Without more efficient testing, none of this is going to work

OPINION: COVID-19 cases are up, and Ontario’s testing system is faltering. That’s a recipe for only one thing: another lockdown
By Matt Gurney - Published on Oct 02, 2020
Premier Doug Ford said at a press briefing on Friday that Ontario will be revising its criteria for testing. (YouTube)

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If Ontario’s testing capacity becomes overwhelmed, we’re in deep trouble.

That’s it. That’s the lede.

Since my editor would likely object to my column being that short (though it would be easy to edit), I’ll add a bit more: Ontario’s testing backlog, as of Friday, has surpassed 90,000. Assuming we stopped all testing, it would take about two days to clear the tests that have already been performed but haven’t yet been processed. But stopping those tests would blow a gigantic hole in our awareness of COVID-19’s spread. And, yet, if we don’t eliminate the backlog, we’ll end up losing that awareness, anyway — the only thing worse than no information is dated, incomplete information. We’re in deep trouble in either scenario.

So I say again: if our testing capacity becomes overwhelmed, we’re in deep trouble.

Testing is our early-warning system. We can’t effectively fight COVID-19 if we don’t know where it is and what it’s doing. Relatively rapid testing, in bulk, is the only way we can monitor the virus in something close to real time. Faster tests, including some approved by the federal government for use in Canada this week, will be helpful. But we don’t have a good timeline on when those tests will be in use. For now, as the second wave continues —  it seems to be accelerating, if anything — Ontario faces a bleak scenario for this month: rapidly rising cases in the major cities, clear migration of cases from younger populations into older ones, steadily rising hospitalization rates, and a testing system that is less and less able to provide meaningful information on the virus’s transmission through the public.

That’s a recipe for only one thing: another lockdown. Perhaps a regional one. But even making that call would require solid testing so that public-health officials could get a sense of the geographic breadth of the second wave. Make no mistake: the only thing between us and another awfully long time inside is an effective testing system.

Is the scenario above certain? No. But it’s looking more and more probable. As recently as a few weeks ago, I was telling everyone who’d listen that, although I cautious and well aware of the downside risk, I was mildly optimistic that we’d manage the second wave effectively. Looking at the numbers as they stand today, with the testing centres already overwhelmed, that optimism is an increasingly expensive luxury. Soon it might not be affordable at all.

Doug Ford and other officials seem to grasp the danger, at least in a general sense. At a press briefing on Friday, the premier and others all took turns explaining that Ontario would be revising (again) its criteria for testing. All testing will now be by appointment, a move the premier said was intended to keep people out of increasingly unpredictable fall weather as they line up for hours for tests. But switching to appointments also allows the government to “throttle” the testing, for lack of a better term. The number of appointments given can be scaled to the province’s current testing capacity. Making it by appointment also allows for  — in theory, at least; it will be tricky in practice — the weeding out of people who don’t really need a test. The province has also adjusted criteria for when children are permitted back into school, reducing the number who’ll require a negative test before being allowed to return to the classroom.

That topic really ought to be a column on its own — indeed, before Friday’s announcement by Ford and his team, that was going to be this column. Suffice it to say that the state of communication between the province’s top health authorities, school boards, principals, teachers, and parents cannot be described in any term that’s fit to print. It’s a disaster. I’m not only a parent of school-aged children; I’m also married to an elementary-school teacher. And no one — no one — that I’ve talked to seems to have the slightest clue what to do or believe. The latest communication from my childrens’ school, for the first time, carried a real note of exasperation. We were told that the provincial guidelines had been changed but that Toronto’s hadn’t yet been, and we were asked to stick with the Toronto ones until they could be updated and that update communicated to us.

I had to laugh. It wasn’t funny, of course, but what else can I do?

A friend of mine is a mother of two. 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 this week; they are waiting for results and have been for days. As Ford’s press conference was continuing, she texted me, lamenting the fact that the result she is waiting for is probably part of the 90,000-some-odd that are backlogged. Her language would also be unprintable, but she made the point succinctly and forcefully: without testing, none of this — none of this — is going to work.

She’s right. But, right now, it’s clearly not working. The modest reductions in social circles and indoor-facility capacity Ford announced today won’t make much difference. If we’re to avoid another lockdown, the testing system has to work — and work well. Right now, it’s not working.

And given how quickly COVID-19 seems to be spreading, we don’t have much time to fix this.

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