Why New Brunswick COVID-19 tests trail rest of Canada

Two weeks after widespread testing for COVID-19 began across Canada to detect and track the virus, figures show testing in New Brunswick continues to trail all other provinces.

On Monday, New Brunswick's Office of the Chief Medical Officer of Health reported 1,096 total test results for COVID-19 have been logged in the province since the beginning of the crisis, the lowest number per person of any province in Canada.

It's less than half the 2,349 tests completed next door in Nova Scotia, a province with just 25 per cent more people.

The most aggressive testing in Canada has been in Alberta. It has six times the population of New Brunswick but on Monday had already reported results from 30,058 tests, 27 times more.

The New Brunswick government referred all questions about the sluggishness of COVID-19 testing in the province to its two regional health authorities but neither one had an immediate explanation about why the numbers are so low.

Focus on travel

One issue appears to be New Brunswick's strict focus on testing only people who recently travelled internationally and those connected to them, even as other provinces have been testing those with symptoms more broadly.

For more than a week national health officials have been warning about the "community transmission" of COVID-19 in Canada or cases with no apparent connection to foreign travel.  

Suspected cases were reported as early March 15 in both Alberta and Ontario, both of which were not limiting testing to recently returned out-of-country travellers or those known to have been in contact with them.

New Brunswick still limits tests to those who have some connection to recent international travel, although chief medical officer of health Dr. Jennifer Russell said that narrow focus may be widened as soon as today. 

"If you have symptoms and you have travelled outside of Canada that's the criteria right now," said Russell during Monday's update on the virus. 

"We are looking at changing that."

811 problems

Other organizational issues have also hampered COVID-19 testing in New Brunswick, especially problems with the province's 811 Tele-Care phone system.

Last week the province announced it was setting up 13 regional testing sites. It said all people concerned they might have been exposed to the virus would be routed through the 811 health information line to be assessed over the phone and referred for testing if they met the criteria.

"In order to minimize the risk of transmission of COVID-19, access to  a community access [testing] centre will be by appointment only following appropriate triage through Tele-care 811," said Dr. Russell on March 15.  

But the service was quickly overwhelmed when call volumes quadrupled. Around the province worried people waited on hold for hours and others who did get through reported being told someone would have to get back to them later — in some cases a day later or more.

On Monday, Premier Blaine Higgs acknowledged problems caused by the phone service are still being dealt with.

"811 got behind a bit initially, but we're catching up on that now," he said.

Testing site delays

There were also problems setting up testing sites themselves with a major centre constructed and then deconstructed in Saint John over three days last week without ever being used. 

Testing has been consistently cited by national and international health organizations as a critical element in confronting the COVID-19 pandemic.

Last week the World Health Organization's director general Dr. Tedros Adhanom Ghebreyesus encouraged all jurisdictions to test for cases extensively to locate and isolate the virus. 

"The most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate," said Dr. Tedros.

"You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don't know who is infected. We have a simple message for all countries: test, test, test."

According to Canada's national microbiology laboratory count, 102,803 Canadians had been tested for COVID-19 as of yesterday — about 271 tests per 100,000 people. That is nearly double the number tested in New Brunswick as of yesterday — 141 per 100,000.