Will you be tested for COVID-19? That depends on where you live
Assessment centres in several parts of the province are denying COVID-19 tests to some people who say they meet the criteria, even as the premier says his "patience has run thin" that the province is not testing to its capacity of 13,000 tests per day and that we should be testing "everyone possible."
Hayley Chazan, spokesperson for Health Minister Christine Elliott, meanwhile, told the Star there is no plan for "widespread testing." That, she said, would only cause a new round of lab test backlogs.
It's the kind of mixed messaging that's led to confusion and concern for people including 21-year-old Caleigh Fera.
Fera, an Oakville resident who developed a fever with a sore throat and cough, was referred for testing by Halton Public Health on Thursday. But when she arrived at the assessment centre at her local hospital, she was told she wouldn't be tested.
"What worried me was the shortness of breath and chest pain," said Fera, a student at Sheridan College's program for technical production for the performing arts.
The province announced Wednesday that it was scaling up its testing to include more at-risk groups, including new admissions to retirement homes or nursing homes, as well as residents of those facilities who have symptoms. The new guidelines also include symptomatic health-care workers and front-line responders, according to a release from the health ministry that outlined the expanded testing guidelines.
But the province also said that where there were limited testing resources, as there have been at times since the start of the pandemic, priority should be given to people who had been referred for testing by individual public health units.
The guidelines appear to include Fera. She figured she was a prime candidate for testing, not only because she was presenting symptoms but also because she had several underlying health conditions - a heart murmur that requires close monitoring, as well as respiratory issues.
Dr. Neil Rau, medical microbiologist and infectious diseases specialist at Halton Healthcare, said the testing criteria continues to evolve as the availability of testing expands in Ontario.
He did not comment specifically about Fera's case.
"When Ontario ran into a problem of limited testing availability and long turnaround times, in consultation with Halton Region, our hospital limited testing to those who work with the most vulnerable people, such as health-care workers or those who work in long-term care who might unwittingly spread the virus to vulnerable people," he said.
A Star survey of testing policies at individual public health units also reveals a variety of different criteria for who is eligible for testing, leaving some to wonder what they're supposed to do if they think they have the virus.
Public health units such as Chatham-Kent said their criteria included travellers who have been to an affected area and had symptoms, as well as people who had been in contact with a probable or confirmed case.
And the William Osler Health System, which operates assessment centres in Brampton and Etobicoke, says online that it tests people who have mild symptoms of an upper respiratory tract infection or flu-like illness in combination with a number of factors, including if they are over 60, immunocompromised or have been referred by public health due to contact with a confirmed or probable case.
The province has said before that there is a global shortage of testing kits. Chazan, the health minister's spokeswoman, said Thursday there were no critical shortages at any of the province's assessment centres, which are being run by hospitals.
And Dr. Barbara Yaffe, associate chief medical officer of health for Ontario, said "currently we're not short of any testing materials. Now, that may not stay that way forever, but that is currently the situation."
But Toronto's public health unit said it is limiting testing to people who may spread the virus to large groups. When asked why, Dr. Vinita Dubey said in an email that "the prioritization of certain groups is occurring now as there is a shortage of testing kits (swabs) across the province."
Lambton County Public Health also said it follows the provincial criteria, but that it may be "applied differently depending on the setting and the availability of swabs."
So while the premier is advocating more testing, it doesn't look like the province is planning to adopt the kind of widespread testing that has slowed the spread of the virus in countries such as South Korea, or even closer to home, in Alberta.
The Western province is testing many of the same at-risk groups as Ontario and this week broadened the criteria to include anyone 65 and older with possible symptoms.
Dr. David Williams, the province's chief medical officer of health, said Thursday that "no country does general population surveys at this time."
Typically, countries track the spread of viruses such as the flu using the Sentinel system. Physicians will swab patients who exhibit symptoms and send the swabs in for testing. Those tests serve as a baseline to estimate how prevalent the virus is in the wider population.
Williams said there's no plan to expand tests broadly while the province is still using conventional lab testing, known as PCR, which is more cumbersome than some of the new technology that's coming on the market.
"We haven't planned to do a population survey with the PCR at this stage but it doesn't mean that we won't consider something in the future as we get more technology around doing population surveys of exposure to the coronavirus," he said.
Not all epidemiologists interviewed by the Star agree with that premise and some say wider testing is needed in the general population, especially due to the fact that 30 per cent of COVID-19 cases are asymptomatic.
On Thursday, when asked if Toronto was close to flattening the curve of infections, Dr. Eileen de Villa, the city's top public health officer, said that's difficult to know without more testing.
"One of our challenges ... is that unless you get to a point where you have a lot of testing, trying to get to make an assessment as to what is happening in the city of Toronto, premised on the existing numbers and the case counts and the information that we have in front of us, only gives us a partial picture," de Villa said.
Based on information from other cities, "we are not quite there yet," in terms of peak number of infections, she said. "It's not always easy to see that you're beyond the peak, or at the peak, until you're (further) beyond it.
"To the extent that we can get more testing, that helps not only to inform the response, but it also helps to inform us as public health practitioners around where we believe we are on this epidemic curve and what actions we might then take."
With files from David Rider