Premier Doug Ford overrode the advice of his government’s medical experts in opening up COVID-19 testing to all Ontarians in the spring, a decision that overwhelmed the province’s antiquated lab system and led to critical backlogs in the long-term care sector.
The revelation is contained in Health Minister Christine Elliott’s testimony to an independent commission examining the devastating impact of the coronavirus pandemic on Ontario’s long-term care homes.
The experts – Chief Medical Officer of Health David Williams; Vanessa Allen, Public Health Ontario’s chief of microbiology and laboratory science; and Jennie Johnstone, chair of the province’s panel on testing strategy – said allowing anyone to get tested for COVID-19 was not advisable because it would add to already lengthy turnaround times for processing results.
Despite the warning, Mr. Ford announced on May 24 that anyone without symptoms who feared they had been exposed to COVID-19 could get a test. Prior to then, only high-risk groups, including health care workers and residents in nursing homes, could get tested.
Ms. Elliott was asked why the government ignored the panel’s advice when, according to her own diary presented at the commission, she was well aware that the province does not have a well-connected lab system that could deal with large volumes of tests.
“How does the science get rejected?” John Callaghan, lawyer for the commission, asked.
“That was very important to the Premier,” Ms. Elliott responded, according to a transcript of her testimony posted Friday evening. “You would really need to speak to him about that.”
Ms. Elliott, who is also Deputy Premier, was the first cabinet minister to testify before the commission last Wednesday. Long-Term Care Minister Merrilee Fullerton followed two days later; her transcript was posted Sunday evening.
Dr. Fullerton, a former family doctor, described her ministry as the “forgotten partner,” which has long been neglected. The Ministry of Health sent out many directives without input from her office, she said. Correspondence tabled at the commission shows that Dr. Fullerton was worried last February that someone who had no symptoms of the virus could spread it to others. Dr. Williams, by contrast, has testified that he did not believe in asymptomatic spread until last summer.
“You were ahead of the Chief Medical Officer in many respects,” Mr. Callaghan said.
The ministers’ testimony provides a glimpse into why the province was ill-prepared to deal with the coronavirus, which has killed 6,980 Ontarians to date. Just more than half of the deaths have been in long-term care homes.
By 2017, most of the Ministry of Health’s large stockpile of personal protective equipment for medical emergencies had expired, prompting the government to begin destroying it.
Between June, 2018, when the Ford government came to power, and December, 2019, 90 per cent of the stockpile was discarded and not replenished before the pandemic began in March, 2020, the commission has heard.
Ms. Elliott testified that the government’s plan to create a centralized procurement system delayed replenishing the stockpile. She said she was not aware at the time that restocking PPE had been held up by the change in procurement but acknowledged it was her responsibility.
Mr. Callaghan asked if the government is also responsible for people who died in long-term care homes that did not have enough PPE, including face masks, to protect them from COVID-19. “The loss of life here is tragic, and is something that I think everyone in government feels some level of responsibility for,” Ms. Elliott said.
The government also went into the pandemic with outdated systems for routing coronavirus test samples to labs across the province, the commission has heard.
Delays getting test results prevented nursing homes from quickly identifying infected residents and staff, and controlling the spread of the virus. In some instances, it took up to seven days to get results.
The province began building up its testing capacity during the pandemic, which Mr. Callaghan said was, “a bit like building a lifeboat during the storm.”
The commission has heard that Dr. Williams and Public Health Ontario’s Dr. Allen both expressed concerns that opening up testing to everyone would overwhelm the lab system.
People lined up for hours at testing centres so they could go to the cottage with friends and family or visit elderly relatives. The line ups grew even longer in September after schools reopened.
Dr. Johnstone, chair of the panel of medical experts set up by Public Health Ontario last April to advise the government on who should be tested for the virus, told the commission in January that she had “real concerns” with the Premier’s decision because it did not preserve capacity for those who needed it.
“This approach did not jive with any sort of strategy,” said Dr. Johnstone, who is also medical director of infection prevention and control at Sinai Health System in Toronto.
Last October, Mr. Ford announced that the province was reverting to an appointment-only system for testing.
Dr. Fullerton suggested that her concerns about asymptomatic spread of the virus in long-term care homes went largely ignored by her colleagues. On April 2, she wrote to Dr. Williams, saying, “One point that is striking is that the number of instances where infection has been introduced, apparently, through a staff member.” She also raised the issue at a cabinet meeting a couple of days later.
Dr. Fullerton testified that she realizes people can overstep their authority. “I needed to listen to the experts,” she said, adding that she was trying not to wear her doctor or public-health hat, “because that’s not the role I had.”
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