Ontario needs testing strategies that work for everyone
Hon. Premier Doug Ford
Hon. Deputy Premier and Minister of Health Christine Elliott
Dr. David Williams, Chief Medical Officer of Health
Mr. Matt Anderson, President and CEO, Ontario Health
We are deeply concerned about Ontario’s COVID-19 testing strategy. As the second wave progresses, COVID cases are once again on the rise. Communities across the province are reporting long testing wait times. In Toronto and Ottawa, people have had to wait in line for up to 6 hours for a test. In more serious cases, testing is completely inaccessible to highly marginalized and at-risk populations and communities. We need testing strategies that work for everyone; a one size fits all approach won’t work for all communities.
The province has previously communicated that testing strategies are being considered locally by Ontario Health in collaboration with local Public Health to make sure there are appropriate access points. This suggests that multi-pronged approaches are needed. We can’t rely on assessment centres in acute centres alone and expanding testing to pharmacies won't address all the barriers to access for all communities. Our testing strategy must leverage assessment centres, make mobile testing available and expand community driven testing in hotspots and in communities where no testing is available at all right now. We are seeing fee for service testing crop up so those who can afford to skip long testing queues can pay $400 for an at-home test, while precarious workers can’t take time off work to stand in long queues, stigmatized communities fear discrimination in mainstream testing environments, and diverse communities aren’t getting culturally appropriate messages about public health and testing measures. This is creating further inequities. Testing, care and treatment must be accessible to everyone who needs it, in a timely manner.
Community driven testing cannot be a one-and-done project. It is a critical ongoing strategy to reach the communities hardest hit by COVID-19. Here’s what the current COVID-19 testing strategy looks like:
- Sick people riding buses to the assessment centre because they can’t get the test close to home.
- Workers taking a whole day off to wait in line, or not getting the test because they can’t get time off.
- Parents not getting tested because they can’t leave their kids at home.
- Grandparents not getting tested because they can’t stand in line for hours.
- Neighbours not getting tested because they can’t self-isolate.
- People getting sick because those around them couldn’t get tested.
In some Toronto neighbourhoods, healthcare providers have worked together to develop solutions that work for hard hit communities. They have developed targeted testing and outreach in COVID hotspots. These models have been shown to address local needs and experiences, combat COVID stigma and misinformation, build trust amongst people who have experienced marginalization, exclusion or racism in mainstream settings, and bring testing to hard hit communities, eliminating the need for people to travel long distances to access testing. They have also trained and worked with outreach workers from those communities to mobilize populations. Despite their efficacy, the province has not made funding commitments to scale up community-led testing and COVID response in a sustainable way for all communities that need it. We urge the province to act now to scale up public, community-driven approaches that will be accessible to more people.
Ontario must act now to:
- Prioritize community-driven testing, fund existing pilot projects and mobile testing, and expand these models to other communities
- Leverage the skills of health system partners and community agencies to provide smaller scale testing centres to meet community needs.
- Resource and fund Indigenous-led health organizations to provide comprehensive testing services; ensure that PPE, contact tracing and case management are appropriately aligned.
- Work with public health to integrate learnings from community-driven testing models into future health system planning.
CEO, Alliance for Healthier Communities
Caroline Lidstone- Jones
CEO, Indigenous Primary Health Care Council