After a day in which Ontario shattered its daily high when it comes to new COVID-19 cases and health experts warn the healthcare system is facing unprecedented pressure, Premier Doug Ford warned “we are in a crisis” with indications that more restrictions are coming.
But are tighter lockdown measures the answer?
Cynthia Mulligan spoke with Infection Control Epidemiologist Dr. Colin Furness, who believes we should be doing even more testing than we are and that part of that solution is within our reach. He also warns that the government has already painted itself in a corner when it comes to lockdown measures and that more restrictive measures would be “very unpleasant” and impossible to enforce.
Cynthia Mulligan: What more can this government do to stop the spread of COVID?
Colin Furness: If we look at other countries, that have gone through before us, there is really two paths forward, and really it’s the same thing we’ve been seeing since the summer. So Victoria for example, Australia, they locked down and they did it for something like 100 days, and people were literally in their homes, couldn’t leave except to go for a walk. Couldn’t leave, except to go grocery shopping, that was it. Everything shut and it was 100 days, and they knocked it down that way. That’s one way.
Then you could look at Slovakia, which is a country, relatively small, they decided that they were going to mass test everybody. They tested everybody, and they found thousands upon thousands of asymptomatic cases. They isolated them, they treated them, and they were done. In the case of Slovakia, the cases actually do start coming up again. Which is to say, once you do this, you’ve actually got to do it more than once, you need a strategy, you can’t just say you’re done. However, really we have these two ways forward.
The wisdom in Ontario is that testing is not what we do. In Ontario, we lock down or we open up, that’s the toolkit. I disagree, I think that we could and should be testing.
Not only that, there are innovative tests that are excellent that we’re ignoring, we’re not using. One of them invented here in Ontario. Brilliant, reliable, fast. We’re not using it.
Some fraction of 1 per cent of our population has COVID right now. The other 99 per cent-plus don’t so why would we want to lock up 99-point-something per cent of the population because we are unwilling to do some simple things to identify the less than 1 per cent that need help?
CM: What is it?
CF: It’s a different kind of PCR test. It’s Eric Brown’s work at McMaster. He essentially identified some innovations and put them together. It takes three hours, it costs a fraction of what we’re doing now, and works on saliva.
So all you need to do is spit in a cup. You don’t need a nurse to stick a swab all the way into your brain, so it can be used on kids, and it could be processed in any university lab. Those are labs that are sitting idle right now.
So we have this capacity, I literally see schools within a line of sight of university labs, all of them shut, and they don’t need to be. All that we need to do is connect the dots here.
CM: So are you saying that mass testing is way better than lockdowns?
CF: Mass testing is way better than lockdowns. Some fraction of 1 per cent of our population has COVID right now. The other 99 per cent-plus don’t so why would we want to lock up 99-point-something per cent of the population because we are unwilling to do some simple things to identify the less than 1 per cent that need help? It doesn’t make sense.
CM: – How do you put the genie back in the bottle?
CF: You would need to have a very aggressive mass testing campaign. You identify risk, and identify that occupationally. We know what work environments – that data is there…
CM: You’ve been saying this since day one Colin
CF: Yes I’ve been saying this since day one, we have more data now. We really know. Toronto Public Health knows exactly which kinds of workplaces are high risk.
We go into every single one and we test, and if there’s positives we shut those down, not the whole economy, where there are outbreaks.
We do it demographically, we do it geographically. We know the hotspot neighbourhoods, we know the demographics of those who are at risk. We go door-to-door, and for those who are in marginalized communities, who are doing precarious work, who don’t get paid sick days. What we need to do is say, we will pay you to take the test. And if the test is positive, we will put you up in a hotel, we will buy your family groceries, and we’ll hand you even more money. You will be okay, we will be okay, this will be okay. That’s got to be the message.
It’s got to be door-to-door, and that would be a lot cheaper than shutting down the economy for the other 99 per cent.
“You are going to have to do major enforcement. I don’t think we have enough police officers to do it. I think we are going to need help from the military to close roads, set up road blocks. It would be very, very unpleasant.”
CM: How many tests would have to be done?
CF: I haven’t actually done that math. You would want it to be hundreds of thousands of tests a day. Again, using the technique developed by Eric Brown – the PCR protocol developed by Eric Brown at McMaster, and using university labs, that’s doable, that is absolutely doable.
We have all the pieces we need to do that, and we just need to decide that we would rather test than lockdown, and that’s a decision that Queen’s Park resolutely has not made.
CM: If there is a lockdown, what does that look like?
CF: If you want this to work, and I’ve never been a law-and-order public health enforcement person in public health because it backfires, it’s very problematic and that’s not the way you want to go, but if you’ve painted yourself into a corner, and perhaps we have, you are going to have to do major enforcement. I don’t think we have enough police officers to do it. I think we are going to need help from the military to close roads, set up road blocks. It would be very, very unpleasant. But if you don’t do it, what recent history has taught us is, the people who are listening and saying ‘I will sacrifice Christmas, I will stay in my home,’ they are not actually the problem. The problem is the people who aren’t taking that kind of responsibility, they are finding ways around it.
And of course you’ve got essential workers who have to continue going to their jobs. So this is really difficult, you’re going to have to make some really hard decisions about what is really essential work. We’re going to have to put a lot of people out of work and we’re going to really have to enforce that.
If this is what we do it’s going to be very unpleasant.