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Ontario needs to 'massively scale up' testing with 2nd wave of COVID-19 almost inevitable, experts say

Ontario needs to drastically ramp up testing for COVID-19 as it inches closer to a full reopening of its economy with a second wave of the virus virtually inevitable, some experts warn.

Surge in infections 'very likely' as economy reopens, says one expert; others say reopening happening too soon

As Ontario and indeed Canada begin reopening, the need for increased testing is paramount, experts say. B.C.'s top doctor Bonnie Henry pointed out Thursday there has never been a pandemic in recorded history that hasn't had a second wave. (Craig Chivers/CBC)

Ontario needs to drastically ramp up testing for COVID-19 as it inches closer to a full reopening of its economy with a second wave of the virus virtually inevitable, some experts warn.

After about three weeks of new infections seemingly trending downward, the past week has seen a steady increase in its five-day rolling average. The statistic, which helps smooth spikes and dips in data to provide a clearer picture of trends, bottomed out at 328 on May 12 but has been rising since then, and currently sits at 410.

"As we try to get our economy back on its feet, we are very, very likely to experience surges in disease," said infectious disease physician Dr. David Fisman, adding his team believes Toronto is already experiencing one now.  

On May 10, Ontario saw its lowest number of newly confirmed cases since the end of March. But by Thursday, the province reported 413  new cases.

At the same time, it failed to meet its testing target for the fourth consecutive day, processing just 10,506 tests — considerably fewer than both Ford's stated goal of 20,000 tests per day and the province's previous target of 16,000.

"COVID's proven itself to be a very slippery foe and you can't fight an enemy that you can't see," said Fisman, also a professor of epidemiology at the University of Toronto's Dalla Lana School of Public Health. 

Ontario 'a tremendous laggard' on testing

"You do need to massively scale up testing in Ontario and in Canada ... Alberta has been spectacular, B.C. hasn't had testing issues, Saskatchewan now has enough test capacity that they're saying, 'Come on in and get a test if you want one,"' Fisman said.

"I think Ontario has been a tremendous laggard." 

WATCH | Health Minister Christine Elliot on easing and tightening restrictions in Ontario:

Factors behind further easing, or tightening, of restrictions in Ontario

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9 months ago
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Health Minister Christine Elliott says there are four key considerations when opening up, or further restricting, activity in Ontario. 1:42

But as Ontario and indeed Canada begin reopening, the need for increased testing is paramount, Fisman and others say.

On Thursday, B.C.'s top doctor Bonnie Henry pointed out there has never been a pandemic in recorded history that hasn't had a second wave. Having successfully flattened its curve, B.C. this week moved to reopen many businesses and public spaces, with Henry saying now is the time to "regroup, learn" and crucially, "prepare."

Premier Doug Ford fielded pointed questions about the province's testing struggles in his daily briefing Thursday, and pledged to improve the system.

"That's what I want and I'm confident it's going to happen," he said. "Believe me, it's frustrating." 

In addition to expanded testing, Ford also said he wants to introduce more random testing, which he said will give the province a more accurate account of COVID-19's presence in Ontario. He listed truckers, taxi drivers, auto workers and food-supply workers as people in critical industries in need of more thorough testing.

Ford did not provide a timeline as to when expanded testing or more random testing will begin.

Uptick not related to reopening: health minister

The province recently amended its testing criteria to allow anyone with symptoms to be tested, instead of leaving the decision to test to individual doctors' discretion. The move followed widespread reports of people being turned away from assessment centres.

Ontario's Minister of Health Christine Elliott has said the uptick in new coronavirus cases isn't because of the province beginning to reopen. 

There's no question that we should be maintaining physical distancing between households.- Dr. Colin Furness

"We will be watching this very closely where we'll be seeing the effect on public health as a result of Stage 1 and that will influence where we go from there," she said Thursday.

But for Dr. Colin Furness, an infection control epidemiologist and a professor with University of Toronto Faculty of Information, the province's reopening has been too much, too soon. 

Furness points out Ontario is still doubling its infections approximately every 30 days.

He also says inconsistencies in the rules, like being able to have a domestic helper in your home but not, say, a family member who lives in another household, sends the wrong message.

"It feels like a blunder," he told CBC News. "There's no question that we should be maintaining physical distancing between households. We're not ready to do otherwise."

Ontario should support regional reopening: epidemiologist

Furness also cautions that Ontario should reconsider the possibility of allowing certain areas to reopen while keeping others relatively locked down, as Quebec has done with hard-hit Montreal.

"The Greater Toronto Area should not hold back all of Northern Ontario. By the same token, opening up… would be putting Toronto at great risk. The premier has ruled out multiple timetables and I think that's foolish," Furness said.

The Toronto area — including the regions of York, Durham, Peel and Halton — have accounted for more than 60 per cent of Ontario's novel coronavirus cases. 

The City of Mississauga in Peel Region, for its part, has said it will take a "made in Mississauga approach" to reopening based on the advice of its medical officer of health.

"We also know that community spread is still happening here in Peel and that our numbers right now in terms of new cases simply don't support a broader reopening," said Mayor Bonnie Crombie in a news release Wednesday. 

Ontario's Chief Medical Officer of Health Dr. David Williams has said the decision to allow retailers to reopen does not mean that they must do so, and drew a distinction Thursday between loosening economic restrictions and public health measures such as social distancing. 

But Fisman says the province will have to be prepared to tighten up more than once as the pandemic progresses. He says while Ontario has increased capacity in some respects, such as adding 1,000 additional ICU beds, the next several months will require a a much more comprehensive approach.

"It's going to have to be a combination of public health measures, common sense, good surveillance and building capacity as much as possible until a vaccine is available." 

With files from Mike Crawley, Lisa Xing

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