Shelley Lundquist was left feeling confused — and concerned — when she was turned away without being tested at Southlake Regional Health Centre’s COVID-19 assessment centre.
After returning home March 30 from a three-week trip to Portugal — a high-risk area for COVID-19 infection — she was racked with coughs and felt some pressure in her chest, as well as had an irritated throat, runny nose, fatigue, some dizziness and disorientation, and loss of sweet taste.
When she spoke to her doctor by telephone, he directed her to immediately go to Southlake’s assessment centre.
On April 1, she donned an N95 mask and gloves and arrived at Southlake, where she was told by a physician that under Ministry of Health protocol, she wasn’t eligible for testing, despite her symptoms and travel to a high-risk country.
“They said that even if I did have it, they can't treat it anyway and that I should come back for testing only if I can't breathe.
“I was shocked. I was gobsmacked. I said that means the reported numbers aren’t real. Which means none of us has any real idea how many people are out there spreading it because they don't know if they have it,” Lundquist said.
She remains in isolation in her Aurora home, despite 14 days having passed since her return from Portugal. She’s slowly getting better but still has not recovered completely.
“Do I have COVID? I don’t know,” she said, concerned about the possibility that even after the mandatory isolation period, asymptomatic individuals can continue spreading the virus, unaware they are carriers.
“Just what are the real numbers? They don’t know — we don’t know,” Lundquist said. “The numbers we have been told don’t give us any indication what is happening here in our community, our province, our country. That is alarming. Terrifying.
“Maybe people would be staying at home if they knew the truth.”
Another reader, who wished to remain anonymous, contacted NewmarketToday with similar concerns when a friend was told by her family doctor that she is "presumptive positive for coronavirus." She was directed to self-isolate and go to the hospital if her symptoms became more severe.
"But no one is following up with where she got it, or who she may have exposed to the virus to prior to her isolation," she said. "There needs to be some accountability from York Region to report presumptive cases as well as confirmed."
There are no statistics being reported on how many people who likely have COVID-19 were turned away when testing was restricted, first by a lack of assessment centres and lab capacity, and then by dwindling supplies of swabs and reagents.
Ontario had tightened its criteria for testing March 12, when the Ministry of Health released new protocols for the health sector to follow. Individuals who travelled outside of the country and had symptoms would no longer be tested.
For much of late March and early April, Ontario was behind all other provinces in the number of tests administered per 100,000 people, at one point lagging Alberta by a factor of three.
But the situation has changed since Lundquist visited the assessment centre at Southlake at the beginning of the month.
York Region medical officer of health Dr. Karim Kurji is now saying now that any resident with COVID-19 symptoms should go to an assessment centre at Southlake, Mackenzie Health or Markham Stouffville Hospital.
“I would urge anyone with COVID-19 symptoms to please, please … get assessed,” he said yesterday in a video update.
“Testing resources were scarce before but are now being liberalized and you’re more likely to get tested now.”
Ontario can now run as many as 13,000 tests daily, and Premier Doug Ford expressed his frustration about the "unacceptable" number of tests being done at the province’s 100 assessment centres at a news conference last Wednesday.
Ontario health officials are saying daily output will rise to about 8,000 tests by April 15, 12,500 tests a day by April 22 and 16,000 tests per day by May 6.
Increasing Ontario's lab testing capacity has eliminated a backlog of approximately 10,000 people within less than two weeks, according to the province.
To date, the province has conducted more than 113,000 tests.
As of April 13, 1,537 patients have been tested at Southlake's assessment centre, according to the Newmarket hospital, and 130 patients who screened positive were sent home to quarantine.
Provincial health officials have expanded guidelines for testing to include severely ill people, health-care workers, residents of long-term care homes and retirement homes, first responders, correctional officers, inmates, residents of group homes, residents of Indigenous reserves, and occupants of homeless shelters.
“We are encouraging everyone with a fever, a new or worsening cough, or new or worsening shortness of breath to present to one of the three COVID-19 assessment centres in York Region, even if you only have mild symptoms,” Scott Cholewa, manager, infectious diseases for the Regional Municipality of York told NewmarketToday.
If you have these or other symptoms and are concerned that you may have COVID-19, Cholewa said you should also contact your health-care provider or call Telehealth Ontario at 1-866-797-0000.
“The more people we test the more likely we are to find cases,” he added. “Testing is a crucially important tool for measuring and slowing the spread of COVID-19 in our community.”
In particular, Kurji has encouraged residents of Vaughan — which has been hit hardest by the virus, and where community-acquired transmission is widespread — to visit an assessment centre.
“It is important that you know your status, as well. Not only does it help us with regards to case and contact investigation, but it also helps you to know that you’re COVID positive because, unfortunately, some folks immediately after they get the symptoms tend to go downhill within a day or two and become seriously ill,” Kurji said.
Hospital websites continue to indicate that not everyone who visits an assessment centre will be tested, and that physicians will determine if the test is required following an examination.
Health Minister Christine Elliott said that physicians will continue to use their clinical judgment regarding who will be tested at assessment centres.
It’s possible being refused testing has discouraged some residents from seeking treatment until their condition has deteriorated.
“Our hospital partners are telling us that they’re seeing people who are seriously ill,” Kurji has said.
And Kurji said some individuals in the region who have died from COVID-19 were not tested beforehand.
“We find out after death that they had COVID-19,” he said. “This shouldn’t occur in our society.”
For instance, a 56-year-old Vaughan man died Saturday, April 11 in a private residence two weeks after the onset of symptoms without being tested beforehand, according to York Region public health.
Public health is actively following any known cases of COVID-19, whether they have been tested for the virus or not, according to Cholewa.
“Public health has advised our health-care provider partners about this reporting requirement as well,” he said.
They are also tracking individuals who have come into contact with someone who has COVID-19 and may be at risk of getting the virus themselves, he added.
The province has re-established same-day testing results, which are accessible to patients through a new online portal. As well, public health units are being permitted to use volunteers, including retired nurses and medical students, to help them conduct the contact tracing and case management that's critical to stopping the spread of the virus.
In the meantime, Lundquist said she'll remain in isolation until her symptoms are resolved, and even after that, while she may venture outside for walks, she intends to stay home.
Memories of the pandemic's rapid and devastating impact on Portugal are still vivid in her mind.
When she and her fiance arrived in Porto March 9, only two COVID-19 cases had been reported for the country. By the time of their departure March 30, there were 44,206 suspected COVID-19 cases and 140 deaths, with schools already closed for two weeks and mandatory “lockdowns” in place.
While the Air Transat repatriation flight was “handled brilliantly”, with social distancing being enforced for boarding, meals provided in bags, and empty seats surrounding passengers, “everything went to hell in a handbag” when they arrived at Pearson, she said.
“Passengers seemed to completely forget that we were supposed to be social distancing and it was a free-for-all with people lined up right behind each other — all in a hurry to get out. The flight attendants said nothing, did nothing, and just let everybody swarm.”
The “chaos” continued on the long walk to customs, where physical distancing was finally enforced, but again “these shockingly ignorant Canadians all swarmed the baggage claim” with no airport staff ensuring the protocols were being followed.
“We got out of there as fast as we could while maintaining distance,” she said.
Family had arranged to drop off their car at the airport so they could go into immediate isolation.
“I was amazed at the number of cars on the road. In Portugal, there are signs posted everywhere for people to stay home and it is being enforced. We had to drive six hours from Lagos to Porto for our flight and there were long stretches of highway where there were no vehicles at all.
“The drive around Porto to our hotel was a little busier, but there were two police stops checking what people were doing out,” she said, concerned that “Canadians were still not getting it."