A medical officer of health in eastern Ontario says the slow lab turnaround time for COVID-19 tests is hampering the ability of local public health officials to do effective contact tracing and control outbreaks.
Dr. Robert Cushman, acting medical officer of health with Renfrew County and District Health Unit, says universal testing for COVID-19 has led to major problems such as expired samples and test results that take upwards of seven days to get back.
He says the slow turnaround times in the Ottawa laboratories where the health unit sends their samples for processing have hindered investigations into COVID-19 cases at a local school and a popular gym.
“It’s bad science to do universal testing, but it’s good politics,” he says.
Cushman says his health unit has received results five days later where samples had expired before the lab was able to process them, thereby necessitating another test.
Epidemiologists across the country believe mass testing is the best way to identify and control COVID-19 outbreaks. But Cushman says that requires testing capacities that are not currently available.
“I think in principle it makes a lot of sense, but in practice it’s starting to impinge our ability off where the action is,” he says.
Cushman says Renfrew County, a rural region northwest of Ottawa, “has been the envy of the province” with its low COVID-19 case count.
“But things have changed dramatically since late August,” he says.
[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]
The region has had 42 confirmed cases of COVID-19 since the pandemic began, but there’s an outbreak at a school in Pembroke, Ont., that led to Cushman and his team to shut it down until further notice. Four staffers have tested positive for the illness.
There has also been a case at a local gym that is open 24 hours a day, Cushman says. The public health unit’s investigators have identified more than 100 contacts to trace.
“The government has to have the courage to say, look, public health cannot do effective contact tracing unless they do strategic testing,” Cushman says.
“When we’re trying to investigate an outbreak in a school or a gym, we really can’t have four-, five-, six-, seven-day turnarounds if you want to really identify and control an outbreak.”
Dr. David Williams, Ontario’s chief medical officer of health, also criticized the slow turnaround times in Ottawa.
“I have heard about long delays in getting results back and that’s not acceptable,” Williams said.
He said the city labs, which are overseen by the Ottawa Hospital, are dealing with “logistical issues they’re trying to work through.”
The hospital did not immediately provide comment.
Demand for tests in Ottawa far exceeds supply with many waiting for hours for a test and many others leaving without getting one.
That same demand has also hit Renfrew County with the outbreak and children returning to school, Cushman says.
“We’ve done a lot of really good testing and we’re opening up additional testing, but our lab results are so tardy that you begin to second-guess what you’re doing,” he says.
“On top of that, we’ve had a gym and school with positive cases, the ‘Johnny has sniffles testing’ got in our way in terms of how we can best focus our energy and expedite testing the contact tracing on the gym and the school.”
He says staff have also been distracted by the numerous phone calls from people wondering when they’ll receive their test results.
“That deflects our attention from what’s really important,” he says.
Last week, Dr. Vanessa Allen, chief of microbiology and laboratory science with Public Health Ontario Laboratory, said the provincial capacity is about 40,000 tests per day and growing.
She said turnaround times suffer closer to capacity and that the goal is to deliver 60 per cent of results in one day and 80 per cent within two days.
Given the capacity and demand issues, Cushman says strategic testing is one way to help public health investigators tackle outbreaks and perform more effective contact tracing.
“I’m going to be like the skunk at the garden party when I tell people ‘by the way, please let us do strategic testing,’ I’m going to be very unpopular,” he said.
Rapid at-home testing akin to a pregnancy test is another tool that would greatly help public health investigators, he said.
Health Minister Patty Hajdu said Wednesday that Ottawa is reviewing applications for rapid testing devices, but will not approve them until they meet Canada’s standards for accuracy.