopening of the economy if the number of COVID-19 cases keeps going up.

“We’re watching the trends like a hawk,” he said.

But almost two weeks after the province started to slowly reopen retail shops and other sectors of the economy, the number of new cases has been increasing, in most instances outnumbering the number of people recovering from the virus for all but one or two days. It’s a concerning trend, but not altogether unexpected. Epidemiologists told us that this would be the case.

But the larger concern for public health officials is that the province’s commitment to ramping up testing and tracing of the virus continues to lag significantly.

While the province says it has the capacity to conduct some 20,000 tests a day, the actual number being done has averaged around 11,000, despite repeated promises by the government to get those numbers up. On Monday, only 8,170 tests were conducted, a drop of more than 3,000 from the previous day. Some 17,768 tests were conducted on May 16, the first day the economy was reopened. They’ve gone down ever since.

More importantly, there is no coordinated effort to test and trace people working in those sectors, which is key if we want to prevent a second outbreak, experts say.

According to a new study out of York University, the government needs to be able to track and trace almost 60 per cent of new cases in order to execute its plan to reopen the first two phases of the economy safely. And right now we’re at around 35 per cent. The research was published in the journal Biology and shared with expert panels advising both the provincial and federal health agencies.

“If we want to open businesses, if we want to open restaurants we should encourage employees expected to have close contact with customers to be tested,” says Jianhong Wu, the study’s author and an expert in infectious disease modelling at York U’s Faculty of Science. “The benefits of going for testing for the purpose of personal protection, and for the purpose of protecting your close contacts, and for the purpose of public health – those benefits have not been communicated sufficiently enough.”

The government has recently changed the criteria for testing. This week the premier announced that anyone who wants to can and should be tested. Initially, only those showing symptoms were being encouraged to do so.

But Wu says the government is not being proactive enough. And that more needs to be done to put testing and contact tracing in place in those sectors of the economy that are reopening or set to come back.

“We should really and truly have more targeted testing,” he says.

He notes that we are already beginning to see some of the consequences of reopening in the recent increase in the number of cases.

“It’s not surprising. When you are reopening you are supposed to see a moderate increase,” Wu says. But what is unexpected is that the province’s full testing capacity is not being reached. “Ideally, tracking and tracing should be comprehensive and coordinated before we reopen the economy.”

A number of infectious disease experts penned an opinion piece in the National Post last week advocating for a more robust reopening of the economy. They argue that the social and economic costs of the shutdown are being felt in a significant way, and that the curve has been flattened enough in Ontario and that enough hospital capacity exists to turn our minds to reopening more quickly.

Wu’s view is not dissimilar. In some ways, he says, “we’re suffering from our own success” – we’ve managed to flatten the curve, but he cautions that we are a long way from achieving the number of cases required in the population at large to begin developing natural immunity. We’re at least two years away from that.

All of which makes more urgent the need to ramp up testing and implement a coordinated approach in those areas of the economy as they return.

“It’s not too late to talk about this,” says Wu. “We’re still at an early stage of reopening. The government can intensify its efforts to coordinate the effort for targeted contact tracing.”

@nowtoronto