Time to test on a wider scale By: Tom Brodbeck Posted: 7:00 PM CDT Monday, May. 25, 2020

Opinion

Hey there, time traveller!
This article was published 25/05/2020 (1931 days ago), so information in it may no longer be current.

As Manitoba prepares for a massive reopening of the economy in the coming weeks, one thing has become clear: we’re not doing enough testing for COVID-19.

The Pallister government last week released a draft plan for Phase 2 of the reopening. It’s an ambitious blueprint that, for the first time in over two months, will allow bars, restaurants, gyms, swimming pools, tattoo parlours and other previously shuttered establishments to open their indoor spaces at 50 per cent capacity. Community centres will open under limited conditions, travel restrictions to the north will be lifted and film production can resume, as long as participants adhere to social-distancing rules.

A date for Phase 2 implementation with finalized details is expected later this week. In the meantime, the allowable group size for indoor public places has already been expanded to 25 (50 for outdoors).

Manitoba’s low COVID-19 numbers are the primary reason for the earlier-than-expected reopening of the economy. The number of new cases in recent weeks has slowed to a trickle (only 13 new probable or confirmed cases so far in May). The percentage of positive cases among those tested over the past two weeks (.05 per cent) is so small, it’s almost statistically insignificant. There were no COVID-19 patients in hospital Monday for the third day in a row. The number of deaths from the disease has remained at seven since May 5.

“Aggressive testing and contact tracing are seen by many experts as one of the best ways to stay ahead of the virus, including enhanced surveillance through random testing of asymptomatic people. Until recently, Manitoba was only testing people with symptoms.”

But the virus is still here. Even with travel restrictions and a closed Canada-U.S. border, the odd case still surfaces. The potential for an outbreak remains, especially if measures taken to reduce the spread of the virus – such as social distancing, hand hygiene and self-isolation when required – are relaxed. The more we reopen the economy, the greater the risk the virus will spread.

Aggressive testing and contact tracing are seen by many experts as one of the best ways to stay ahead of the virus, including enhanced surveillance through random testing of asymptomatic people. Until recently, Manitoba was only testing people with symptoms. Last week, it quietly introduced a plan to test asymptomatic people, but only on a very limited basis.

The question is, given the massive amount of unused testing capacity Manitoba now has, why is the province not conducting asymptomatic testing more extensively?

Manitoba is only using about one-third of its testing capacity. It has the capacity to test between 1,000 and 2,000 people a day. But so far in May, it has only tested a daily average of 565 people. In April, the daily average was 550.

Manitoba has tested 2,823 people per 100,000 since early February. That’s well below national testing levels of 3,904 per 100,000. Part of that is a function of Manitoba’s success in limiting the spread of the virus. Testing has been primarily demand-driven. Fewer people presenting with symptoms means fewer tests. Even as the province expanded the criteria for testing over the past several weeks, average daily testing has largely plateaued, leaving a ton of slack in the system.

“We have lots of lab capacity,” Lanette Siragusa, Shared Health’s chief nursing officer, said Monday.

Testing people with no symptoms is less reliable than symptomatic testing because it produces more false-negative results. A person with no symptoms can test negative, but may later test positive with symptoms. However, in jurisdictions with surplus testing capacity, asymptomatic testing is seen by many experts as a way of finding new cases that may otherwise go undetected. Since there is a growing body of evidence that shows asymptomatic people can spread the novel coronavirus, the fact Manitoba is not doing more random testing raises serious questions.

Dr. Brent Roussin, the province’s chief public health officer, says it’s more important to look at the quality of the testing than the total numbers. But he also agrees asymptomatic testing can be useful “to get an idea of what may be circulating in the community,” he said Monday.

If the capacity is there, why not use it?

Manitoba could double its daily average testing to over 1,100 and still have excess capacity. Considering the degree to which Manitoba is planning to reopen the economy in the coming weeks, it seems short-sighted not to take advantage of that opportunity.