Most experts agree that without more and more widespread testing, it would be difficult for the country to return to normal while avoiding the threat of another major epidemic.
Those who decide when and how to open the economy need to better understand the spread of the virus community. It is not something they currently have in provinces where testing is limited to specific categories of people.
“We don’t have enough information to be able to make these decisions on a solid basis,” said Dr. Camille Lemieux, medical manager of the COVID-19 assessment center at the University Health Network in Toronto – who had to turn people symptomatic left because they were not sick enough to be hospitalized, which means they were not eligible for testing under Ontario’s restrictive rules.
“It’s like having an arm tied behind your back,” she said.
Provinces decide who will be tested
Experts warn that provinces that do not increase testing rates will face a brutal choice between delaying a return to normal and choosing to ease restrictions while risking a runaway epidemic.
The federal and provincial governments collaborated in carrying out the tests, but it is ultimately up to the provinces to decide who will be tested and how the data will be collected.
Ontario, for example, screens people who are sick enough to be admitted to hospital, long-term care residents, health care workers, Aboriginal people and those who live in remote locations.
Quebec also gives priority to those who live and work in long-term care facilities, essential health and public safety workers and people who live in at-risk environments, such as homeless shelters. .
Until recently, Manitoba had such narrow criteria when it expanded to include workers in all essential services.
Alberta, on the other hand, provides tests for coughs, fever, shortness of breath, runny nose and sore throat to anyone with symptoms of the virus.
Testing is the key to reopening the economy
A senior federal government official familiar with the matter said that the provinces “become territorial” with respect to their jurisdiction over the provision of health care.
Prime Minister Justin Trudeau was asked last Friday what level of testing Canada needs to reopen the economy.
“We have to keep increasing our testing capacity. We need to better coordinate our testing methods and approaches across the provinces so that we have a better picture of exactly what’s going on, “said Trudeau.
The federal government has been instrumental in providing testing supplies for the provinces, which have faced a shortage of key items such as swabs and reagents. Trudeau recently announced that Canada now has a domestic producer of the necessary reagent.
And Health Canada has accelerated its approval process for new tests, including a promising new rapid coronavirus test.
“Normally it takes a long time to get approvals and one of the best things we have seen with COVID is the rapid acceleration of approvals,” said Christine Nielsen, CEO, Canadian Society for Medical Laboratory Science, the certification body for medical laboratory technologists.
Search for “labor-intensive” contacts
She said the process of validating new tests – comparing their results with other precision tests – has also accelerated, as have the validations of new laboratories to process the tests.
Scientists say they hope an accurate and rapid blood test will eventually be developed to look for COVID-19 antibodies – helping to identify people who have had the virus (even if they were never tested when it had) and determine if these people are now immune, at least in the short term.
Health officials say Ottawa can also help bring together the large number of people needed to do contact tracing. The government recently launched a call for volunteers; more than 36,000 have applied so far, although it is unclear whether any of them have started working with the provinces on contact tracing.
“Imagine a virus that takes 14 days, where you can be contagious or not. I mean, tracking this phenomenon is really painstaking, “said Dawn Bowdish, Canada Research Chair in Aging and Immunity at McMaster University.
“And so, we couldn’t do the level of testing for the virus that we would have liked to do. “
Part of the challenge is that the federal government does not have the power to set enforceable national standards on who should be tested, or whether the list of test criteria should now be expanded.
Need for national standards
Some experts believe that Ottawa could at least provide more forceful advice on this matter.
“I would give the federal government the power to prescribe standards after consultation with provincial health departments,” said Amir Attaran, who teaches at the law school and at the university’s school of epidemiology and public health. of Ottawa.
Attaran and other University of Ottawa researchers have reviewed online self-assessment tools provided by the provinces and found no consistent approach to who should be screened – or even on a symptom list which indicate a possible infection.
“What will change the situation right now would be complete data on where the epidemic is, because we are fighting a war and the generals need to know where the battles are going on,” he said. “They need to know where the cases are … They don’t know it.” “
Ontario the “laggard”
Government officials say Federal Minister of Health Patty Hajdu and federal leaders in public health are continuously contacting provincial ministers for assistance.
” [The provinces] need to raise your hand, “said the senior federal official. ” If the [testing] the numbers are not increasing, there will be more conversations. ”
“It is a challenge for us. We have the financial resources and the human capacity, but they have the jurisdiction. “
Ontario – which has the lowest testing rate per 100,000 in the country and is not testing to its full capacity, according to Premier Doug Ford – is clearly the “laggard”, said the federal official.
There are wide variations in test rates across all provinces, but federal officials say Alberta and British Columbia are the undisputed leaders in testing. All provinces have promised to step up testing.
Alberta, for example, aims to test 20,000 people a day by the end of May, while Ontario wants to test 16,000 a day in early May.
Dr. Theresa Tam, Canada’s chief public health officer, said Monday that she expects more testing.
“We are working closely with each province and it is their collective goal to increase testing in Canada,” she said at a press conference.