Ontario restricts COVID-19 tests to people with symptoms or other risks

Facing long line-ups and backlogs, Ontario is focusing COVID-19 testing on only those who need it, prompting criticism that the government's failure to plan has led to test "rationing."

Public assessment centres are now being instructed to only test people showing one or more symptoms of COVID-19, people who are a close contact of a confirmed case, high-risk individuals or those who were close to a confirmed outbreak.

"There's no value" in others getting tested, said Dr. Barbara Yaffe, Ontario's associate chief medical officer of health. She said it can lead to false positives, "which just complicates things even more."

The centres are not being instructed to police who gets tested, Ontario Health CEO Matthew Anderson said, adding that the province is counting on Ontarians to be honest.

"We're all in this together," he said.

But when asked whether testing centres would turn away people with no symptoms or other risks, Anderson said, "That is what we're talking about. We want to ensure that we have the testing capacity for our priority populations."

He said there will be a "full communication plan" to reinforce this.

Those who are asymptomatic and "part of a targeted testing initiative" under the government will be able to get tested at up to 60 private pharmacies across the province starting on Friday. Those with symptoms will not be able to get tested at pharmacies, which will operate on a booking system, Anderson said.

"So a great example would be our long-term care workers," Anderson said. "We do want to test them. We also test our retirement home workers. So if they're asymptomatic, they can go to the pharmacy and test through that fashion."

The newly released 15-page guidance document also contains guidance for hospitals and assessment centres on things like testing in long-term care homes and for priority populations like health-care workers.

NDP leader Andrea Horwath said the province is "rationing" testing because it failed to prepare for the second wave.

"The plan is obviously being written and re-written, erased and papered over as we speak, at this very moment in time, even though we are well into the second wave," she said.

Green leader Mike Schreiner agreed.

"It should not have taken mile-long testing lineups to force the government’s hand," he said in a statement. "Our testing capacity should have been expanded weeks ago, not weeks from now."

Horwath said she wouldn't blame anyone if they were confused, noting that Ford had encouraged asymptomatic people who wanted to get tested to do so just the previous day.

Liberal MPP John Fraser said "the government's communications have been about as clear as mud as far as testing goes."

"There shouldn't be any confusion," Premier Doug Ford said, noting that the plan was developed by the province's health experts.

The province has taken lessons from the first wave as it gets into what appears to be the second, Yaffe said. When Ontario first opened up testing to anyone who wanted it, "we did not find cases," she said.

Ford said the province's investment in testing and contact tracing has topped $1 billion.

"This investment will make a huge difference," he said, promising more announcements on the Tories' fall COVID-19 plan soon.

The government has taken heat recently for extremely long line-ups at testing centres across the province. Ford has said his government has been preparing a second wave plan "for months," but it has only started to roll out piece-by-piece this week.

The situation has been worsened by increasing caseloads in the province in recent weeks, with new cases above 400 in five of the last seven days. Death rates and hospitalizations have not yet jumped, but experts say those indicators often lag behind spikes in cases.

Total tests have fluctuated between 30,000 and 40,000 daily for the past week, but Anderson and Health Minister Christine Elliott have said they expect the province to handle 50,000 per day sometime in the next couple of weeks.

Anderson said Ontario, like many jurisdictions, is struggling to get equipment amid global supply chain pressures but expects that to be worked out soon.

Ford once again called on Health Canada to approve rapid saliva tests in use elsewhere, to help with Ontario's testing capacity. Until that happens, he said, experts told him the province needs to continue to restrict tests.

Anderson said the province is trying to take pharmacy tests off of the main laboratory "path" so they don't clog up the system.

"We're opening up all channels to see, where can we acquire more capacity. Perhaps from other provinces, perhaps from outside of the country, in the U.S.," he said.

Ford said he'd much rather send tests for analysis to other provinces, if possible. "I don't care if it's private, public, whoever it is, as long as we can get these tests moving forward."

While a high-profile group of physicians, backed by the Ontario Hospital Association, issued a statement urging the government to essentially roll back to an earlier stage of lockdown by closing things like dine-in restaurants, nightclubs and gyms, Yaffe said the province is taking a more "targeted" approach.

"We cannot just close down everything and assume everything will be fine," she said.

A statement from Ontario physicians and health care leaders specializing in infectious diseases, general internal medicine, medical microbiology and infection prevention and control.

Thanks @larissamatukas & @ASPphysician for your leadership on this. https://t.co/QJj6aqhR3q

— Irfan Dhalla (@IrfanDhalla) September 24, 2020

But Ford said he'll continue to monitor the numbers and listen to his health experts. "And if it's a huge spike, everything's on the table."

Yaffe noted that there are downsides to the economy, social lives and mental health when things shut down. She urged Ontarians to help avoid that by being mindful of public health guidelines like wearing a mask.

"People should be thinking about every interaction they have with other people," she said. "Think about it everywhere, everything you're doing."

Elliott said the province is going to look at how it can better communicate the importance of following public health measures.