Why is Canada not testing everyone for coronavirus?


When did Canada’s coronavirus tests derail?

The first indications were evident on January 24, the day after the closure of Wuhan, in China.

“We are ready, we are ready. “

These are the confident words of Dr. David Williams, Ontario’s chief medical officer of health, at a press conference 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 have this. After all, Ontario had survived SARS.

“My friends, it will always be as usual,” said Peter Donnelly, Chief of Public Health Ontario, during the same briefing.

One of the testing machines at the Ontario Public Health Laboratory that operated at full capacity to test samples from COVID-19 patients. (Craig Chivers / CBC)

Through the relentless slowness of the retreat, they could not have been more wrong.

It is now brutally clear that SARS was just a warm-up – that about as many Canadians would die in the first weeks of this pandemic as in the entire SARS epidemic.

And a critical weapon in the battle, laboratory testing, became stuck in the early days.

A week after the province closed schools, shops and banned large gatherings, many laboratories were overwhelmed.

On the first weekend, Ontario had a over 7,200 tests backlog. BEFORE CHRIST. also reported a backlog, as did Alberta, Quebec and Manitoba.

Almost immediately, the provinces started restricting who could be tested – limit it to front-line health workers, people with severe symptoms and those who work with vulnerable groups.

Over the past week, arrears have disappeared, but testing restrictions remain in most parts of Canada.

Laboratory staff at the Ontario Public Health Laboratory worked long hours for weeks trying to meet the demand for COVID-19 tests. (Craig Chivers / CBC)

And the hard truth testing will continue to be limited, even in Ontario, which has just announced that it will soon be able to test 19,000 people a day.

“Even if we do 19,000 tests a day, we won’t be able to test everyone and it would be the same in all other jurisdictions,” said Vanessa Allen, chief of medical microbiology at Public Health Ontario, the agency government. responsible for provincial laboratories.

Ontario Solves Problem And Creates Another

Just as the backlog has been resolved, a new and equally frustrating problem has arisen. Media reports on Tuesday said the Ontario detection rate was dropping to just over 2,500 per day, but the province said it could perform about 13,000.

Why isn’t Ontario testing more?

The province has created a new network of clinical laboratories in the middle of the pandemic – like building a bigger boat in the middle of the ocean in a hurricane.

The Department of Health has asked the accounting firm KPMG to organize all laboratories in the province that are capable of performing microbial tests. This includes 10 hospital networks, six public health laboratories and three private laboratory networks.

When combined, they can perform 13,000 tests a day and hope to reach 19,000 in three weeks.

But this additional capacity was created suddenly, which means that there were not enough patient samples awaiting testing, as testing restrictions are still in place.

A panel of experts is working on new recommendations on test subjects and Premier Doug Ford is calling for more testing in long-term care homes and other vulnerable people.

Meanwhile, frightened patients like Nick Marceau of Toronto cannot be tested, even though his doctor suspects he has COVID-19.

Dr. Kevin Katz is the medical director of laboratory tests at six hospitals in Toronto. Katz started stocking COVID-19 test supplies in early February, preparing for the worst. (North York General Hospital)

“It’s frustrating for … someone who lives alone when faced with this,” said 38-year-old Marceau.

Marceau is not eligible for a test because he has not traveled, is not in a high-risk group, and his symptoms are not severe enough to send him to the hospital .

“It has been determined to be a surveillance situation,” he said.

“Completely unmatched”

Why test such a big problem?

The answer is simple: the COVID-19 tsunami caught almost everyone by surprise.

“Everyone is preparing for the same tests and everyone is fighting over the same reagents,” said Allen, referring to the chemicals needed for the tests. “This is not an Ontario problem, it is an international problem. “

“The demand for this test is completely unmatched. “

The low rate is frustrating for epidemiologists trying to create models of the disease, which politicians use to support their decisions. (Nova Scotia Health Authority)

Two months ago, Dr. Kevin Katz felt uneasy about what could be going to him.

He is an infectious disease specialist who manages the analytical laboratories of several Toronto hospitals, including North York General, Sunnybrook and Michael Garron.

“As soon as I thought it was going to be a pandemic, I had concerns about the supply chain,” he said. The announcement was based on more than a decade of pandemic planning.

During the first week of February, he quietly started to stock up on reagents. A few weeks later, he ordered more, along with the materials needed to extract the genetic material from the virus and additional test material.

“We were quite aggressive. We ordered and asked to take delivery the next day. We wanted everything to be delivered physically, so we have pallets scattered around the laboratory, ”he said.

One of the consequences of the low level of testing in Canada is that no one has a clear idea of ​​the scale of the epidemic in this country.

“Right now, we almost certainly only see the most serious cases,” said Ashleigh Tuite, epidemiologist at the University of Toronto.

The low rate is frustrating for Tuite and other epidemiologists who are trying to create models of the disease, which politicians use to support their decisions.

Ideally, with sufficient capacity, Tuite believes there would be no restrictions on testing. Currently, model reliability is affected by underreporting of cases.

“Until we have a constant number of tests in the population, I think it’s hard for me to say that I have confidence in these projections,” said Tuite.


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