Premier declares Ontario's low testing numbers 'absolutely unacceptable'

Premier Doug Ford publicly blasted the low rate of COVID-19 testing in his own province and vowed the number of people tested for the coronavirus will increase from a daily average of just over 3,000 to about 13,000 soon.

"My patience has run thin. No more excuses," said the premier.

He made the apparently off-the-cuff-comments at the end of his prepared remarks at a press conference Wednesday, saying he wanted address some things that were on his mind.

"What is unacceptable, absolutely unacceptable, is the numbers of testing that we're doing," he said. "I may not understand health but what people understand around this province, and I what I understand, are numbers."

Ford says he wants all long-term care residents, all health-care workers and all other frontline workers such as police and firefighters to be tested. "We have to make this happen."

As recently as Tuesday evening, the policy was still being finalized, according to a spokesperson for the minister of health.

"We expect to finalize and share a renewed testing strategy that more proactively targets priority populations, including long-term care home and retirement community residents, as well as other congregate settings, health care workers, Indigenous communities, among others," said Press Secretary Hayley Chazan in a statement to QP Briefing. "By expanding testing of these groups, we can identify cases as early as possible and contain the spread."

Since the beginning of the pandemic Ford has said he's been taking the advice of the public health and health-care experts who've been advising him — specifically the province's chief medical officer of health, Dr. David Williams. Ford said he continues to trust his expert advice, while at the same time admitting he is frustrated.

He listed some of the problems the province has are experience, a lack of test kits or swabs, not enough assessment centres, and a lack of reagent to analyze the test — but said those issues are solved now.

"We have everything in place, no more excuses,"  he said. "Let's come up with solutions, not excuses."

He added that he has "all of the confidence in the world" in Matt Anderson, the head of the province's new super agency, Ontario Health, to implement the new testing policy.

At a press conference later in the day, Williams was asked if he felt he'd been taken to the woodshed by the premier.

"I didn't see it as taking to the woodshed myself," said Williams, adding that it was nice to see the premier on the same page and working hard. "I would see it more as the captain saying, 'You want this, I want this, let's go.'"

Williams said the new testing strategy will be released soon, but the details were still being worked out. "We don't want to go out and trip going out the door, so we have to make sure we get it right," he said. "I know urgency sometimes dictates value... but really if you rush out and make mistakes and people are misinformed and not dealt with correctly, that would be of more concern to me."

Two weeks ago, the province announced plans to ramp up its capacity to analyze tests to 18,900 per day and has reached 13,000, officials said. However, the number of results has hovered between between 2,500 and 5,000 all week.

Ontario is still conducting the fewest tests per capital in Canada, a figure Williams said did not concern him.

As recently as Tuesday, Williams had characterized the low testing numbers as a positive sign that could indicate fewer people were presenting with COVID-19 symptoms. Meanwhile, concerns about the low-testing numbers have grown, particularly concerning vulnerable patients in long-term care.

Williams said repeatedly that more widespread testing would be helpful for the epidemiologists who use modelling to understand the pandemic, but his chief concern is the morbidity and mortality of the population. While Williams said people with significant COVID-19 symptoms have generally been tested, and those with mild symptoms had not.

One of those epidemiologists has been highly, publicly critical of Williams, as well as the province's other public health leaders, Associate Chief Medical Officer of Health Dr. Barbara Yaffe and Public Health Ontario CEO Peter Donnelly, and has called on them to be replaced.

"I understand that it is not optimal to change horses in midstream, but there are circumstances that require it," said Dr. David Fisman, a professor with the Dalla Lana School of Public Health, in an email to QP Briefing. "We do need competent provincial public health leadership right now and we don't have it."

One of Fisman's chief concerns is the lack of sufficient testing, which he said has contributed to the institutional outbreaks in long-term care and other congregate settings that have lead to deaths. "We could literally be doing 10,000 more tests a day to protect patients, healthcare workers, long term care, and the prison and shelter systems," he wrote. "Why in the name of sanity are we not?"

His other concerns are that the province has been too slow to act and protect vulnerable long-term care residents, as well as an overall problems with clear communication, including mixed messages about whether or not community transmission was occurring in Ontario when there was clear evidence that it was.

Others have called for increased testing without damning Ontario's public health leadership.

Dr. Bob Bell, who served as deputy health minister under the previous government, said it's important to test people in congregate settings such as long-term care.

"I think we should also be encouraging people to be tested if they have influenza-like symptoms as well," he said, adding that the general advice from family doctors and telehealth to people who have milder symptoms to self-isolate without being tested should change, so that the province can know how many people actually have COVID-19. "I think right now, we have a pretty substantial underestimate of the number of people who are unwell."

However, Bell cautioned against taking too much stock in "inflammatory" statements about the public health leadership, saying the public should have confidence that the province is doing all of the appropriate things that need to be done. Bell said he thinks the province's public health leadership is doing the best it and he particularly lauded its advice to the premier on social distancing, which has saved lives.

"The testing issue is one that needs to be improved, but let's face it, we're only really three weeks into this and they have got testing up an in a broader scale," he said.

Bell also lauded the health-care side of the province's response, overseen by Anderson, the CEO of Ontario Health, and Deputy Health Minister Helen Angus, saying their leadership has been extremely competent amid the evolving pandemic.