'We need to test them,' a roundup of Ontario COVID-19 news

New testing guidance

The provincial government is expected to announce a new COVID-19 testing strategy on Friday, but in the meantime Ontario's chief medical officer has given updated guidance for testing vulnerable populations and priority groups.

It came shortly after Premier Doug Ford on Wednesday publicly blasted Ontario's low testing numbers and called on his own officials to boost testing, and offer "no more excuses."

The guidelines say that new residents and those re-admitted to long-term care and retirement homes should be tested, as well as contacts of symptomatic and confirmed cases.

It also widens the kinds of signs and symptoms that should be considered when screening priority groups — health-care workers, caregivers, first responders and First Nations people on reserve — to include some that are atypical of COVID-19, such as digestive problems.

Meanwhile, Chief Medical Officer of Health Dr. David Williams also issued a directive to all long-term care homes requiring all staff and visitors wear surgical masks at all times. He also repeated the advice that homes try to arrange staffing so that workers only work in one home, to avoid spreading COVID-19, but has not mandated that, as British Columbia has done.

At a press conference on Thursday afternoon, Williams said that was because workers' rights must be respected.

He also said there will be more updates on testing in the coming days — however, he suggested that it won't include a directive to test people who have only mild symptoms.

"While people have a desire to know, it's more important they know what to do," he said. Typically, people with mild symptoms are instructed to self-isolate.

He also rejected arguments that testing for COVID-19 is meant to provide a population-wide assessment of the prevalence of COVID-19, saying instead it is meant to direct clinical care for the individuals involved.

At a press conference earlier in the day, Ford had a simpler explanation of what he believes needs to happen. "If someone has symptoms and they come in, we need to test them," he said. "And that's the point we need to get to and I know we're going to be moving rapidly on this."

Meanwhile, Associate Chief Medical Officer of Health Dr. Barbara Yaffe said the province should have all the supplies it needs for expanded testing, for the time being at least.

PHO CEO

The CEO of Public Health Ontario has stepped aside for health reasons unrelated to COVID-19, Ford confirmed. He expressed his confidence in him.

"I think Dr. Donnelly is an absolute champion, he's amazing," said Ford, adding he can't wait to have him back on the team.

The Toronto Star has also reported that former Toronto Medical Office of Health David McKeown has joined the province's COVID-19 efforts.

NDP

The NDP is calling on the province to pay the accommodation costs for health-care workers who've had to leave their homes out of concern of infecting a vulnerable loved one with COVID-19.

“We’re hearing from health care workers who are devastated at the very thought of going home after their shift because someone they love there is vulnerable,” said NDP Leader Andrea Horwath in a statement. “If a health care worker or first responder has higher-risk people in their household, we need to help them keep their family safe.”

Promising ICU data

One of the key concerns about COVID-19 is that the province's intensive care units will be overrun, but in recent days there have been some promising signs — the province's ICUs have not filled up as quickly as the provincial government's modelling forecast.

The provincial modelling released April 3 forecast about 770 to 870 ICU patients with COVID-19 at this point in time, in either the best-case or worst-case scenarios. But as of April 8, there were 264 confirmed COVID-19 patients in the ICU, and another 270 suspected cases. And suspected cases won't all become confirmed cases — according to public health officials all should be tested and some will be confirmed within a matter of days and others will be found negative.

Williams said Ontario is also not on track to follow the worst-case scenario, in terms of case numbers and deaths, laid out by the modellers. Williams said he's expecting new projections next week that would show if Ontario is bending the curve.

According to Critical Care Services Ontario, there were 714 free beds as of April 8, with ICUs at about 64 per cent capacity.

The chart below, based on data from Critical Care Services Ontario and the modelling released by the province, and informed by the work of howsmyflattening.ca, shows how ICU admissions have not been as high as the province's modellers expected.

(Click on the image to see the chart in a new window.)