Understanding COVID-19 testing in Ottawa

It was just a little more than week ago that Ottawa saw its first confirmed case of COVID-19.

Two days later, hospital officials began assessing and testing thousands of locals who worried theymay be ill with the virus. There's been some confusion about who should be tested, how the testing works and exactly how many cases of the novel coronavirus we actually have in Ottawa.

On Thursday, for example, the provincial health authorities confirmed two more cases of COVID-19 in the city for a total of 16 cases, while Ottawa Public Health said there are 19 cases in the capital, including indeterminate cases.

"The information is changing very quickly," said chief medical officer of health, Vera Etches at the start of Thursday's media briefing. "I know it's an understatement."

Indeed, in these highly turbulent times, it can be difficult to keep on top of the latest COVID-19 updates. Here's what you need to know about COVID-19 testing right now.

Treat every interaction as a potential source of infection, OPH says

5 years ago

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Vera Etches, with Ottawa Public Health, says its likely that there are many undiagnosed cases of COVID-19 in the community and that residents should limit their interactions as much as possible.

1. Who's being tested now?

Right now hospitals are screening and testing anyone who comes through the door forCOVID-19 symptoms, in particular fever, cough and shortness of breath.

For others and this will likely change soon (see Question No. 4) If you have mild symptoms andhave travelled outside Canada in the past 14 days or been in contact with with someone who has tested positive for COVID-19, you should go to the Brewer Park arena for an assessment and possible test.

If you have travelled recently and are asymptomatic, or you only have mild symptoms, just self-isolate at home health officials are asking you don't request a test.

2. How does the testing work?

If you meet the criteria for being tested, a health worker will stick a specialized nasopharyngeal swab up your nose. It's long and skinny, so that it can reach the back of your nose and throat.

Theswab gets transported to anOttawa public health lab the same day.

The testing protocol has changed since the COVID-19 crisis began. Technicians used to perform two tests at once, which would confirm a positive right away.

But this was taking too long given the volume of tests being performed. Consider that by the end of Wednesday, more than 1,800 swabs were taken at the Brewer assessment centre.

So to speed things up, technicians are now doing one super-sensitive test first. If thatcomes backnegative then, well, it's negative. People can get those results on the "My Chart" patient portal run by the Ottawa Hospital.

The ones that come back positive are then sent for the second testto confirm that positive diagnosis.

3. So are those the 'presumptive' or 'indeterminate' positive cases?

Yes. After the first test comes back positive, health officials presume that case is positive. Etches said that those tests that come back positive are"likely", so Ottawa Public Health treats them that way, including letting people know their early results.

Getting these final results can sometimes take four to five days.

It's why there is sometimes a disconnect between the number of local cases being cited. Etches admitted that keeping track of the confirmed and indeterminate cases is "messy" and public health officials are working on posting those numbers in a clearer way on their website.

Unfortunately, hairsplitting on the numbers will soon be meaningless.

On Sunday, Etches said there could be as many as 1,000 people with coronavirusin the city who didn't know there were carriers. By now, that number could be 2,000, she said Thursday. We just don't know the exact number, but we do know that the number of positive cases are expected to increase exponentially everywhere, including in Ottawa.

In fact, once officials have solid confirmation that COVID-19 is being transmitted in the community and not just through international travel the criteria for who will be tested is going to change.

4. So what will happen at the COVID-19 assessment centre in the future?

While now the focus is on travel-related cases and the general public who may have been in contact with someone who's tested positive, that's going to change shortly, especially once community transmitted cases have been confirmed. At some point, it just won't make sense to keep testing the general public with mild symptoms, especially considering the scarcity of swabs.

"The future the goals of the COVID-19 testing are likely to shift toward being used to limit outbreaks in settings of high risk," said Etches.

This would include health-care workers, hospitalized patients, people in long-term care homes and correctional facilities places where an outbreak of COVID-19 could spread extremely quickly and to a vulnerable population.

Etches said she understands that the future limiting of testing could cause anxiety, but she points out that the advice on how to behave remains the same whether someone has a test result or not: stay home when you're sick, go to the hospital if you're really sick, and self-isolate if you've travelled recently or been in contact with someone who's tested positive.