Doctor says thousands of babies have missed crucial hearing screening during pandemic

A pediatrician and first-time father says the COVID-19 pandemic means thousands of babies across Ontario have missed a crucial form of screening to identify newborns at risk for hearing loss.

Dr. Hasan Merali is an assistant professor at McMaster University and father to a six-week-old girl named Arya.

"I'm worried about my daughter not being screened, but more importantly about all the other families that might not even know that this was supposed to happen," he said. 

"This is something that's going to be completely missed for them which could lead to severe speech and language delays."

The Infant Hearing Program (IHP) is funded by the Ministry of Children, Community and Social Services and provides screening for all newborns in the province to identify babies with permanent hearing loss and those at risk of developing it. 

It includes two forms of screening:

• A blood spot test for rare conditions and common genetic factors that cause hearing loss.
• Physiological screening, which uses specialized equipment to test response to soft sounds played in a baby's ear.

The ministry says blood spot screening has continued amid COVID-19, but acknowledged in a statement to CBC News that because of the pandemic most of its 12 IHP lead agencies suspended universal newborn hearing screening.

Longer delay means longer backlog

That statement echoes a message Merali received saying physiological screening has been suspended in "many regions."

That message, which includes the signatures of both minister Todd Smith and Jill Dunlop, associate minister of children and women's issues, was sent to the doctor on July 24 in response to a letter he sent sharing his fears.

In his letter,the doctor noted that every area of the province had moved to Stage 2 of Ontario's reopening plan, meaning people can get haircuts or drink on patios, but there still seems to be no plan to fully bring back the screening.

"I am at a loss to understand why," he writes.

"To date, thousands of babies have missed their newborn screening, with dozens to hundreds more each day. The longer the limited services continue, the longer the backlog of newborns to be screened will be and many babies, unfortunately, will not even get screening."

Merali's daughter is among the thousands of newborns who haven't been able to be tested, something that would typically happen in the hospital before discharge.

He's contacted testing facilities in Halton, Hamilton and Toronto, but said only limited screening is taking place for high-risk infants.

In the meantime, the window for screening is quickly closing.

The ministry says physiological screening produces valid results for babies up to two months old, which leaves just a few weeks for Arya to undergo testing.

The ministry's website states that two out of every 1,000 babies have hearing loss at birth and two more develop it by age five.

The children may hear some sounds, but miss others, making it harder to learn speech and language, it explains.

"This can lead to behavioural and emotional challenges," reads the site. "It is important to detect hearing loss as early as possible."

Timeline to bring back screening unclear

In a statement to CBC News, a spokesperson wrote that the ministry has recommended its agencies prioritize cases for babies with Congenital Cytomegalovirus and meningitis as well as urgent audiology services for those who screen positive through the blood spot test for genetic risk factors for permanent hearing loss. 

Geneviève Oger added that the ministry is encouraging the agencies to communicate directly with families that haven't been offered physiological hearing screening to let them know the blood spot test had been carried out, to "encourage them to monitor their child's early development" and to speak with doctors if concerns arise.

However, that approach appears in contrast to the information on its own site which states it's "not possible" for parents or even most doctors to accurately test a baby's hearing as the screening requires specific training and equipment.

The ministry says as the province continues to reopen its planning for a gradual resumption of in-person services, including hearing screening that was reduced or suspended, but doesn't provide any specifics for when it will be widely available.

It's a general response the doctor said he feels doesn't addresses the actual issue, adding the longer it takes the more likely it is babies with hearing loss will be kept from support.

"It is unfortunate that there is no definitive time-frame on when my daughter will be able to be screened," Merali said.