As Ontario labs fail to hit turnaround time targets, Hamiltonians are left in the lurch

The provincial agency responsible for COVID-19 testing says an influx of tests has caused a delay in getting people results within the target time frame

Experts worry this might be the canary in the coal mine for what's to come.

Ontario Health, the agency responsible for leading the province's testing network - which includes Public Health Ontario, hospital, community and private labs - says it has set targets of turning around 60 per cent of tests in one day and 80 per cent in two days.

But increased test volumes in recent weeks have led to completion lags.

With the volume increase, the network is experiencing a seven-day average of 66 per cent of turnarounds within two days," said Ontario Health spokesperson Gillian Wansbrough. We are not aware of cases in which test result turnaround is significantly beyond the targets, however there are unique situations that have resulted in longer than anticipated timelines."

Wansbrough did not state the labs' previous average turnaround time, but said: The lab network has succeeded in improving turnaround by 70 per cent in the last two months."

The news comes in the wake of concerns raised by Hamiltonians about long wait times they've faced, particularly in cases where they need negative test results within two weeks to visit loved ones in long-term care. Resident Gaye Welch waited 12 days before receiving her negative COVID test, leaving her just two days to visit her 97-year-old mother.

The extent of Hamilton's delays are unknown; public health only has access to turnaround time data for positive cases, not negative ones, which are the majority of cases.

But public health knows residents' patience is running thin.

We know it's frustrating. We're frustrated along with you," said Dr. Elizabeth Richardson, Hamilton's medical officer of health, on Friday. She said public health is getting calls from residents looking for their results, which it has no power to speed up.

Richardson said she couldn't speak to any potential issues labs might be having but said she's aware people are waiting up to 10 days for results - something the province is working on."

And Dr. Dominik Mertz, associate professor in the division of infectious diseases at McMaster University, isn't sure it's even the labs that are entirely to blame for lags, especially since Ontario Health says it's not aware of cases with turnaround times significantly beyond" targets, with the exception of unique situations." He believes the delay might be somehow tied to the provincial system used to transmit test results, called the Ontario Laboratories Information System (OLIS).

The Ministry of Health directed questions about OLIS to Ontario Health late Friday. Ontario Health did not respond to questions.

Perhaps more pressing a concern than today's delays, says Colin Furness, a University of Toronto epidemiologist, is what they might signal for the future.

If lab capacity is overwhelmed now in terms of timely results, the bigger story is going to be what happens in the fall when we will have a need for a heck of a lot more testing than we are doing now," he said.

The province is currently processing upwards of 20,000 tests a day - a goal Premier Doug Ford set weeks ago.

Hamilton public health, meanwhile, says it is seeing a tremendous increase" in demand for testing.

Assessment centres were designed to complete 200 tests a day but are regularly completing 400 a day, Richardson said. At times, upwards of 700 tests are completed in a day.

Richardson partly attributed increased demand to residents' need for negative tests prior to undergoing surgery or visiting loved ones in long-term care.

Certain tests are expedited, including those for people potentially exposed to someone with COVID and those at risk of exposure through their job. Due to those expedited measures, about 60 per cent of positive cases find out their results within 24 hours, Richardson said.

As for the cause of the lab lags, Mertz points to increased testing of asymptomatic people.

(Ontario Health) suggests that there is an ongoing creep in true turnaround times ... which is primarily because of asymptomatic testing, which is concerning," he said.

Anyone - including those without symptoms - can now get tested in Ontario.

In a recent Toronto Star op-ed, Mertz and Zain Chagla, co-medical director of infection control at St. Joseph's Healthcare, argue testing people who show no COVID-19 symptoms has limited value" to most Ontarians.

Mertz and Chagla note testing people unlikely to be sick backs up testing and processing at assessment centres and labs. Tying up resources can mean it takes longer for people who are actually sick to get their results, which can lead to further spread, they argue.

The Ministry of Health did not respond to a question asking if the province is concerned about turnaround time delays impacting public health units' ability to rapidly track and trace positive cases.

Mertz also calls the requirement for people to get tested before visiting loved ones in long-term care a problematic directive."

A negative test two or more days prior to the visit cannot rule out that a visitor is incubating the virus on the day of the test, and as such could be presymptomatic and therefore highly infectious on the day of the visit," he said.

Katrina Clarke is a Hamilton-based reporter at The Spectator. Reach her via email: katrinaclarke@thespec.com