In the midst of an ever-evolving COVID 19 pandemic, who in their right mind, would privatize testing and stop tracking cases? That’s exactly what Ontario Premier Doug Ford has done.
On Dec. 30, 2021, Ford announced very stringent guidelines restricting access to public testing for COVID-19. The list for access to publicly funded Polymerase chain reaction (PCR) testing was limited to people and communities at risk. Ontarians experiencing COVID symptoms, and those who may have been exposed to COVID, did not make the cut.
That meant Ontarians were unable to access COVID testing through local hospital assessment centers or public health units—even if they had kids in child care or elderly family members.
During the Ontario Health Coalition (OHC) press conference this week, Natalie Mehra, Executive Director of the OHC stated, “The rate of testing declined precipitously leaving infectious disease specialists and epidemiologists lamenting. Ontario is now shooting in the dark when gauging the severity of the current sixth wave that we’re in.”
Testing, contact tracing and quarantine are fundamental to containing the spread of COVID. These important public health measures are no longer part of the government’s plan. Instead, Ford signed contracts with pharmacies and private, for-profit clinics to provide COVID testing. The terms of these contracts, including remuneration, have not been made public.
The Dec. 30th provincial budget stated, that as of Mar. 2021, Ontario had the capacity to perform 105,000 COVID tests each day and could deliver results within two days for over 90 percent of those tests.
By Dec. 2021, Ontario was providing a mere 50,000 to 85,000 tests per day. That discrepancy of 85,000 to 90,000 tests per day begs the question, what is the actual COVID testing capacity of the public health care system?
Public testing currently sits at about 12,000 per day. This unbelievably low rate of testing can in absolutely no way be attributed to a lack of capacity as Health Minister Christine Elliott and Chief Medical Officer Kieran Moore have repugnantly claimed.
Instead, the truth can be tracked back to Sept. 2020 when Ford began contracting testing to private, for-profit pharmacies. Then, in Nov. 2021, he expanded the scope of the contracts to include symptomatic patients. Ford followed that in 2022 by strictly curtailing public testing and forcing Ontarians to use private testing or go without.
Currently, 18 corporate chains and private clinics are contracted to provide publicly funded swabs for symptomatic people. Meanwhile, public assessment centers with ample capacity are prohibited from testing people with these same symptoms.
At least five chains and private clinics are charging between $129 to $200 per test. That violates the Canadian Health Act which prohibits charging user fees for medically necessary services.
According to Mehra, “It is the fundamental principle of our public health care system that we have access based on need. Not based on being able to afford to pay for it when we are sick, when we are elderly, when we are least able to pay.”
She went on to say, “If there is ever a time to uphold the Canada Health Act, it’s during a pandemic.”
Dr. Gordon Guyatt, Professor at McMaster University and Board Member of the OHC, knows, profit as the motivator doesn’t work in a health care setting. He says, “Any time you have private delivery of publicly funded services, it is a problem.”
Guyatt referred to research conducted in private, for-profit hospitals, dialysis clinics and nursing homes that exposed lower quality care provided at far greater costs. Specific to COVID, Guyatt highlighted safety issues unique to pharmacies and private, for-profit clinics.
While public facilities have strict COVID guidelines that must be followed, pharmacies and private clinics do not. They don’t require N95 masking and allow clients waiting for COVID testing to share waiting rooms with clients having routine, non-COVID procedures. These pharmacies and private, for-profit clinics also fail to inform people falling within the new testing guidelines that they could access free COVID testing at public facilities.
Cathryn Hoy, President of the Ontario Nurses Association (ONA), says, “There is a two-tier health care system right now in Ontario. And, if we allow this [for-profit COVID testing] it’s only going to get worse.”
Hoy’s experience has shown that wealth moves patients to the front of the line in a two-tier system. She believes “It’s just fundamentally wrong when you can buy access to health care services. And, really, when you can buy the right to live in some cases.”
With 68,000 front line nurses and 18,000 nursing student members in the ONA, there is abundant evidence that charging for PCR testing does not improve access. Instead, those who can’t afford the fees simply forgo testing. That’s a very real concern because these individuals could, unknowingly, spread COVID to family members and their wider community.
Sara Labelle, Chair of the Ontario Public Service Employees Union’s (OPSEU) Hospital Professionals Division and lab technician at Mount Sinai Hospital, maintains the public system has all the resources required to carry out COVID testing.
It seems the lack of capacity is actually due entirely to the limited resources and inadequate funding provided by the provincial government. According to Labelle, “At one time our hospitals were running all COVID tests and taking a hit of $1 million to $2 million in their budgets for extra COVID testing. Funding that was not guaranteed to be reimbursed by the government.” The conservatives eventually reimbursed some costs that fell within a designated period of time determined, of course, by them.
This is alarming since hospital diagnostic lab PCR testing is the gold-standard with over 95 per cent specificity and sensitivity. In fact, the results from pharmacy administered PCR tests were intended to be used exclusively in LTC settings and not as a public health measure.
Additionally, Labelle pointed out that hospital public labs can run dozens of tests every 38 minutes while individual pharmacists perform four per hour.
We are in the sixth wave of COVID with the most vulnerable and at-risk Ontarians unable to access free tests. Labelle says, “Not tracking how many people have COVID is a public health disaster and it means more people are going to get sick with COVID.” She maintains the public health care system has the capacity and the trained technologists to do the work. All they need now is the funding to pay for it.
According to Labelle, “This is a bad direction to go. Bad public health measure. And, this government needs to smarten up and take this seriously because we are not going to get out of it unless they invest in public services and public contact tracing and testing to get us through this pandemic.”
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