Ontario's new pandemic strategy risks 'out of control' transmission, epidemiologists warn

Two Ontario epidemiologists are warning that recent changes to the province's COVID-19 pandemic strategy risk uncontrolled transmission of the virus, while at the same time, limiting the ability to measure its spread.

Province restricting testing, shortening isolation period, opening schools amid exponential growth

PCR testing will no longer be available to the broader public in Ontario, after the province changed its testing strategy in response to a surge in cases of the Omicron variant that was straining resources. One epidemiologist says the move amounts to 'turn[ing] out the lights in the room and leav[ing] everyone in the dark.' (Evan Mitsui/CBC)

Two Ontario epidemiologists are warning that recent changes to the province's COVID-19 pandemic strategy risk uncontrolled transmission of the virus, while at the same time, limiting the ability to measure its spread.

Raywat Deonandan, epidemiologist and associate professor at the University of Ottawa, and Colin Furness, infection control epidemiologist and assistant professor at the University of Toronto, both say they aren't convinced the province's new approach will be able to protect Ontarians and the broader health system from the impact of a surge of the highly-infectious Omicron variant.

"There seems to be an acceptance that transmission will be out of control the next few weeks and maybe there is a silent hope that unrestrained transmission might result in sufficient immunity in the population without much cost," said Deonandan.

"I think that's a dangerous way of thinking, if indeed that is what they're thinking."

"I feel abandoned by the province. I feel that kids and teachers have been abandoned," Furness added. "We're set up to be mass infected over the next several days, and we don't have the health supports in order to be able to deal with that."

The criticism comes after Ontario announced Thursday a major shift in its approach to testing and isolation, as well as a two-day delay in the return of schools in response to an unprecedented increase in cases. The province has set successive records for daily COVID-19 cases in the past week, with the latest — 16,713 new infections — reported Friday morning, New Year's Eve.

Early research suggests Omicron may cause milder illnesses than earlier versions of the coronavirus. Still, experts have warned that the sheer number of people becoming infected — and therefore having to isolate or quarantine — could overwhelm hospitals and threaten the ability of businesses to stay open.

The province's announcement didn't include any new restrictions on gatherings, beyond a limiting capacity at large indoor venues.

LISTEN | Chief Medical Officer of Health, Dr. Kieran Moore, explains the province's plan for testing, schools:

The province has announced major changes to its pandemic strategy, in the face of surging Omicron cases. Ontario is restricting access to COVID testing and cutting the minimum isolation period to just five days for people who are vaccinated. School, meanwhile, will resume in-person on Wednesday, two days later than planned. The changes come as record-breaking COVID numbers strain public health resources. Dr. Kieran Moore, Ontario's Chief Medical Officer of Health, explains why.

A shift in testing

As of Friday, publicly-funded PCR testing will only be available for high risk individuals. People with symptoms are being told to assume they are infected and self-isolate.

The change will greatly reduce the significance of new daily case counts as a measure of community spread, and Furness equated the move to "turn[ing] out the lights in the room and leav[ing] everyone in the dark."

Speaking on CBC Radio's Metro Morning Friday, Dr. Kieran Moore, Ontario's chief medical officer of health, said the province needs to preserve its testing resources for those at highest risk of severe illness. He said the province will be closely monitoring other metrics, including hospital admissions, ICU capacity, deaths and long-term care home outbreaks.

"The most important metric is — and our goal as a society has always been — to protect our health system so that we can provide the right care at the right place, at the right time for all Ontarians," Moore said. "At present, we have good ICU capacity."

WATCH | Ontario announces changes to PCR testing:

Ontario’s Chief Medical Officer of Health announces changes to PCR testing

11 months ago
Duration 0:59
Starting Dec. 31, publicly-funded PCR testing in Ontario will only be available for high-risk individuals who are symptomatic or who are at risk of severe illness from COVID-19. Chief Medical Officer of Health Dr. Kieran Moore announced the changes during a press conference Thursday.

Inside schools, Moore said absenteeism will replace positive tests as a measurement for COVID-19 prevalence when classes resume on Jan. 5. 

Furness called that the most "confusing" and "baffling" part of the province's plan.

"I guess we ask our kids every day: Was someone missing from your class today? If so, be afraid," Furness said. "That's not contact tracing."

In letters to Toronto Public Health and Peel Public Health, Furness asked the local health units to delay the reopening of schools for 13 school days, which he said would help spread out the number of new infections and allow more time for teachers and students to get vaccinated.

The province says the two-day delay will allow it to provide N95 masks for school and child care staff and deploy an additional 3,000 standalone HEPA filter units to school boards.

Infection control epidemiologist Colin Furness says the return of schools should be delayed for 13 school days, not two, to provide more time for teachers and students to get vaccinated. (Dale Molnar/CBC)

On Friday evening, the Ontario NDP issued a statement calling on the Ford government to reverse the changes it's making to testing and contact tracing.

"Parents have to decide to send their kids to school not knowing if the school has a high number of COVID cases," said NDP education critic Marit Stiles. "If we can't track where the virus is, we can't fight it."

Shortening self-isolation

On top of the changes to PCR testing, the required self-isolation period for people sick with COVID-19 has been reduced to five days from 10 for the fully vaccinated and children under the age of 12. 

The province says the shortened isolation requirement is based on research showing that generally healthy people with COVID-19 are most infectious for the two days before and three days after symptoms develop.

"If we stay home for those five days, that's almost 90 percent of the viral shedding that risk is gone," Moore said.

Raywat Deonandan, an epidemiologist and an associate professor at the University of Ottawa, says the province needs to implement more 'mitigation tools' to prevent hospitals from being overwhelmed. (Trevor Pritchard/CBC)

Ontario's decision to loosen isolation restrictions follows one by the U.S. Centers for Disease Control and Prevention. Other provinces, including Alberta, B.C., Saskatchewan, and New Brunswick have adopted a similar approach.

But Deonandan said the isolation changes are risky because they are based on an average — and they could lead to infectious people mingling with healthy ones.

"Some can be infectious for three days, some for 12 days or longer," he said. 

"The concerning part is that we have people who are re-entering society with suspected infection and infectiousness without a negative test to clear them."

Deonandan said rapid tests could be deployed strategically so that people can test themselves out of isolation.


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