Ottawa Public Health aiming for expanded COVID-19 testing in the fall

OTTAWA -- Ottawa's top doctor says Ottawa Public Health is ready for the start of the school year.

Speaking to reporters Tuesday, Medical Officer of Health Dr. Vera Etches said that although OPH is still waiting for some additional guidance from the provincial government, the public health unit is prepared for the start of the school year.

"We have the mechanisms to be advising schools right now," Dr. Etches said. "Schools that are opening have a point person to turn to if they have questions. We know how to do case and contact tracing. We can implement that today if needed. It's not holding us up."

Dr. Etches spoke to the start of the school year by reminding families and educators that they do not need to have a COVID-19 test before returning to school.

"Ottawa Public Health is currently recommending testing for those showing symptoms of COVID-19. This is the most important reason to be tested," she said. "Those who are in close contact of someone who has tested positive for COVID-19, who do not have symptoms but are a close contact; those people should also be tested."

If you or your child has no symptoms, Dr. Etches says a test is not required to go back to school.

"Testing your child before returning to school is generally not recommended if they do not have symptoms because it is extremely unlikely to find an active COVID-19 infection. For the same reason, teachers and school staff do not need to be tested before returning to school," she said.

Instead, she stressed the importance of the daily screening that school boards are requiring before a child, teacher, or other staff member can attend school.

OPH has launched a new webpage about the return to school with resources about the return to school at ottawapublichealth.ca/schoolscovid19.

Nevertheless, the health unit is anticipating an increased demand for COVID-19 testing as the school year begins. Dr. Etches said the current testing capacity is not under stress right now, but added that OPH and its hospital partners are working to get more testing sites online.

Dr. Alan Forster, Vice President of Innovation and Quality at the Ottawa Hospital, said the testing centres in Ottawa process about 1,500 tests per day, but they want to increase that in the fall.

"Right now, our capacity is meeting the demand and the wait times at the assessment centres have decreased," he said. "We're currently building up more capacity in our testing centres to accommodate anticipated need in the fall. In the short-term, we're looking to get up to 2,500 to 3,000 tests a day and then later in the fall aiming to get to 5,000-7,000 range."

Doing that would require finding suitable locations for more testing centres and ensuring there is enough trained staff on hand who can process the tests.

"There's a front-end piece where we collect specimens (i.e., assessment centres) and a back-end piece where specimens are analyzed in the lab. Both have to happen in parallel," Dr. Forster said. "With respect to the back-end, there's a lot of action right now in acquiring equipment, making sure we have the connectivity of that equipment, making sure we have the trained staff. That will help us ramp up the ability to analyze the number of samples we anticipate will be coming through.

"In terms of the front-end piece, we have certain types of facilities in play. We will be making sure those facilities are used as efficiently as possible. With the expansion of facilities is really about finding the appropriate locations within the city. There are a number of requirements for those, including the traffic flow in and out, in terms of the quality of air for the staff, and in terms of the electricity, heating and water supply. Those things all have to factored in."

Dr. Forster also said assessment centres need the appropriate amount of staff, and there are logistical requirements in terms of registering and sharing testing information with OPH, the patient, and their health-care providers.

Dr. Etches said, should demand exceed capacity, testing may have to revert to a priority model, where certain groups are given tests before others.

WHAT HAPPENS IN CASE OF AN OUTBREAK AT SCHOOL?

Dr. Etches says draft guidance from the Ontario government defines an outbreak at a school as two confirmed cases of COVID-19 in the school environment with a link between them.

One case will not trigger an outbreak in a school, as it does for long-term care facilities or daycares, she said.

In the event of a positive case of COVID-19 in a school, Dr. Etches says families of the infected child and of any close contacts will be contacted first.

"If someone in a schools setting tests positive for COVID-19 and your child is a close contact, an Ottawa Public Health case manager will contact you directly to let you know and to advise you to access COVID-19 testing at the appropriate time," she said. "Otherwise, the only reason to have your child tested for COVID-19 is if they are showing symptoms consistent with COVID-19."

• SEE MORE: Symptoms of COVID-19 | Health Canada

If an outbreak does occur in a school, Dr. Etches said it would be made public.

"When we have one person who has been confirmed to be infected with COVID-19 and they've been infectious while they were in school, and we identify one of their close contacts in the school environment with COVID-19, that indicates there has likely been transmission in the school environment," she said.

"The very first thing is to identify all of the close contacts. Then, a public health nurse will phone all of the parents to let them know with all of the next steps to take, which includes staying home and watching for symptoms, and to go for a COVID test at the appropriate time after the potential exposure."

However, she does note that every case must be investigated fully, as there are other ways COVID-19 can spread outside the school.

"There are other risks for transmission in the community which are greater at this point in time, we know that, so we need to look at all of the situations and the context to determine what to do in the school setting," she said.

Dr. Etches said contact tracing for infectious diseases in schools is not new, but what is new is the nature of COVID-19.

"This is COVID and it is a tricky one because of the way you have infectiousness before people know they're sick," she said.

"What's also new is all of the protections that we're putting in place," Dr. Etches said. "Schools have never had a rigorous screening system to keep people home when they're sick and this will help us. These measures to keep COVID out of schools will help keep other infections out of schools."