We have to test and trace more to end lockdowns safely

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As we end lockdowns and Canada starts reopening for business, knowing where coronavirus is in the community is more important than ever.

The public needs to keep respecting public health restrictions, albeit looser ones, but governments also have to monitor vigilantly to ensure we don’t have flare-ups of cases that wipe out the gains that have come from our sacrifices.

Yet, it’s not clear public health has the capacity to do so.

The data we have are cruelly lacking, the testing we’re doing is inadequate and the tracing of contacts of the infected leaves much to be desired.

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So the announcement by Prime Minister Justin Trudeau on Friday that Ottawa will fund COVID-19 testing, tracing and data sharing is welcome, especially the news that thousands of civil servants will be made available to do contact tracing.

But how is it possible that we have only now, at the end of May, figured out that we don’t have enough people doing contact tracing?

The first case of coronavirus in Canada was more than four months ago. Since then, we’ve seen the most devastating pandemic in a century take hold, reshaping our social mores and ripping the economy to shreds.

And we’re still not getting the basics – test-trace-isolate – right?

While the PM announced a national program, let’s not kid ourselves. This is an Ontario problem and, to a lesser extent, a Quebec problem.

British Columbia did a tremendous job of embracing the test-trace-isolate public health mantra while its Provincial Health Officer, Dr. Bonnie Henry, delivered a master class on public health communication. Alberta showed us that testing can be ramped up quickly and shared lots of data. Saskatchewan and Newfoundland and Labrador snuffed out worrisome outbreaks with dogged contact tracing.

Then there’s Ontario.

Sixteen weeks and almost 25,000 cases later, Ontario is still struggling to actually test people. One day this week, the province conducted only 5,000 tests, about one-quarter of its capacity. Quebec has more cases, 45,000, and is doing only slightly better on testing. The promises to do better never end, but the improvements never seem to come.

Worse yet, it’s unclear why testing targets are falling short. Is it lack of supplies such as swabs and reagents? Lack of laboratory capacity? Bureaucratic disorganization?

The lack of transparency is appalling, the data gaps worse.

On Friday, Ontario Premier Doug Ford said the problem is that not enough people are coming forward to be tested. That’s a lame excuse. Testing has to be targeted and proactive. Yet, there doesn’t seem to be a plan.

As bad as Ontario’s record is on testing, contact tracing is worse.

The coronavirus is spreading in the community, mostly in the Greater Toronto Area, to the tune of 400 to 500 new cases daily. Quebec is seeing 600 to 700 cases daily, most in Montreal.

But no one seems to be sure exactly how or where the infections are happening. If they do, they’re not saying. The scant data published lists the source of infection as “unknown” in about two-thirds of cases.

Why? Is it because there are not enough people doing contact tracing? Is it because they’re not asking the right questions? Is it because we’re still using outdated tools such as fax machines? Is it our obsession with privacy (read: secrecy)? Again, we have no idea.

Testing is important. But even more important is using that information to contain further spread.

As we relax public health measures, we know there will be new infections. But we need to limit the harm. One way to do that is sharing data.

There are more than 1,000 new cases of COVID-19 reported daily in Canada – virtually all of them in Quebec and Ontario. Where are the new cases occurring? At supermarkets? On buses? In the workplaces that are already open? We know about the big clusters, such as meat-packing plants, but that’s not enough.

If we don’t have that basic information, how can we reopen the economy smartly and safely?

The relaxing of rules needs to be accompanied by a further ramping up of testing. Not just more testing, but smarter testing.

We have to go find the infected, not wait for them to come forward. And every single positive test has to be followed by a seek-and-destroy mission.

Vigilance remains the order of the day.

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