Her kid had a stuffy nose. Now hers is one of many Ontario families in COVID-19 testing limbo (Details)


When Morgan Sim’s five-year-old son woke up with a stuffy nose Tuesday, there went the rest of her day — and week.

The night before, parents at her son’s school had received an email telling them to properly screen children each morning and not to bring them in if they had any symptom of COVID-19.

So, instead of dropping off her son and his 2 1/2-year-old brother at their kindergarten and preschool, Sim and her husband submitted the whole family to COVID-19 testing at Scarborough Health Network’s Centenary hospital site.

With the lines for testing getting longer since schools reopened, Sim was told it would take three to five days to get the results, during which both her children must isolate at home. The boys can’t return to school unless they are symptom-free for 24 hours.

“We’re basically back in the same situation that we were in from March until two weeks ago,” said Sim, who has her own law firm.

Sim said she understands the needs to get children with symptoms tested but would like to see testing available at schools.

“I know it costs money, but frankly the amount of lost productivity cost to parents who are spending half a day at these testing centres would more than compensate whatever cost is involved.”

Sim isn’t the only parent feeling frustrated. In addition to the health worries, the lag time can be more than an inconvenience.

According to Decent Work & Health Work, 58 per cent of Canadian workers do not have paid sick days. The majority of them are low-income households.

Carolina Jimenez is a registered nurse and the co-ordinator of an advocacy group that’s pushing to restore paid sick days for all Ontarians.

“We need to make sure we have paid sick days delivered in a way that everyone has access to them,” said Jimenez. “We are coming up on the flu season. This is … going to be happening with all the different potential symptoms and people needing to stay home and not having the money to stay home.”

Health experts say they are not surprised to see the surging demand for COVID-19 testing during the past two weeks, with adults returning to work and children to schools.

They recognize the challenges.

“The lines are getting longer, the turnaround times (for results) are getting higher. We have to go where the money is: That’s the people who are symptomatic. It’s important they get tested quickly and effectively,” said Dr. Zain Chagla, an infectious disease specialist with McMaster University. “When we start introducing barriers for that group to get high-priority testing and rapid turnaround… we are going to discourage people to get tested when they do have symptoms.”

As of Tuesday, 116 Ontario public schools had a reported case, including two that were shut down as a result. Thirty licensed child-care centres also reported infections, with eight being closed.

Ontario’s current school COVID-19 screening checklist includes: fever, chills, cough that’s new and worsening, shortness of breath, sore throat, runny nose, congested nose, headache, pink eyes, digestive issues, fatigue and sluggishness.

Even though children tend to have milder COVID-19 symptoms and normally don’t get as sick, Chagla said, they should get tested even with very minor symptoms.

Dr. M. Mustafa Hirji, Niagara Region's acting medical officer, says the province needs to prioritize testing for those who show symptoms and have close contacts with an infected person.

However, some say there is room for the screening checklist to be refined when more scientific evidence can show health officials what symptoms are more common and reliable indicators of an infection among this demographic.

In British Columbia, for instance, the latest daily health checklist for children has been refined to just seven key symptoms, from 17.

Dr. Mustafa Hirji, the Niagara region’s acting medical officer, said there have been far fewer infections in children than adults because schools and child-care facilities have been closed until recently. More data such as percentages of positve cases are needed to determine if the current protocols are effective and justified, Hirji said.

In the Niagara region, parents whose kids are sent home for symtoms are told to speak to health officials before they take their children to a testing centre.

“A parent or school (administration) are not health providers. They are going to ask people to get tested all the time. But health-care professionals can provide that guidance. That should be the ideal policy,” Hirji said.

The long queues for testing that Ontarians are seeing now can be attributed to the volume of what Hirji calls “low-value testing” with spaces taken up by people with no symptoms or close contacts with an infected person.

That can partially be attributed to the province’s strategy to maximize the number of testing being done indiscriminately, including some routine workplace testing.

“Right now, dealing with the long lineup and frustration of parents and teachers, we need to back off on the low-value testing to make sure we have the testing capacity and prioritize the people who have the symptoms and do need to be tested,” Hirji said.

Dr. Zain Chagla, an infectious disease specialist with McMaster University, says children need to get tested for COVID-19 even with minor symptoms even though they normal don't get as sick.

“Otherwise, you are doing testing like shooting in the dark and you are not going to be very effective.”

It’s hard to pinpoint precisely the proportion of low-value testing but it could be potentially as high as two-thirds of all the tests currently undertaken in the province.

Hirji said Ontario had similar level of new infections in May and this month, but only 10,000 tests were completed daily then, compared to the 30,000-plus tests being done now.

“These tests are designed to diagnose illness in a person who has symptoms. It is less accurate when done on those with no symptoms,” he noted.

And officials can raise the testing capacity only so much, because they will need more money, machines, testing agents, physical space and lab technicians.

To reduce the wait times at testing centres, Chagla recommended health authorities streamline the registration process and move it online, while exploring rapid testing kits as an alternative to supplement the current testing capacity.

Nicholas Keung
Nicholas Keung is a Toronto-based reporter covering immigration for the Star. Follow him on Twitter: @nkeung


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