Forget the carbon tax: COVID-19 testing is the latest failure of federalism

OPINION: Doug Ford wants the feds to approve new types of coronavirus testing — and that makes sense. But why did Ontario make a plan that hinges on what Ottawa will do?
By John Michael McGrath - Published on Sep 25, 2020
Prime Minister Justin Trudeau and Premier Doug Ford take part in a ground-breaking event at a mining site in Gogama on September 11. (Nathan Denette/CP)

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In Ottawa this week, the provinces and the federal government, along with a passel of non-governmental organizations, argued for and against Canada’s carbon tax in front of the Supreme Court. It was a reasonably spirited debate, as these things go, although those who paid attention to the related arguments at lower courts in Alberta, Ontario, and Saskatchewan wouldn’t have heard much, if anything, new about the ins and outs of federalism.

But that doesn’t mean federal-provincial affairs have gotten boring, because there’s already a new front in the never-ending battle between Ottawa and Queen’s Park: rapid COVID-19 testing.

Premier Doug Ford wants Health Canada to approve rapid tests for the increasingly-less-novel coronavirus, on the not-ridiculous grounds that they’ve been approved elsewhere by advanced, careful countries (and also by the United States), so they’re presumably safe for use here as well.

Health Canada is refusing to hurry its deliberations, insisting that any tests approved for use must meet stringent criteria for accuracy (I’ve already written once this month about why I think Health Canada’s requirements may, in some cases, be too stringent). And the Liberal government is defending the work of the federal civil service and saying it won’t try to expedite the process.

“I want to be assured that any medicine, any tests that are used here in Canada, have been approved by our regulators without any political interference or pressure,” Deputy Prime Minister and Finance Minister Chrystia Freeland said Thursday. “And, look, the reality is, this is not how it’s working in some other countries. We’re seeing interference and pressure on regulators around the world, and I think we can all see the very dangerous consequences of that kind of an approach.”

The insinuation that Ford’s request for approvals of testing methods already used in other countries is somehow analogous to Donald Trump’s recommendation that people inject themselves with hydroxychloroquine is, of course, ridiculous, but I can’t help but admire how skilfully the deputy prime minister delivered it.

The accuracy of tests is undoubtedly an important consideration. It’s not the only one, though. No test is perfect — even the gold-standard (high-quality, but also expensive and sluggish) PCR varieties Canada is currently forced to rely on create false positives when used in a haphazard way, as Ontario’s associate chief medical officer of health reminded reporters this week.

But in Ontario, right now, today, there are unquestionably people who are infected with COVID-19 and haven’t been able to get a test due to long lineups at assessment centres — or, as of Friday, because they’re asymptomatic and don’t meet the new criteria for testing. If symptom-free spread weren’t such a concern with this virus, this wouldn’t be such a problem. But it is, so it is. The root cause of the lineups and the new need to triage tests is the same: lack of capacity.

The parties involved are arguably just doing their jobs, but I’m more than a little sympathetic to Ontario’s position here. Yes, the federal government is supposed to ensure that unsafe medical devices don’t enter the Canadian market, but surely when provinces — which actually operate hospitals and public-health systems — are begging for a break, something needs to give.

What’s harder to explain is why Ontario’s plan depends on new testing technologies in the first place. The PCR test is expensive, yes, but not absurdly so. Other countries substantially expanded their testing capacity while sticking with PCR; there’s no physical law of the universe that says Ontario couldn’t have done so, too.

Charitably, it might simply have been the best plan anyone thought was realistic: Canada has struggled all year to ensure an adequate supply of the inputs that go into PCR testing, which certainly suggests that a major ramp-up would have been challenging. It’s not at all hard to believe that this was the best advice Ford was given.

Less charitably, it wouldn’t be at all out of character for this province to have fixated on the promise of new, faster, cheaper testing methods as an alternative to the existing off-the-shelf solution on the grounds that building out a more robust PCR testing capacity would just be throwing money away. That’s basically the same questionable justification the Tories have provided for their pursuit of hydrogen-powered trains — shiny baubles the Liberals, too, once chased after. This is also the province that insisted it had to reinvent transit-fare cards for its own precious reasons. (It just settled a long-standing conflict with Toronto over their janky performance.)

But, more fundamentally, anyone building a plan that hinges on Health Canada’s approval of new methods should already have considered a pretty basic question: What if it doesn’t come through?

At the moment, Ford’s only recourse is yelling in the direction of Ottawa and hoping somebody on that end of the 401 cares. But, if this goes on much longer, the premier and his cabinet may need to come up with a Plan B.

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