I know better than to hang a whole column on an anecdote — editors: I promise I know better — but I’m starting with one here. My last column for TVO.org went online last Friday. In it, I wrote about a friend (I didn’t identify her, and I won’t today) who was stuck in Ontario’s COVID-19 testing system. “A friend of mine is a mother of two,” I wrote. “Both of her children have had mild symptoms that could, but probably don’t, suggest COVID-19. Now she has symptoms, too. Their illnesses predate the testing changes announced [last] week; they are waiting for results and have been for days.”
It’s now Tuesday. As of this morning, she still doesn’t have results. But she still has a cough, and an increasingly sour attitude toward the provincial government, to boot. It’s not being helped much by the fact that when she goes online to look for her result, the website seems to have failed entirely. It won’t load.
There’s more and more of that popping up on social media, as people complain of delayed results and post photos of broken web portals. Don’t draw any broader conclusions from that yet: social-media anecdotes are risky stuff in journalism. But it seems that people are still struggling to get their results even after they’ve been tested (and getting tested was itself a challenge until recently).
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There’s progress on that front, and on the backlog. Premier Doug Ford said on Tuesday that switching to appointment-only testing, removing asymptomatic people from the wait-lists, and a one-day pause in testing has allowed Ontario to catch up. The appointments system is also preventing the long lines that were a tangible sign of dysfunction in recent weeks. This is good news, of a kind, though it has torpedoed any sense of scale in comparing case counts as an indicator of how Ontario’s second wave is progressing. Are the lower numbers this week a sign of improvement, that the second wave is slowing down and proving less fearsome than was expected? Or is it entirely because of the changed testing protocols? I suspect it’s largely the latter, but we won’t know for weeks.
And it’ll be hospital admissions that tell us then. They’re still rising, though they remain well below the government’s red lines, which were disclosed last week. For now, they’re the only consistent indicator, but they’re also an indicator of last resort. As I wrote here last week, the testing gives you a clear sense of where your hospitalizations are likely to be in two or three weeks. The hospitalizations tell you only how much trouble you’re in at that precise moment. It’s good to know! But you can’t do much with the information except manage as best you can.
So we are a bit in the dark again. Our hospitalization numbers will lag. Our case counts are no longer meaningfully comparable to previous data — which doesn’t mean we’re not testing appropriately now, in fairness (for more on that, see my conversation with Zain Chagla). But we just have to wait and see what happens now. Will this week’s lower case counts remain lower? Or will they start rising, reflecting the continued arrival of the second wave and growing COVID-19 prevalence, even under the new testing criteria? No one knows yet. We must wait and see.
The timing for this isn’t great. We are days away from the Thanksgiving long weekend. There is a lot of confusion about what the best guidance is for hosting events or travelling to see family (shortly after I wrote this column, the premier gave a press conference that was so confusing and convoluted that he had to clarify his position on Twitter; I could have told him in advance that talking to your wife is always good advice). And after Thanksgiving is done, Halloween is just around the corner. And then Christmas.
Christmas, at least, seems far enough away that we’ll hopefully have some guidance in place that is clear, evidence-based, and generally understood by the public at large. Thanksgiving is obviously going to be a complete shot in the dark. Halloween is marginal — maybe by then we’ll have enough data via the new testing protocols to make a good, informed decision. But until then, this entire saga feels lot like the early days of the first wave. We’re flying blind, but without much in the way of excuses this time. Everyone was caught by surprise before. What’s our excuse now?
I think of my friend again — the mom of two, who’s symptomatic and has both kids home from school, trying to get test results from a broken website. I think of how many others just like her live in this province. I wonder how many people are reluctant to venture out to get a test or see a doctor because of all the reports about dysfunction. How many of them will end up getting sick with something that’s not related to COVID-19 at all? The sickest I’ve ever been as an adult was about seven years ago. My daughter had brought home some bug from daycare, and, buried by deadlines and assignments, I loaded myself up on over-the-counter cold medication and kept on working (from home, thank God, at least). What I assured myself was just an irritating little virus turned out to be a streptococcal infection that I ignored just long enough for it to become a major problem. I was flattened for three weeks as it bounced from my ears to my throat to my chest.
I promised myself then that I’d be smarter and see a doctor when in doubt, but hearing about all the dysfunction now, if I had the same symptoms, I really don’t know whether I’d rush out to an appointment.
Public confidence is a fragile thing. Ford came through the first wave with his poll numbers — a useful proxy for confidence — reasonably intact. But a second wave is here. And the public may not prove as forgiving this time.