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Omeera Miraj watches as her dad Miraj gets tested.Cole Burston/The Globe and Mail

When Miraj Morshed and his seven-year-old daughter, Omeera, arrived at a pop-up COVID-19 testing site in North Scarborough this week, they found themselves among just a handful of other test seekers inside a cavernous community centre gym.

Mr. Morshed was relieved he didn’t have to book an appointment or stand in line. Two hours earlier, he had learned that Omeera’s grandfather was positive for the coronavirus. Omeera had slept over at her maternal grandparents' place on Halloween weekend.

“There was no lineup at all,” Mr. Morshed said after he underwent a deep-nasal swab with his daughter, gripping his hand for support. “It was so fast.”

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The family’s experience at the pop-up clinic, operated by the Scarborough Health Network, was the polar opposite of the situation in major Ontario cities six weeks ago, when queues for coronavirus testing stretched for blocks.

A back-to-school surge in demand overwhelmed the laboratory network, prompting the provincial government to halt the indiscriminate testing of people without symptoms and make assessment centres appointment-only. Around the same time, in early October, the province also tweaked its list of COVID-19 symptoms for children to allow youngsters with a runny nose to return to school without a negative test result if their symptoms were improving.

Taken together, those changes may have overshot the mark: Now the Ontario government is facing questions about why testing has dropped to well below the lab network’s maximum capacity of about 50,000 tests a day. The network of public, private and hospital labs processed an average of 33,980 coronavirus tests daily in the past week. On three of those days, the total fell below 30,000.

The government “can’t force people to get tested,” Premier Doug Ford told reporters on Wednesday, the same day Omeera and her father walked into the Scarborough clinic. “Outside of knocking on every door and dragging people to get tested, our capacity is up to 50,000 right now. If you’re showing symptoms, please go get tested.”

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Nurses at work at the pop-up COVID-19 Assessment Centre in Scarborough's Milliken Park Community Recreation Centre.Cole Burston/The Globe and Mail

In the case of Toronto, the old approach of offering tests to anyone who could make their way to a hospital-based assessment centre often missed people living in virus-battered neighbourhoods, according to data the city’s public-health unit began releasing in mid-October.

The data revealed that some of the places with the highest COVID-19 test positivity rates also had some of the lowest rates of per-capita testing. Those neighbourhoods, located mainly in north Etobicoke and north Scarborough, have high proportions of new immigrants, racial minorities and people living in poverty.

Barriers to testing abound for such groups, said Jen Quinlan, the chief executive officer of a community health centre in Flemingdon Park, a pocket of high rises that is home to many new immigrants.

“The neighbourhood is about three buses away from the hospital. If you’re not feeling well, if you have a young child or an older relative, it’s quite a trek to Michael Garron [Hospital] or even further over to Sunnybrook.”

Non-English speakers struggled to book online testing appointments, Ms. Quinlan said. And for a time, newcomers were being turned away because they did not have Ontario Health Insurance Plan (OHIP) cards, she added.

In a bid to lower those barriers, Michael Garron Hospital (MGH,) the Scarborough Health Network and their community partners have launched a slew of new walk-in testing centres and pop-up clinics in coronavirus hot spots, including Flemingdon Park. Hospitals and community groups in other parts of the Greater Toronto Area are doing the same, according to the provincial superagency Ontario Health.

MGH and SHN have also been offering pop-ups at or near schools when a student or teacher tests positive.

On Sept. 29, SHN took pop-up testing to Mason Road Junior Public School, the first in Toronto to be closed temporarily because of a COVID-19 outbreak.

SHN also encouraged students and staff at Glamorgan Junior Public School – which is in the midst of an outbreak that has prompted some education staff to refuse work – to get tested at the one-day pop-up clinic it ran at Milliken Park Community Centre near the corner of McCowan and Steeles avenues on Wednesday.

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Leeza Guo gets a swab test.Cole Burston/The Globe and Mail

The pop-up was the eighth one-day clinic SHN has offered and its third since the fall wave of the pandemic began. The clinic ran like a well-oiled machine. Aside from the 15 early birds who lined up indoors before testing started at 9 a.m., none of the 182 people tested had to wait more than a minute or two to get in.

That was a significant help to Mr. Morshed, who was able to return later with his parents, Mamataz Begum and Serajul Islam, who immigrated from Bangladesh last year. They all share a single-bathroom bungalow.

Mr. Morshed said the last time he took his father to get tested at a hospital assessment centre he waited in line for two hours, even with an appointment. “He has a cane. It was really tough.” As of Friday, the family was still awaiting test results.

The Milliken Park pop-up attracted twice as many clients as two similar clinics SHN operated the last week of October at the Malvern Recreation Centre and Global Kingdom Ministries – but all three fell short of SHN’s best-attended pop-ups last June, one of which tested more than 500 people.

Glyn Boatswain, SHN’s interim chief nursing executive and leader of its pop-up testing efforts, said the hospital is working with the TAIBU Community Health Centre in Malvern to survey local residents about whether they’ve ever had a COVID-19 test.

"If they say, no, then why?' Ms. Boatswain said. “What are some of the barriers to coming to get tested?”

Since the new provincial testing policies took effect, MGH’s assessment centre has seen about a 50-per-cent drop in volume. Anecdotally, there has been an “enormous shift” from majority asymptomatic visits to majority symptomatic visits, said Erica Di Maio, a spokeswoman for the hospital.

Ontario Health said the largest drop in testing has been among people who are well-off and white. The smallest drop has been among the poorest and more marginalized, spokeswoman Jennifer Schipper said in an e-mail.

“Our focus,” she wrote, “is about getting at-risk populations that the province has had trouble reaching from the get-go, to be tested.”

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Nurses and healthcare workers don PPE in a change room as they prepare to start the day.Cole Burston/The Globe and Mail

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