Virus data gaps threaten to become gulfs


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OTTAWA — Manitobans might think everyone has caught COVID-19 in recent weeks, based on social media postings of positive antigen tests.

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Hey there, time traveller!
This article was published 03/04/2022 (420 days ago), so information in it may no longer be current.

OTTAWA — Manitobans might think everyone has caught COVID-19 in recent weeks, based on social media postings of positive antigen tests.

However, residents of the Northwest Territories actually know when there’s an uptick in novel coronavirus transmission, thanks to a website to report positive antigen tests — and a legal duty to do so.

It’s just one example of an increasingly splintered network of gathering and reporting COVID-19 data, with provinces taking a hands-off approach to the pandemic after months of hard work to get consistent metrics.

“It reminds me of the early scramble for data at the very beginning of the pandemic, when there was just really variable information from different sources in different provinces,” said Jean-Paul Soucy, a epidemiology PhD student at the University of Toronto.

“We’re kind of seeing that again.”

Soucy co-founded the COVID-19 Canada Open Data Working Group, which since early in the pandemic has been assembling the patchwork of information from official sources, to create comparable datasets.

The group created dashboards with information that appeared months later on the Public Health Agency of Canada’s website, allowing comparisons of regional cases, mortality and hospitalizations.

Last week, Manitoba went blank on the agency’s daily epidemiology map, as it ceased daily case reporting in favour of weekly updates. It’s also joined a provincial trend of winding down molecular testing or sharing information on the demographics of those dying from COVID-19.

Last week, Manitoba went blank on the Public Health Agency of Canada's daily epidemiology map, as the province ended daily case reporting in favour of weekly updates. (PHAC)

“It’s very much a mixed bag, when previously we saw it as pretty consilient across the provinces,” said Soucy.

He noted in Manitoba, cases are being reported by region but not deaths. Newfoundland and Labrador has the opposite, with region-level data on deaths and hospitalizations but not cases.

There’s also no standard frequency for when provinces and health regions update their data.

“We really have a lot less information as a country, of where things are going,” Soucy said.

Last month, Manitoba and federal officials said they’d both shift to reporting COVID-19 data similar to how influenza has been tracked for decades.

Every flu season since 1996, the FluWatch program has issued weekly reports on the severity of infections, and the strains circulating in Canada, based on a sub-sampling of cases that get genetically sequenced.

That involves hospitals across Canada testing a sample of patients for the novel coronavirus and having those samples sequenced to learn about strains, just as researchers do for the flu.

Yet, governments are asking Canadians to gauge their risk of COVID-19 while publishing less data or even stop-light coded levels of how much transmission is actually occurring.

“We have a shift in focus toward personal mitigation… of risk, and at the same time reducing the amount of information that is being given,” Soucy said. “That strikes me as a contradiction.”

Meanwhile, Canada is a global laggard in testing for the novel coronavirus.

Among the 38 mostly rich countries who make up the Organisation for Economic Co-operation and Development, Canada has ranked among the bottom three during the past week, in terms of COVID-19 tests conducted per capita.

That’s according to data assembled by Our World in Data, a research project run out of the University of Oxford in England.

The series is smoothed by averaging daily figures over a rolling 7-day window. Not all countries report testing data on a daily basis. To generate this series Our World In Data assumes that testing changed equally on a daily basis over any periods in which no data was reported. This produces a complete series of daily figures, which is then averaged over a rolling 7-day window. Tests may refer to the number of tests performed or the number of people tested, depending on which is reported by the particular country. (Our World in Data)

In raw numbers, Canada reached its peak in testing during the Omicron variant surge, with 165,000 daily tests nationwide the week surrounding Jan. 10.

By that point, provinces restricted access to testing, leading to a steady decline. There were just under 40,000 tests conducted each day of the past week, a rate that hasn’t been so low since June 2020, as the first wave abated.

Canada’s top doctor said the provinces need to determine how much testing is sufficient.

“I can’t tell you whether that’s too much or too little, but it needs to be enough so that we can monitor trends,” Dr. Theresa Tam said April 1.

“Jurisdictions are adjusting to what is a good, sampling size and distribution in terms of trends, analysis,” she said, in response to questions from the Free Press.

“I meet with the provinces all the time, very frequently, to try and get that more consistent approach… I’ll be really disappointed if we went backwards and let go of the actual gains that we made during this pandemic.”

Yet, University of Saskatchewan epidemiologist Nazeem Muhajarine argues the wide-scale suspension of PCR testing makes it hard to tell when provinces have entered a new wave.

“We have compromised our ability to really measure (new) cases of COVID-19,” Muhajarine said last week. “That then compromises our ability to say with confidence that we are seeing a sustained increase in cases.”

The result could be exponential growth that only gets noticed by hospitalizations and work absences, though Muhajarine noted wastewater trends can also help.

Ottawa has also scaled up work to provide more detailed and recent data from sewage detection of the coronavirus, which can indicate an uptick before large numbers of people start experiencing symptoms.

For now, Winnipeg’s wastewater data comes through a federal program that reports statistics two weeks late. That’s the incubation period for the coronavirus, making the sewage data of limited use.

Tam also has concerns about Manitoba curtailing its definition of a COVID-19 death, to exclude people who had certain illnesses.

Researchers believe many COVID-19 deaths go unreported, based on comparing the projected number of deaths pre-pandemic to those that occurred, known as excess deaths.

“Mortality surveillance is very important, and I personally think that in the Canadian context, we need to do better.” –Dr. Theresa Tam

“Mortality surveillance is very important, and I personally think that in the Canadian context, we need to do better,” she said.

Soucy said Canada has been underwhelming in sharing information about COVID-19. He pointed out a dashboard the U.S. Department of Health & Human Services published on hospital capacity and COVID-19 patients in each state.

“That would be unthinkable here, in terms of health data availability,” he said of Canada, arguing this matters for more than just data geeks.

“Transparency builds trust, (and) trust is the fuel that public health runs on.”

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