Private schools, large firms won big in Ontario’s rapid testing program, while hot spots lost out, Star analysis finds

When Ontario launched its rapid testing program in the fall of 2020, Premier Doug Ford touted the swabs as game changers" in the pandemic battle. As infections ripped through front-line workers in hard-hit areas like Brampton and Toronto's northwest corner, the province hailed the initiative as a vital tool to stem the tide.

Over the next 10 months, however, just one-fifth of the 20.7 million taxpayer-funded COVID-19 rapid tests distributed through the program went to hot spot neighbourhoods, according to provincial data obtained by the Star and never before seen by the public.

And while the province got rapid tests to some crowded workplaces and areas of high transmission at this crucial time when vaccines were only just rolling out, the internal data show that only a fraction of the tests went to communities the province designated internally as high priority."

Meanwhile, the government gave private schools almost 175,000 free rapid tests - more than went to paramedics, daycares, shelters and jails combined, a Star analysis of the data reveals. The pipeline to private schools was not being closely monitored by the Education Ministry, which was still advising that the tests were not necessary for public school students on the recommendation of Ontario's chief medical officer of health.

The records reveal the province's strategy failed to prioritize the most vulnerable while benefiting those with resources, knowledge or connections.

The province left it up to individual organizations to access a vital public health tool, foreshadowing the free-for-all scramble that extended beyond workplaces and engulfed all Ontarians when Omicron hit in late 2021.

This is a lack of co-ordination that results from a retreat from responsibility," said Prachi Srivastava, a Western University professor whose research has underscored the disproportionate impact of COVID on schools in marginalized neighbourhoods.

When it's first-come, first-served,' usually the organizations that come first are the ones that are better networked ... it's not going to be uniformly distributed."

With COVID surging again, rapid tests are now the only tool for most people to identify cases. But today, complaints about inequitable access persist.

While millions of screening kits flowed to essential workplaces that remained open work under lockdown regulations, some companies were big winners in the program's first 10 months.

Linamar, a Guelph-based auto parts maker, received more than 100,000 rapid tests from the province, almost a fifth of all those provided to the manufacturing and warehousing sectors, the provincial data shows. CEO Linda Hasenfratz is a former member of Ontario's vaccine task force, a role she was appointed to in December 2020 - shortly after the province launched its rapid testing initiative. In the spring of that year, after Linamar announced it would make ventilator parts, Premier Doug Ford praised the effort.

In a statement, Linamar vice-president of global human resources Roxanne Rose said Hasenfratz's political connections were in no way relevant to Linamar's involvement in the program." The company, which employs around 9,000 workers in Guelph, said it was among the first in line" to ask for rapid tests after recognizing screening as one of the key tools in our approach to dealing with the pandemic."

St. John's-Kilmarnock School, an elite private school nestled in a 36-acre rural campus outside of Waterloo, received more than 14,000 free rapid tests shortly before classrooms reopened last fall - the largest number of any private school. The supply would have been large enough to test all of St. John's-Kilmarnock's 425 students twice weekly through to Christmas break - when Ontario first widely distributed rapid tests to kids at publicly funded schools.

Under freedom of information legislation, the Star obtained the rapid test program data from November 2020 to September 2021 as well as more than 200 pages of internal government emails and memos. Health Minister Christine Elliott and Education Minister Stephen Lecce declined interview requests, and their ministries repeatedly refused to directly answer questions about the records.

Bill Campbell, a spokesperson for the Health Ministry, which administers the provincial rapid testing program, said the initiative began as a pilot for high-risk congregate settings." Rapid tests were later made available to all organizations permitted to be open and (that) had individuals physically present, as well as organizations that are required to have a vaccine policy."

Colin Furness, an infection control epidemiologist at University of Toronto who reviewed the provincial data for the Star, noted the rapid testing program successfully sent millions of tests to long-term care, workplaces and other organizations.

However, he said after his review that one of the program's overarching goals of managing the pandemic equitably seems to be missing."

(Rapid tests) are a vital tool for managing the pandemic," said Furness. And therefore they need to be not just tossed up in the air to see who's got the longest arms to grab them."

Ontario initially asked certain organizations if they wanted tests. Then the government allowed essential workplaces to apply online while also working with ministries and partners to help raise awareness of the program, Campbell said. He would not say how the province identified prospective applicants, vetted their applications or decided how many tests to send them. He said the ministry fulfils all orders placed by eligible organizations."

With the free supply of tests from the province, some companies were able to set up expansive testing programs to screen workers. Meanwhile, other large essential workplaces with histories of large outbreaks did not get a single rapid test in the first 10 months of the provincial program, the data shows.

The list of recipients obtained by the Star does not include Toronto meat packer Belmont Meats, the site of the city's largest workplace outbreak last year, or FGF Brands, a North York bakery where hundreds of workers fell ill in the early days of the pandemic. (FGF said it later obtained 6,200 rapid tests from the province after being approached by local health authorities in October 2021. Belmont Meats did not respond to questions for this story.)

In agriculture, where more than 2,800 low-wage workers were infected by the virus, 10 farms with the largest recorded outbreaks do not appear on the province's list of rapid test recipients, the Star's analysis found.

Campbell responded that until recently, public health guidance stated that rapid tests were only to be used for testing of asymptomatic individuals and in non-outbreak settings." During the 10-month period the Star analyzed, anyone with symptoms was still being told to get a more sensitive polymerase chain reaction (PCR) test.

Campbell did not comment on why certain workplaces with past outbreaks did not get tests during that period.

The provincial data does not list individual small businesses that got screening kits from local chambers of commerce and boards of trade, which received 3.8 million tests from the province to distribute in their communities.

But Karen Weidenfelder, who operates a small pipe-supply business in Toronto's northwest corner, said she didn't know free rapid tests were available until December 2021, when she learned about the initiative from the local business improvement association. By the time she tried to get tests through this channel, there were none left, she said.

I wish I'd known about it," she said of the provincial program. There's nine or 10 of us here, and if we have to close because of (COVID), we're toast."

There were also barriers that likely dissuaded some employers from participating, said Steve Chaplin, vice-president of health, safety and environment at construction giant EllisDon - including the resources required to set up a screening program in the workplace.

EllisDon received one of the largest numbers of rapid tests of any employer in the province, the data obtained by the Star shows. The Ministry of Labour, tasked with reaching out to the construction sector during the program's pilot phase, contacted the company about taking part, Chaplin said.

There wasn't tons of people putting up their hands to say they wanted to try this," he recalls.

Chaplin, who sits on the federal round table on rapid testing as well as the provincial Labour Ministry's prevention council committee, saw the initiative as a bold step in the right direction and believed rapid testing was the right thing to do to keep families and workers safe," he told the Star.

But workplace screening was also new territory; at EllisDon, it would become the subject of an (unsuccessful) union grievance. With no provincial paid sick days, some hourly workers worried a positive test result would mean lost income, said Chaplin. And while the province's rapid tests were free, the program initially required the screening tool to be administered by medical professionals - a hefty cost" that Chaplin believes was likely a deterrent to some employers.

Two employers in the high-risk, low-wage food production sector told the Star they did not apply for free rapid tests, despite experiencing outbreaks, because they believed regularly testing workers was too resource-intensive or less effective" than other protections.

Furness says organizations that mobilized to get tests should be applauded for adding this layer of protection. But the province's strategy bore lopsided results. By September 2021, the province had sent the construction sector almost 620,000 tests; nearly half of them went to EllisDon. (For a period, the company used tests to screen every worker on their job sites, including subcontractors.) In the hard-hit manufacturing and logistics industries, two companies - Linamar and Toyota - received more than a third of all tests sent to Ontario's factories, plants and warehouses.

The tests enabled Linamar to screen hundreds - sometimes thousands - of workers every week, said Hasenfratz, the company's CEO, in a statement to the Star.

Finding asymptomatic cases in this way was a key element in our excellent safety record of keeping our employees safe at work during the pandemic."

To our knowledge there were no limitations to engagement in the (rapid testing) program. Companies wishing to fully engage in testing were encouraged to do so and Linamar did take the opportunity offered to ensure our people were safe," a statement from Linamar said.

Before schools reopened last fall, some parents, experts and advocates were urging the province to use its stockpile of rapid tests to screen the two million children who attend public schools. But in July, Ontario's COVID-19 Science Advisory Table advised against using rapid tests to screen asymptomatic students because of the lower sensitivity" of the tests, especially when COVID rates are low - an opinion shared by the chief medical officer of health, who also cited the risk of false positives.

While the province gave rapid tests to public schools for unvaccinated staff, officials decided not to provide tests to screen public school students. At the same time, the government had opened a pipeline that was allowing private schools to obtain publicly funded rapid tests for precisely this purpose: the province's online portal for its rapid testing program included private schools among the list of eligible organizations.

A Star analysis of the internal provincial data shows that of the roughly 175,000 tests the government gave to private schools, around 90 per cent were distributed between August and early September 2021.

On Aug. 26, Branksome Hall - an all-girls school in Toronto's Rosedale neighbourhood and that costs more than $37,000 a year to attend - received 9,600 tests. That same day, the all-boys Upper Canada College received 2,400 tests, followed the next week by another 6,400 tests. Bayview Glen Independent School also got two shipments in late August and early September, totalling 12,800 tests.

St. John's-Kilmarnock, outside Waterloo, received more tests than any other private school - more than 14,000.

Hasenfratz - Linamar's CEO and a former member of Ontario's vaccine task force - is also a parent of former students and a donor for the school. Cheryl Boughton, St. John's-Kilmarnock's head of school, said the institution found out about the provincial rapid test program through the Conference of Independent Schools of Ontario and that Hasenfratz played no role in facilitating access.

While the controversy emerged in public, behind the scenes, Julia Danos, a senior Education Ministry official, acknowledged in an email to other ministry officials that there wasn't a systematic process in place" to review the rapid testing data over the summer and/or flag any issues on private schools."

A slide deck ministry officials exchanged the next day states that private schools were accessing rapid tests through the provincial program to support a testing regime that significantly exceeds current provincial guidance." Eight schools had ordered more than 8,000 tests each, it notes.

Public school boards, trustees and parents have expressed interest in access to tests for students, and expressed concern about the inequity in access," the slide deck said.

Rachel Chernos Lin, a trustee for the Toronto District School Board, was among those pushing for rapid testing for public school students. Rich people aren't supposed to have better access to health and safety," she told the Star, adding that arming private schools with better COVID safety tools risks eroding faith in public education.

The province stopped allowing private schools, which operate independently of government, to order rapid tests through the online portal on Sept. 10, according to the slide deck. Education Ministry officials drafted a memo to private school principals, stating the tests were not to be used" on students, but subsequently watered down the language, saying instead that the province didn't recommend" screening students with rapid tests.

Caitlin Clark, spokesperson for Education Minister Stephen Lecce, would not confirm what direction the ministry ultimately gave private schools about the use of free rapid tests.

Laryssa Tyson Lebar, spokesperson for the Conference of Independent Schools of Ontario, which represents the 10 private schools that received the largest number of rapid tests, said the schools obtained the tests through the provincial program according to the eligibility requirements in place at the time the orders were placed."

Once the criteria changed, the schools could not give them back, she said.

There was no mechanism in place for the schools to return or pay for test kits, nor were they permitted to redistribute them after they were received," Tyson Lebar said.

Some private schools that obtained tests through the provincial program used rapid tests to screen students in the fall, according to their websites. Tyson Lebar would not say whether any schools used the publicly funded tests to support these programs. She said some schools bought additional rapid tests directly from the manufacturers.

The government didn't widely distribute rapid tests to students in public schools until December, when the province began to encourage broader use of rapid tests. By then, recent COVID cases in schools had reached a record high of 3,181. The Ontario government closed schools again for several weeks in January as Omicron surged.

Clark said Ontario was the only province to distribute rapid tests before Christmas break.

This proved to be extremely prudent as the highly transmissible Omicron variant arrived and quickly spread in Ontario," she said, adding that the province handed out 16 million rapid tests to schools in January and February.

The large volume of tests flowing to private schools during a pandemic that hit marginalized communities hardest has left Norm Di Pasquale, a trustee for the Toronto Catholic District School Board, wondering: Was everyone asleep at the switch?"

As the province rolled out its rapid testing program, Health Ministry officials told the Star the province was willing to explore further measures to encourage uptake, including mandating tests, particularly in workplaces in hot spot areas, if necessary."

That mandate never came. Over the rapid testing program's first 10 months, Toronto - where workplace outbreaks crushed the city's northwest region and spurred high infection rates - received some of the lowest number of tests in the province, the Star's analysis shows.

The province also considered jails, shelters, hospices and group homes to be among the congregate settings most vulnerable to COVID transmission. Yet these settings received a collective total of 83,561 tests - a tiny fraction of the millions of rapid tests sent out by the province up until September 2021, the data shows.

Closing down a non-essential business is sometimes a better weapon than rapid tests to combat soaring infection rates, Furness said.

But for at-risk settings that could not shutter, rapid tests could have provided an extra layer of protection, he said. A strong rapid testing program should prioritize the very young, the very old and the immunocompromised," who are at greatest risk of falling seriously ill, as well as those without the ability to advocate for their own safety, he added.

In the program's first 10 months, the government's oversight ended when the rapid tests reached employers, the provincial data obtained by the Star suggests. Although the program's guidelines required employers to report test results to the province, the data includes results for less than one-third of the tests sent out during this period.

Furness says it was a program fail" that the government did not collect more reliable data, which could have helped health authorities better target places where more tests needed to be distributed.

We're not able to learn, we're not able to sharpen our method, we're not able to gauge the value of these tests," he said. We're pouring them into a black hole."

Today, free rapid test kits are available in pharmacies and grocery stores. However, concerns about equity and access persist, said Dr. Dalia Hasan, a medical school graduate in the Kitchener area who runs COVID Test Finders, a Twitter account she started last fall. She said she gets daily messages from people from all over Ontario, asking where they can find free rapid tests.

It becomes a game of whack-a-mole," she said. It's still those marginalized communities who are suffering the most."

Sara Mojtehedzadeh is a Toronto-based reporter covering work and wealth for the Star. Follow her on Twitter: @saramojtehedz

Rachel Mendleson is a Toronto-based investigative reporter for the Star. Follow her on Twitter: @rachelmendleson