The country doesn’t have enough testing capacity, and might never get it
When did Canada’s coronavirus testing go off the rails?
The first clues were evident back on Jan. 24, the day after Wuhan, China, was locked down.
“We’re ready, we’re prepared.”
Those were the confident words from Dr. David Williams, Ontario’s chief medical officer of health in a news briefing that day. The province already had a “specific and reliable” coronavirus test that could deliver results in 24 hours.
The public message was clear. We’ve got this. After all, Ontario had survived SARS.
“Folks, it will still be business as normal,” said Peter Donnelly, head of Public Health Ontario, at the same briefing.
Through the unforgiving lens of the back, they could not be more wrong.
Now brutally clear that only heating SARS – roughly as many Canadians will die within the first few weeks than in the whole of this pandemic outbreak of SARS.
And an important weapon in the battle, laboratory testing, become log-jammed on opening day.
One week after the province closed schools, shops and banned large gatherings, many laboratories are overwhelmed.
By the end of the first week, Ontario has a backlog of more than 7,200 tests. BCE also reported backlog, as did Alberta, Quebec, and Manitoba.
Almost immediately, the province began to limit who can be tested – limiting for front-line health care workers, people with severe symptoms and those who work with vulnerable groups.
Over the past week, the backlog has been cleared, but the restrictions on testing still remain in most of Canada.
And the hard truth is that testing will continue to be limited, even in Ontario who has just announced it will soon be able to test 19,000 people per day.
“Even when we were in 19,000 tests a day we will not be able to test every person and it will be the same in any other jurisdiction,” said Vanessa Allen, a chief medical microbiologist at Public Health Ontario, the government agency responsible for provincial laboratories.
Ontario problem solve, create another
Just as the backlog cleared, new problems and equally frustrating appear. Media reports on Tuesday revealed that the level of testing Ontario dropped to just over 2,500 per day, but the province said it could run around 13,000.
Why does not Ontario testing?
The province is creating a new network of clinical laboratories in the midst of a pandemic – such as building a bigger boat, at sea, in the storm.
The Department of Health has set all the accounting firm KPMG in the province laboratory capable of testing microbes. That includes 10 network hospitals, six public health laboratories, and three private laboratories network.
Added, they can do 13,000 tests per day and expects to reach 19,000 in three weeks.
But the extra capacity created suddenly, which means there are no sufficient patient samples waiting to be tested because they examine the restrictions in place.
The expert committee is working on a new recommendation on who should be tested and Premier Doug Ford calling for expanded testing in long-term care homes and other vulnerable people.
Meanwhile, fears of patients like Nick Marceau of Toronto can not be tested, although doctors suspected he had COVID-19.
“It’s frustrating for someone who lives alone … when you are faced with this,” said Marceau, 38.
Marceau did not qualify for the exam because he was not traveling, not in a high-risk group and its symptoms are not severe enough to send him to the hospital.
“It is considered that it is a situation that watch-and-wait,” he said.
Why test such a big problem?
The simple answer – COVID 19 tsunami caught nearly everyone off guard.
“Everyone in the world is ramping up for the test is the same and they are all vying for the same reagents,” said Allen, referring to the chemicals required for the test. “This is not an Ontario issue, this is an international problem.”
“Demand for these tests really unmatched.”
Two months ago, Dr. Kevin Katz had a bad feeling about what might be on the way.
He is an infectious disease specialist who manages laboratory tests for several hospitals including North York Toronto General, Sunnybrook, and Michael Garron.
“As soon as I thought it would be toward me pandemic have concerns about the supply chain,” he said. This hunch is based on over a decade of pandemic planning.
In the first week of February, he began secretly stocking up on reagents. Weeks later, he ordered more, plus materials needed to extract additional material and viral genetic testing equipment.
“We’re pretty aggressive. We ordered and asked to take the next day’s delivery. We want everything to be physically delivered so we have some sort pallets scattered around the lab,” he said.
One consequence of the low level of testing in Canada is that no one has a clear idea of how big an epidemic in this country.
“Now we are almost certainly only see the most serious cases,” said Ashleigh tuite, an epidemiologist with the University of Toronto.
Low levels of frustration and epidemiology tuite else trying to make a model of the disease, which politicians use to support their decision.
Ideally, with enough capacity, tuite believes there will be no restrictions on testing. Now, the reliability of the model is affected by the lack of reporting of cases.
“Until we have a consistent amount of testing in populations I think it’s hard for me to say that I have confidence in their projections,” said tuite.
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