'Frustrated' Doug Ford brings in troubleshooter to ramp up Ontario’s COVID-19 response
A troubleshooter has been brought in to help Ontario's public health officials manage the COVID-19 pandemic with a "frustrated" Premier Doug Ford going public over concerns the province's testing regime is falling short, the Star has learned.
Sources said former Toronto public health chief Dr. David McKeown came aboard last week to lead a table of experts reviewing and scrutinizing major public health measures to fight the new coronavirus that has infected more than 5,000 Ontarians and killed more than 200.
In a brief interview with the Star on Wednesday, McKeown downplayed the importance of his role, although health sector sources said that's how it was described during an April 2 conference call hosted by the Ministry of Health.
"I've just been brought in to give some assistance at the ministry and the chief (medical officer of health's) office. That's all I'm going to say for now," said McKeown, an adjunct professor at the University of Toronto's Dalla Lana School of Public Health.
A spokesman for Health Minister Christine Elliott confirmed McKeown has joined the effort. "This isn't a time for egos in sandboxes. This is a time for the best and brightest to come together," Travis Kann told the Star.
McKeown, who left the city job in 2016, was praised as a "steady hand" at city hall, where former councillor Joe Mihevc described him as "a progressive scientist who knows where things need to go."
Ford sounded off on the province's relative lack of testing - using just a quarter of its lab capacity since a testing backlog was cleared on Friday - and ordered health officials to do better.
"My patience has worn thin," Ford said, calling the failure to take advantage of the province's full testing capacity "absolutely unacceptable."
Ontario can now process 13,000 samples a day. Health experts have been calling for it to be used and expanded to get a more accurate sense of how and where the virus is spreading, including in prisons, homeless shelters and health-care institutions, as well as among first responders and even grocery store workers.
The number of COVID-19 tests completed in Ontario has fallen sharply over the last eight days, from more than 6,000 tests on April 1 to a recent low of just 2,568 on Tuesday.
Despite the decline, the tests that are being completed are returning positive results much more often than at the beginning of Ontario's epidemic, a telling sign of growing infection levels. Overall, the province has tested nearly 85,000 people, among whom it has found 5,276 confirmed COVID-19 cases, a positive test rate of 6.2 per cent. That rate has risen to 11.1 per cent for tests completed since April 1. Wednesday was the second day in a row to hit a record positive rate, at 16.9 per cent.
"We need to start doing 13,000 every single day," Ford said, noting he has spoken to Ontario Health chief executive Matt Anderson about the problem, which has also been highlighted in a series of Star stories.
"I've made myself loud and clear to the table," he said of the panel of public health experts regularly discussing pandemic measures.
"I've been following the advice of our chief medical officer " but we need to increase testing. Let's come up with solutions, not excuses."
Chief medical officer Dr. David Williams, who has been saying for days that the health ministry is developing a protocol for increased testing, pushed back at a suggestion officials have been upbraided.
"I didn't see it as taking (us) to the woodshed, myself," he told reporters later.
"We were working on it and when the premier joined our command thing to make some comments and ask some questions, it was right along the line of what we were doing. It's nice when you're exactly on the same direction as the premier."
Williams warned that "testing for the sake of testing" in the general population is ineffective. He said it must be targeted to people in places such as to long-term care homes, where hundreds of residents and workers are already infected in almost 60 outbreaks that have accounted for about half of Ontario's fatalities.
The new directive on testing is expected Friday, a health ministry source told the Star.
While Ford said he was not threatening officials, he warned, "I'm going to be on this like a dog on a bone."
On a per-capita basis Ontario is testing at a lower rate than several other provinces. The World Health Organization says a positive rate of 10 per cent is a "general benchmark" of a system that is catching most COVID-19 cases, but sampling more people will give a better picture of the epidemic.
Dr. Anna Banerji, a professor at the Dalla Lana School of Public Health, said Ontario's testing capacity should be focused on people who are out in the community and at a higher risk of acquiring the virus and spreading it, such as grocery store workers, health-care workers, as well as those who work in long-term care homes and the essential services.
"All of them need to be checked," she said, noting the actual number of people who have been infected is "many, many times higher than the actual tests that are positive" because of the number of people with mild symptoms who haven't and won't be tested.
Ford's comments were "spot on" but more testing should have been done "weeks ago," said Dr. Isaac Bogoch, an infectious disease expert at the Toronto General Hospital Research Institute.
He cautioned it's unrealistic to expect testing to ramp up to 13,000 in a single day, as Ford is pushing for starting Thursday.
"Right now we don't have the best idea as to how much this is impacting in Ontario," Bogoch added. "The criteria for testing needs to open so you shouldn't be turning people away."
Confusion remained over testing Wednesday, with one Toronto resident who fell ill last week telling the Star she contacted a testing centre Wednesday because of continuing symptoms and was told to come in - but was refused a test when she arrived because she was not a front-line worker.
"I'm going back to bed," said the woman, who requested anonymity.
While Ontario will never have the capacity to test all 14 million of its residents, there is no time to waste in testing as many people as possible, said Kevin Smith, the CEO of Toronto's University Health Network, which shares a testing lab with the Sinai Health System.
"None of us want to say, 'I wish we had done this when we had the chance.'"
Rob Ferguson is a Toronto-based reporter covering Ontario politics. Follow him on Twitter: @robferguson1
Ed Tubb is an assignment editor and a contributor focused on crime and justice. He is based in Toronto. Follow him on Twitter: @edtubb
Kenyon Wallace is a Toronto-based investigative reporter. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca