This is a bad news story, about what went wrong yesterday. But it also contains the ingredients for a good news story, about something poised to go right tomorrow.
Since the start of the COVID-19 pandemic, Ontario has trailed the rest of the country when it comes to testing people for the novel coronavirus that causes the disease.
It’s been a fundamental, fatal, gap in the province’s pandemic response, since a key method of stopping the outbreak involves figuring out who has the virus, and then isolating them and their contacts. Doing public health without adequate testing is like telling the fire department to rush to a seven-alarm blaze, but asking them to guess where the fire is.
Putting the Canadian economy into a medically induced coma was necessary, but stay-at-home orders and mass business shutdowns are blunt weapons, delivering heavy collateral economic damage. Testing is a precision instrument.
So: The bad news. Ontario, home to four out of 10 Canadians, is in last place among the provinces when it comes to testing.
British Columbia has tested twice as many people, relative to its population. Alberta has tested at three times Ontario’s rate. Quebec, despite having barely more than half as many people, has administered tens of thousands more tests.
Ontario is the province with the largest number of deaths from COVID-19, yet its public health officials, hospitals and nursing homes don’t have a handle on where the coronavirus is. The fire department is wearing blindfolds.
More than two weeks ago, Ontario Health Minister Christine Elliott said help was on the way. The province aimed to have the capacity to process 5,000 tests a day by late March, and 19,000 a day by mid-April.
However, as Ontarians, including health-care workers, shared stories of being refused a test, or waiting a week for results, the province’s test volume failed to move up as promised. This week, between Sunday and Wednesday, the province averaged fewer than 4,000 tests a day.
But now for some good news. Everyone in authority in the province appreciates the seriousness of the situation. Premier Doug Ford’s daily briefing on Wednesday was almost entirely devoted to the testing crisis. It has become Job No. 1 for the Ford government.
And the province appears to have solutions.
Mr. Ford says the province has the capacity to test 13,000 people a day – more than the number of tests performed on an average day in the other nine provinces combined. He says Ontario has the kits and laboratories to achieve those numbers.
It remains unclear why, if Ontario ramped up capacity in recent weeks, that this failed to translate into a lot more tests. It may be that local authorities, used to shortages and effectively having been told to be stingy with a scarce resource, continued to stick to outdated guidelines. Ms. Elliott has promised to update the rules.
What will more testing reveal? Ontario’s official number of confirmed infections will rise at first, perhaps dramatically. That will make it seem like the pandemic is suddenly getting worse, but it will actually mean seeing more of the iceberg – the part that is now underwater. Every jurisdiction has a high number of cases that are never accounted for, but the less testing there is, the more cases go unnoticed and unmonitored, and the more opportunities there are for people unaware of their infection to unknowingly infect others.
Overall, Canada is testing more than many other countries. The number of fatalities relative to the official number of cases is deceptively high in places such as Italy and the United Kingdom, because they’ve done so little testing. That’s also true in the United States, which was doing barely any tests until late March. However, it is now testing at a higher rate than Canada.
To fight the virus, Canada needs to be able to test tens of thousands of people a day. Ideally, hundreds of thousands.
When the time comes to begin loosening physical-distancing measures, testing is going to be even more vital. The more successful the current stay-at-home orders are, the sooner we can begin to withdraw them.
And the more we have the capacity to test, trace and isolate – and to do a type of test that confirms who has already had the virus – the less likely we are to have a renewed outbreak that necessitates a return to economic lockdown.