Hospital-based laboratories are mobilizing to become testing centres for COVID-19 to help alleviate the growing backlog at overwhelmed public labs, which some health experts say is slowing Canada’s response to the virus.
About 77,000 tests have been performed in Canada as of Friday evening, according to the Public Health Agency of Canada. But increasing demand for coronavirus tests and a shortage of testing materials are hampering efforts to identify cases.
Some provinces are lagging behind. Ontario, for instance, has a backlog of more than 7,200 tests as of Saturday, and results are taking almost a week to come back in some cases, according to accounts from patients and clinicians. As a result, infectious disease experts say the true number of COVID-19 cases in Canada is far greater than official figures show and the risk of catching it is much higher than many members of the public realize.
Which is why researchers at Toronto’s Mount Sinai Hospital and the University Health Network are teaming up to repurpose research labs for COVID-19 testing. Jim Woodgett, director of research at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, said the hope is that in the days and weeks ahead, those labs could process an increasing number of tests, taking some of the pressure off public health labs.
"We’ve got to get a handle on this as fast as possible, as safely as possible," Dr. Woodgett said.
The longer-term goal, he said, is to develop new testing methods that could allow labs to potentially process 10,000 to 20,000 tests a day.
“Every hospital, I think, wants to do this,” Dr. Woodgett said. “There’s just a tremendous amount of co-ordination going on.”
Scaling up testing is critical, according to numerous health experts, because it allows public health officials to get a better sense of how widespread the disease is and to focus their efforts on containing the spread. That’s how countries such as South Korea have been able to keep COVID-19 from becoming a major epidemic. Widespread testing could also be used to better communicate the true risk of contracting COVID-19 and increase compliance with social distancing and self-isolation requests, they say.
According to Dr. Woodgett, the hospital research labs don’t yet have permission to process samples from the general public, so they will initially focus on testing health-care workers. Once they prove they can do the tests safely and accurately, they should receive permission from provincial authorities to process samples from the public, he said.
David Williams, Ontario’s Chief Medical Officer of Health, said hospital labs could play an important role in scaling up testing and added that the province could also look to private operations to help deal with the demand.
Most people who contract COVID-19 will experience relatively minor symptoms and may not realize they are infected, which means they are likely to go out in public and spread the disease to others, said Janine McCready, an infectious diseases physician at Toronto’s Michael Garron Hospital. That’s why so many experts are demanding increased testing capacity in Canada; in order to understand the scope of the problem and stop transmission, officials need a realistic picture of how many people are infected, Dr. McCready said.
“Before you even realize you have it, you could have already exposed a number of other people,” she said.
Dr. McCready said she has contacted numerous patients in recent days who were surprised to learn they tested positive for COVID-19, as their symptoms were so mild.
She and other infectious disease experts say there is widespread community transmission of the virus in Ontario, meaning infections with no known link to international travel. Despite this, Ontario officials have stopped short of confirming community spread in the province.
In a briefing with reporters Saturday, Barbara Yaffe, Ontario’s Associate Chief Medical Officer of Health, said 50 per cent of the province’s cases are linked to travel and 12 per cent are close contacts of confirmed COVID-19 cases.
That means almost 40 per cent of the province’s cases could be linked to community spread. But Drs. Yaffe and Williams said many of those cases remain under investigation and while community transmission is possible, it hasn’t been definitively proven.
Dr. McCready said the province should be more transparent to help people understand the risks.
“We clearly have widespread community transmission,” she said. “I think if the public clearly heard that message, people might modify their behaviour.”
On Friday, Prime Minister Justin Trudeau announced that Ottawa-based Spartan Bioscience will receive fast-tracked federal funding to produce a rapid test for COVID-19. But it will be weeks before such technology is ready.
In the interim, Canada needs to act more like Taiwan, where strict quarantine measures have been used to contain the virus, said Peter Phillips, an infectious diseases specialist at the University of British Columbia.
“We really need to take the lessons that can be learned from experiences in parts of the world where this epidemic never really got started,” Dr. Phillips said.