Federal government has limited ability to ramp up COVID-19 testing nationwide, say officials

Federal government officials say Ottawa is doing what it can to help provinces ramp up their COVID-19 testing and contact tracing but insist their ability to intervenein provinces that fallbehindis limited.

Most experts acknowledgethat without a lot moreand more widespreadtesting,it wouldbe difficult for the country to return to normal while avoiding the threat of another major outbreak.

Those making the decisions on when and how to open up the economy need to have a better understanding of the virus'scommunity spread. That's not something they have rightnow in provinces where testing is limited to specific categories of people.

"We don't have enough information to be able to make those decisions in a robust way," said Dr. Camille Lemieux, the medical lead for the COVID-19 assessment centre at the University Health Network in Toronto which hashad to turn symptomatic people away because they were not sick enough to be hospitalized, meaning they didn't qualify for testing under Ontario's restrictive rules.

"It's like having one arm tied behind our back" she said.

Provinces decide who gets tested

Experts warn that provinces that fail to increase testing rateswill be faced with a stark choice between delaying the return to normalcy and choosing to ease restrictions while risking a runaway outbreak.

The federal government and provincial governments have collaboratedon testingbut it's ultimately up to the provinces to decide who getstested and how the data are being collected.

Watch:Health Minister Patty Hajdu on helping provinces increase the number of COVID-19 tests they can do:

Hajdu: Government has its "eye on testing"

4 years ago

Duration 1:29

Health Minister Patty Hajdu explains how the federal government can help provinces increase the number of COVID-19 tests they can do.

Ontario, for example, reserves testing for those sick enough to be admitted to hospital, long-term care residents, health care workers, Indigenous people and those living in remote locations.

Quebec is also prioritizing those who live and work in long-term care facilities, essential health and public safety workers and people who live in at-risk settings, such ashomeless shelters.

Manitobahad similarly narrowcriteria until recently, when it expanded them to include workers in all essential services.

Alberta, on the other hand,makes testing available to anyone showing symptoms of the virus cough, fever, shortness of breath, runny noses and sore throats.

Testing is the key that reopens theeconomy

A senior federal government official familiar with the issue said the provinces "get territorial" when it comes to their jurisdiction over health delivery.

On Friday, Prime Minister Justin Trudeau was asked what level of testing Canada needsto reopen the economy.

"We need to continue to ramp up our testing capacity. We need to do a better job of coordinating on testing methodology and approaches across the provinces so that we can have a better vision of what is exactly happening," said Trudeau.

Watch:Prime Minister Justin Trudeau on opening the economy again and if there should be a national standard:

PM on reopening the economy

4 years ago

Duration 2:30

Prime Minister Justin Trudeau is asked whether federal or provincial governments decide when the economy comes back and if there should be a national standard.

The federal government has been instrumental in procuring testing supplies for the provinces, which have struggled withshortagesof key items likeswabs and reagents. Trudeau recently announcedthat Canada now has a domestic producer of the necessary reagent.

And Health Canada has expedited its approval process of new tests, including a promising new rapid coronavirus test.

"It normally takes a really long time for approvals to happen and one of the most beautiful things we've seen with COVID is the rapid ramping up of approvals," said Christine Nielsen, CEO for the Canadian Society for Medical Laboratory Science, the national certifying body for medical laboratory technologists.

'Labour-intensive' contact tracing

She said the process of validating new tests comparing their results against other tests for accuracy also has accelerated,as have validations of new labs to process the tests.

Scientists saythey hope an accurate and rapid blood test will be developedeventually tolook for COVID-19 antibodies helping to identify people who have had the virus (even if they were never tested when they had it)and determining if those people are nowimmune, at least in the short term.

Health officials say Ottawa also can help assemble the vast number ofpeople needed to do contact tracing. The government recently put out a call for volunteers;so far more than 36,000 have applied, although it's notclear if any of them have started working with the provinces on contact tracing.

"Imagine a virus that takes 14 days where you may or may not be contagious. I mean, the tracking for this is really very labour-intensive," said Dawn Bowdish, Canada Research Chair in aging and immunity at McMaster University.

"And so, we have not been able to do the level of testing for the virus that we would have liked to do."

Part of the challenge is that the federal government has no power to set enforceable national standards on who should be tested,or whether the list of testing criteria should now be expanded.

A need for national standards

Some experts believe Ottawa couldat least provide some more forceful guidance on that.

"I would give the federal government the power to prescribe standards after consultation with the provincial ministries of health," said Amir Attaran, who teaches at the faculty of law and the school of epidemiology and public health at the University of Ottawa.

Watch:Chief Public Health Officer Theresa Tam on strengthening contract tracing resources:

Tam stresses the need for contact tracing

4 years ago

Duration 0:54

Chief Public Health Officer Theresa Tam explains what the federal government is doing to help provinces and municipalities strengthen their contract tracing resources.

Attaran and other researchers at the University of Ottawa reviewed the online self-assessment tools provided by the provinces and found no uniformapproach on who should get tested or even on a list ofsymptoms that indicate possible infection.

"The game-changing thing right now would be complete data about where the epidemic is, because we are fighting a war and the generals need to know where the battles are occurring," he said."They need to know where the cases are They do not know that."

Ontario the 'laggard'

Government officials say federal Health Minister Patty Hajduand federal public health leaders continually reach out to provincial ministers to offer help.

"[The provinces]need to put their hands up," said the senior federal official. "If the [testing] numbers don't go up, there will be more conversations."

"It's a challenge for us. We have the financial resources and the people capacity, but they have the jurisdiction."

Ontario which has the lowest rate of testing per 100,000in the country and is not testing at its full capacity, according to Premier Doug Ford is the clear "laggard," said the federal official.

There is wide variation in testing ratesbetween all the provincesbut federal officials say Alberta and British Columbia are the clear leaders in testing. All provinces have promised to ramp up testing.

Alberta, for example aims to test 20,000 people per day by the end of May, while Ontario wants to get to 16,000 per day by early May.

Dr. Theresa Tam, Canada's chief public health officer,said Monday that she expects there will be an increase in testing.

"We're working really closely with every province and it is their collective goal to increase testing in Canada," she told a news conference.