Promises aren’t enough anymore – it’s time for the government to massively increase testing

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Earlier this week, officials in Wuhan, China, announced that they had six new cases of coronavirus infection, the first since their lockdown lifted on April 8.

The response was swift and unequivocal. All 11 million residents of the city will be tested, and the testing and tracing of contacts of any infected persons will be done in 10 days.

Meanwhile, in Canada, we pat ourselves on the back because we have done 1.2 million tests – since January.

Despite the “massive scale-up” rhetoric from politicians and public-health officials, our embrace of testing has been halfhearted and the pace of the increase in testing can be described, generously, as dawdling.

Quebec, the epicentre of the Canadian coronavirus outbreak, completed just more than 6,000 tests on Tuesday.

Premier François Legault keeps saying that will increase to 14,000 a day “soon,” but that has been the company line for some time, with little marked improvement.

Just as importantly, there are reports that contact tracing (finding and testing the people that infected patients have interacted with and potentially infected) is taking up to 10 days.

Testing by province and territory

In neighbouring Ontario, things aren’t much better.

Five weeks ago, Premier Doug Ford raged about the “unacceptable” levels of testing in the province and vowed an imminent increase to 19,000 tests daily from 5,000.

Since then, Ontario has moseyed on up to almost 12,000 tests a day (still far from the 19,000-a-day target) and Mr. Ford has gone from being frustrated to uttering whoppers such as “we’re leading the country now in tests, overall and per capita … we’re one of the leaders in testing globally worldwide per capita.”

Hardly.

Ontario’s testing rate is 31 per 1,000 population, slightly below the Canadian average. (Alberta is the runaway leader at 44.)

Globally? Denmark has a testing rate of 56 per 1,000 population; Portugal 55; Spain 52; heck, Lithuania is 68. Even the U.S., which has monumentally botched its pandemic response, has a testing rate of 31 per 1,000 population − the same as Ontario.

Epidemiological experts in Canada and the U.S. share two important common beliefs: The testing rates need to at least double before we reopen the economy broadly and; the only way to avoid a resurgence in cases is having the ability to test and trace swiftly, ideally within 24 hours, so further spread can be contained.

We’re not even remotely close to that standard in large swaths of the country.

In Canada’s we-don’t-like-to-talk-about-it political culture, no one has been forthcoming about the reasons why we’re still puttering along. Initially, it was blamed on lack of medical reagents, swabs and other supplies. Then it was a shortage of laboratory staff. More recently, it’s insufficient contact tracing staff and, in Ontario in particular, on bickering about priorities between provincial and regional public-health officials.

Not to mention that we still do contact tracing using paper charts and fax machines – not exactly state-of-the-art technology. Countries such as South Korea use people’s cellphone data for tracking.

Last week, after an infected man visited five bars in Seoul, South Korean officials were able to contact and test almost 11,000 people whose paths he crossed – directly and indirectly – almost immediately, and found more than 100 were positive for coronavirus. If that scenario unfolded in Canada, the public-health response would likely take weeks.

Whatever the excuses, it’s clear we have not made testing and tracing a priority. We have not invested in the response that the urgency of the situation requires. Testing tells us who is infected and who is spreading the coronavirus to others. If we can’t identify sources of transmission, we can’t slow the spread.

In Canada, we have focused a lot of media attention on long-term care homes, where the death rate has been appalling. Yet the majority of spread of coronavirus is not in so-called congregant settings, but in the community at large.

Dr. David Williams, Ontario’s Chief Public Health Officer, said that after almost eight weeks of public-health measures such as businesses closing and physical distancing, this reality is “perplexing.”

You will never get an outbreak under control if you are perplexed by the source of disease spread.

The only way to resolve that is to test. Not just promise to test. But actually test. And test, and test.

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