Ontario plans to ramp up COVID-19 testing capacity sixfold

Ontario public health officials briefed the media Thursday on plans to boost the province's COVID-19 testing capacity to 18,900 by April 17.

A week ago, the province began to see a backlog in testing for the novel coronavirus that has grown to over 10,000 tests awaiting analysis over the past three days. It's meant a four-day wait, on average, for tests to be processed, but tests for some groups have been prioritized to get results faster — including health-care workers, people expected to be admitted to hospital and Indigenous people who live on reserves.

Officials said there should be progress on chipping away at that backlog in the coming days.

The added testing capacity will be coming from a network of community research labs and hospitals in addition to the testing already being done at four Public Health Ontario (PHO) sites and the National Microbiology Lab in Winnipeg. That will mean the province's daily testing capacity will progressively increase until it hits 18,900 by April 17, officials said.

Ontario's current daily capacity is 3,000, but so far no more than 2,763 tests have been analyzed in a day, as samples have been concentrated with Public Health Ontario, where there is a backlog.

One of the problems Ontario has faced so far is a shortage of reagents used for RNA extraction, as have other jurisdictions around the world. In recent weeks the province has been looking for other approaches for RNA extraction and ways to bypass that step, said Dr. Vanessa Allen, chief of medical microbiology at the Public Health Ontario laboratory.

Before, PHO was dependent on one testing platform that was in short supply, but has since added two more, said Allen.

The officials fielded several questions about how well Ontario's current testing regime actually captures the number of positive cases in the province, which indicates not only the number of cases but the shape of the epidemic curve.

So far the assessment centres have been mostly focused on testing people in certain groups, including returning travellers, but the criteria has been determined on a case-by-case basis. But in general, people who have COVID-19 symptoms but who have no travel history and no known contact with a positive case are not tested, unless they are part of a priority group, such as a health-care worker.

Associate Chief Medical Officer of Health Dr. Barbara Yaffe replied the criteria will like be expanded, and added that tests aren't the only way the province is trying to determine the extent of the coronavirus in Ontario. Officials are also keeping tabs on people presenting at hospital with symptoms, being treated in intensive care, and entering data into the provinces self-assessment tool indicating they have symptoms.

As of Thursday, 29 people were in ICU, an increase of 12 over Wednesday, and 20 were intubated, she said.

As the province increases its testing capacity, Ontarians can expect to see the publicly released total of positive tests rise faster than it would have otherwise, said Chief Medical Officer of Health Dr. David Williams.

He said he also expects the numbers to continue to rise in the coming days because there was a large influx of people returning over the week of March Break and now is the time many of their tests would be processed, given the time it would take for them to develop symptoms, get tested, and then get results. He added that as of next week, Ontario might start to see if the social distancing measures that have been implemented are successful at flattening the epidemic curve.

This chart shows Ontario's testing problem. The red line shows the backlog of cases, which has increased as the number of people swabbed has outpaced the number of tests being processed in the province's labs. As of this week, the backlog has been about four times larger than the number of tests the province has been completing in a day, resulting in a four-day backlog on average. Data from https://www.ontario.ca/page/2019-novel-coronavirus.