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Zalan: Shame on the province for failing to be ready for a second wave

Ontario needs to start mass testing, vigorous tracing of contacts and targeted lockdowns in COVID-19 hotspots, says health-care columnist Dr. Peter Zalan
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Shame on our governments, who had the time to prepare for the second wave. They threw that advantage away. Testing and contact-tracing in Ontario’s hotspot cities are not meeting the demand.

Shame also on the individuals who do not wear a mask when they should, disregard social distancing, and put their families, friends and colleagues at risk. 

I am thinking back to March and April. It seems long ago when we were in the first wave of the pandemic. I recall that we were short of testing kits and laboratory capacity, much as now.

Testing was approved only for individuals with serious illness and a history of international travel. Results came back slowly, sometimes up to a week after testing. In late March, Pinecrest Nursing Home in Bobcaygeon declared an outbreak. Twenty-nine people died during Ontario’s first major long-term care outbreak.

A lockdown was imposed in late March throughout all of Ontario. In April, the Ontario government ordered public health units to test every resident and staff member at long-term care homes for COVID-19. To date, more than 70 per cent of deaths have occurred in long-term care homes.

Things got better. Infection numbers dropped dramatically. There were only 79 cases reported in Ontario in early August. Restrictions were eased gradually and economic life began to recover. Testing criteria were eased: anyone could get tested. Schools were to open in September. It was summer and life was almost normal.

No longer. The average number of new cases reported daily in Ontario is now running four times higher than at the end of August and reached the highest number of new infections on a single day since the outbreak began in late January.  

Testing capacity in the province has increased dramatically. The province can perform 40,000 tests per day and intends to increase that to 50,000 per day. Results come back usually within two days. 

Nevertheless, it is not good enough to meet soaring demand. Long line-ups are snaking around testing centres. Contact-tracing in Ottawa and Toronto cannot keep up with the volume of new infections. 

In response, Ontario altered its "anyone can get a test" policy. Far fewer people without symptoms are now eligible for testing. New regulations feature a shorter list of symptoms that would require a child to be tested for COVID-19. 

It is very significant what Ontario has not done.

New Zealand imposed a lockdown of Auckland in August following the confirmation of an outbreak of COVID-19: no face-to-face retail shopping, no school attendance and no gatherings until contact-tracing had finished. To ensure that the infection did not spread beyond the city, there was a ring of police imposed around Auckland, limiting travel in and out of the city to essential individuals.

Ontario must do the same in our hotspot cities if it hopes to prevent infection spreading throughout the province.

Wuhan, the city where COVID-19 was first detected had a flare-up in May that led to a vast drive to screen the city’s 11 million residents within two weeks.

There were outbreaks in other regions of China in July, raising fears of a serious resurgence. In response, cities with populations in the millions were tested in their entirety in order to unearth asymptomatic carriers of the virus. There have been few infections since early August. Rapid mass testing coupled with vigorous tracing of contacts and targeted lockdown restrictions appear to have succeeded in cutting off hidden chains of transmission.

Sao Paulo, Brazil’s capital and home to 12 million people, is planning to test 777,000 students and teachers, as part of the process to restart in-person classes. 

A hundred small colleges in northeastern United Sates are showing particularly low rates of infection. They are testing all students and staff twice weekly. 

So, here is the thing. If China can do it, if Brazil and U.S. colleges can do it, so can we. If New Zealand’s government can take the tough steps, so can we. It only requires the will, the commitment and the courage to make it so. 

Ontario should ramp up testing capacity so it can mass-test everyone in Ontario’s hotspot cities, much as in China. Schools should begin testing all students and staff immediately, much as in Brazil and northeastern U.S. colleges. Ditto for repeated testing of individuals in high-risk occupations, much as we are testing staff and visitors in all long-term care homes in the province twice monthly. 

Testing is not particularly expensive when compared with hundreds of billions of dollars in lost economic activity, if the province is forced to return to general lockdowns. Worth the cost if we gain the ability to control the pandemic earlier rather than later.

Shame on our governments which had the time, but failed to get ready for the second wave. Shame for remaining unready to impose, in Ontario’s hotspot cities, the restrictions that worked in Auckland: mass testing, coupled with vigorous tracing of contacts and targeted lockdowns.

Then there is what we, as individuals should be doing.

After an infected woman with the coronavirus visited a café in South Korea, more than two dozen patrons tested positive days later. The four employees who were wearing face masks escaped infection.

The take-home messages are clear. Spending time in busy Indoor spaces, without wearing a mask and without maintaining social distancing, puts you at high risk of contracting the coronavirus. Masks prevent infecting others. Masks also protect the wearer from infection.

Shame on the individuals who do not wear a mask when they should, disregard social distancing, and put their families, friends and colleagues at risk.

Dr. Peter Zalan is past president of the medical staff at Health Sciences North