What we have here is yet another failure to communicate.
Canadians – mostly in Ontario and Quebec – are lining up by the thousands, for hours on end, to be tested for the coronavirus. This is irrational and wasteful.
To date, more than seven million tests have been done and laboratories are cranking out results at a rate of about 75,000 a day.
As a country, we have dramatically upped our testing capabilities. Back in April and May, we were struggling to complete 10,000 tests daily.
Yet, testing remains a debacle.
That’s because volume is not the only thing that matters.
We need to make it clear who exactly should be tested and why. Everyone? Those with symptoms? Those who have been called by contact tracers because of possible exposure?
Being Canada, we have no clear national guidelines. Each province has its own rules, but say only people with symptoms and those who have been exposed to someone with COVID-19 should be tested.
B.C. has an excellent online self-assessment tool (in 130 languages, no less). Quebec urges people to call the Info-Santé health line (8-1-1 in many provinces), which is less efficient.
Alberta, the first province to say everyone who wanted a test should get one, this week changed its approach. Dr. Deena Hinshaw, the province’s Chief Medical Officer of Health, said indiscriminate testing is not sustainable during cold and flu season.
She’s right. We can’t realistically be swabbing and testing everyone with the sniffles or a cough. Targeting is necessary even if we risk missing a few asymptomatic carriers.
Yet, Ontario continues with the test-everyone approach with predictably chaotic results.
In some places, people are lining up before dawn and all the testing spots are full before assessment centres even open. Elsewhere, people are waiting up to six hours for a test, or being turned away at test sites.
A lot, if not most, are the worried well, who have neither any symptoms nor any exposure to people who are infected. Worse still, there are disturbing reports, again mostly in Ontario, of people using a negative test as a ‘free pass’ to party or attend large gatherings.
That is not what diagnostic testing is designed for.
But Ontario’s messaging on testing (and virtually everything else) has been abysmal. Clear guidance is not something that Dr. David Williams, the province’s Chief Medical Officer of Health, seems capable of delivering.
As a result, Ontario seems to constantly leave the public perplexed about its policies, and on edge.
In addition to being clear on who should be tested, we need to improve testing.
B.C. has introduced a mouth rinse/gargle test for young people that allows them to gargle a liquid and spit it into a tube instead of the uncomfortable nasal swab. But those tests still go to a lab to be processed.
With the stampede to testing, one thing we don’t know is how quickly people are getting results. Anecdotal reports suggest anywhere from a day to a week. If you can’t get results to people quickly, you might as well not be testing them.
Given the fact that almost 99 per cent of tests are negative, we could be doing pooled testing. That entails testing several samples together then returning to do individual tests only if there is a positive in the pool.
Rapid screening tests are also desperately needed, but have yet to be approved in Canada. They are not perfect, but a good way to determine quickly who should get a more precise test.
In recent days, we have seen a disturbing spike in cases in Canada. There are now more than 1,000 cases daily and there is every indication that number will keep climbing. An increase in hospitalizations and deaths will follow in the coming weeks.
To get some control over the outbreak, we need to re-implement aggressive public-health measures, especially in Quebec and Ontario.
We also need a good testing strategy. Not the one we used back in the spring, but one adapted to flu season and the return to school and work.
Just as importantly, we have to explain these strategic changes to the public, and get buy-in.
In real estate, the mantra is “location, location, location.” In public health, it must be “communication, communication, communication.”
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