Ontario will not follow Quebec’s lead and test all residents and staff in long-term care homes for COVID-19, but vowed to significantly boost the number of vulnerable people being tested for the potentially deadly virus.
On Friday, Ontario released its new “testing strategy” for the novel coronavirus, which focuses on priority groups such as hospital workers, first responders and long-term care residents, in a bid to boost testing and contain the spread of the virus.
But the strategy does not call for systematic testing in long-term care homes, despite concerns from some doctors and epidemiologists that elderly residents without symptoms of COVID-19 should also be tested for the virus.
Quebec this week announced it will systematically test all residents and staff of long-term care facilities for COVID-19, and redeploy hundreds of doctors and nurses from hospitals to the long-term care homes to deal with the outbreak among the sick and elderly.
Health Minister Christine Elliott said Friday that Ontario will not follow suit, but noted the province has broadened its criteria for testing asymptomatic patients in the case of an outbreak, meaning more people in long-term care will now be tested.
“If there is an outbreak, then the situation changes, and there is clearly more extensive testing that needs to be done," Ms. Elliott said.
“Not every province does everything exactly the same way. We are doing what the chief medical officer of health believes is the best for Ontario.”
She said 99 long-term care or retirement homes in Ontario currently have, or have had, an outbreak, now defined as one resident or staff member testing positive for the virus.
David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said the new guidelines give more latitude on testing asymptomatic long-term care residents in outbreak situations, but still constrains who gets tested based on symptoms.
“This obsession with who is symptomatic and who is asymptomatic … is absolutely maddening," he said. “We need to know what fraction of staff are infected and what fraction of residents are infected. And we need to do it starting today."
This week, Premier Doug Ford slammed the province’s low testing rate as “unacceptable," directing his health officials to immediately start testing more people to reach the province’s current capacity of 13,000 tests a day.
According to the new testing strategy, the province plans to reach a goal of 16,000 tests a day by May 6. Ontario is now conducting around 4,000 a day, which it says will double to 8,000 by April 15.
The province also added other vulnerable groups, such as people with cancer or pregnant women, as well as essential workers, to its list of “future” priorities.
Ms. Elliott also announced new symptoms that qualify for coronavirus testing, such as hoarse voice, difficult swallowing, nausea and diarrhea. For seniors, new symptoms include chills, delirium, increased heart rate and blood pressure change.
The province’s modelling suggests Ontario will reach 13,000 tests between April 22 and 29 - but only if it can acquire sufficient personal protective equipment, reagent (the substance used in tests) and swabs.
However, testing supplies remain a global issue, health officials said.
The province’s top health officials, who spoke during a technical briefing on background only, said they would not implement widespread testing at long-term care facilities because testing asymptomatic people is “of limited value," since it does not rule out people from contracting the virus in the future.
If someone has COVID-19 symptoms, such as fever or cough, but does not have other underlying conditions or is in a priority group, they will likely not get tested at the moment, officials confirmed.
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