Canada will miss COVID-19 cases as testing systems become overwhelmed: experts

Click to play video: 'B.C. government faces growing criticism over long COVID-19 testing line-ups'
B.C. government faces growing criticism over long COVID-19 testing line-ups
WATCH: The B.C. government is expected to unveil its latest COVID-19 testing program on Tuesday, as line-ups at testing sites, and criticism, continues to grow. – Dec 20, 2021

Daniel Bear would like to get a COVID-19 test.

“I know I have COVID,” the father from Toronto told Global News on Tuesday.

He’s taken five rapid tests since his nose started running nearly a week ago. At first, they were negative, he said. But on Sunday when his symptoms got worse, he took another, and it was positive. He’s had two more positive tests since.

Bear said he’d like to get a PCR test from a government testing centre because his daughter’s school won’t notify families who may have been exposed without a positive PCR test result.

“I don’t need a PCR test for vanity’s sake, I need a PCR test so that the school can notify other families that I was there for pick-up,” he said.

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But, he wasn’t able to find an appointment until this upcoming Thursday, and he fears that might be too late to produce an accurate result. After hearing of his plight, he said, a private company sent him an at-home kit that he plans to take right away, though not everyone has that option.

Click to play video: 'COVID-19: Nova Scotia announces changes to testing strategy'
COVID-19: Nova Scotia announces changes to testing strategy

Bear isn’t the only one having trouble finding a PCR test in Ontario, or elsewhere. And some experts warn that tests will have to be prioritized for high-risk groups as testing systems become overwhelmed – which will likely lead to inaccurate case counts.

“I think we’re in crisis,” said Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa.

“People cannot get PCR tests. The rapid tests are hard to find as well. So we’re at the stage where we’re probably rationing PCR tests to a large extent, by which I mean reserving them for health-care workers or people who need them for clinical diagnostic purposes.”

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Testing demand

Ottawa Public Health has already warned residents that testing cannot keep up with demand, and people with symptoms or exposure to COVID-19 should self-isolate even if they can’t get tested.

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Quebec’s health minister warned Monday that testing capacity is stretched thin in that province too – and asked that only people with symptoms seek a test. Labs have recently been processing around 40,000 tests a day, hitting a high of 46,830 on Dec. 15.

“It’s a record since the beginning of the pandemic, and it’s, unfortunately, our maximum capacity,” Quebec Health Minister Christian Dube said. “Testing centres should not be a tool to get tested if you’re asymptomatic and you want to gather with your loved ones.”

Dube asked people to prioritize at-home rapid tests to avoid clogging laboratories.

Ontario’s chief public health officer Dr. Kieran Moore said Tuesday the province would soon announce further guidance on prioritizing PCR tests and using rapid antigen tests.

Data problems

When not everyone who wants a COVID-19 test can get one, it can wreak havoc on data and record-keeping, said Fahad Razak, a general internist at St. Michael’s Hospital, an assistant professor at the University of Toronto, and a member of the Ontario COVID-19 Science Advisory Table.

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“We will probably in the next few days lose sight of where the infections are happening in the province,” he said. “What areas are the most concentrated things like high-risk exposures? So were you in a place where you exposed a lot of other people? All of these things become more difficult to do when you don’t have a reliable testing mechanism.”

He says daily case counts could soon be a “considerable underestimation” of the number of people infected, he said.

Deonandan agrees.

“Very soon we’re going to see a plateauing of cases and a reduction or stabilization of the reproduction number that’s going to be an artefact. It’s not going to be real. It’s going to be the result of limited testing,” he said.

Provinces might have scaled back their testing capacity during comparatively quieter times, and are now having trouble keeping up, he said. “We’ve never had great TTI capacity: test, trace and isolate capacity,” he said.

The other problem is Omicron itself, he said, and its ability to spread much faster than health systems can test for it.

“It’s crazy contagious. I’ve been saying that Delta is the most contagious respiratory virus we’ve ever seen in modern times. Omicron leaves Delta in the dust,” Deonandan said.

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“It’s so contagious that everyone’s going to be exposed in a matter of weeks, everybody. So, you can’t test everybody in a matter of weeks.”

Click to play video: 'Confusion, frustration as rapid antigen tests demand soars across Canada'
Confusion, frustration as rapid antigen tests demand soars across Canada

We have to slow the wave of infections somehow, Razak said.

“In the coming weeks, everyone in this province, in this country, is probably going to develop some immunity to Omicron, either by being vaccinated or getting sick,” he said.

“We can slow the wave and slowing the wave means the public health measures we’ve always talked about. So it’s restricted access to venues for only those who are vaccinated, ensuring good ventilation, wearing a mask, not going into a public setting if you’ve been sick, reducing the size of gatherings for the holidays,” he said.

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“No single thing is a magic bullet, but everything together starts to reduce the exposure and the risk of the numbers. And it gives time for more vaccines to be delivered.”

In the meantime, if you think you have been exposed to COVID-19 or are showing symptoms and you’re unable to quickly find a test, both Deonandan and Razak suggest you act cautiously and follow the advice of your local public health unit.

Symptoms of Omicron COVID-19 infection can include cough, fatigue and congestion or runny nose, according to the World Health Organization. If you have those, Deonandan says, stay home.

“We err on the side of caution. So if you’ve got symptoms, we assume that you’ve got the disease and we ask you to stay home and isolate until the symptoms abate. And if you’ve got rapid tests, we can use those as well. And that’s where we are,” he said.

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