Getting the swab done: How Manitoba wound up with a Winnipeg COVID backlog

For months, the people leading Manitoba's pandemic response have cited more testing for COVID-19 as one of the most important means of keeping the disease at bay.

"We know that through increased testing there is an increased possibility that we'll be able to build confidence — not only in the general public, but in the health officials whose guidance we must listen to — that we are not opening the door to a resurgence in COVID infections," Premier Brian Pallister said on April 16, only one month into the pandemic.

Additional testing capacity gives Manitobans confidence "that when they move around, when they shop, they're able to do so safely," the premier continued on April 28.

Five months later, Manitoba has vastly increased the number of genetic tests that can be processed in a given day. Cadham Provincial Lab and private laboratory service Dynacare have the combined capacity to process around 2,600 to 2,800 tests per day, various officials have stated over the past two months.

That's shy of the 3,000 daily tests Pallister set out as a target on April 28, but a vast improvement over where Manitoba was in April.

The problem is there is a logjam right now in Winnipeg that has little to do with lab capacity. 

For nearly a month, Manitoba has been unable to keep up with the demand for COVID-19 swabs in Winnipeg, where cases of the disease have spiked as a result of more widespread community transmission.

The bottleneck exists at the start of the testing process. Winnipeggers have been forced to wait in lines or in their cars for hours for a COVID-19 swab at one of five sampling stations.

Winnipeggers have complained about the time it takes for staff to collect their personal information at these sites, the relatively short hours of operation and, of course, the wait itself.

A deterrent to testing

The severe inconvenience of getting tested has become a deterrent to testing. 

"Do you know many people left that line, because they just couldn't wait there any more?" asked Maria Mannello, who waited six hours for a test at the Main Street drive-thru site on Tuesday.

This is a major epidemiological problem. Until an effective vaccine is developed, the main way to keep COVID-19 in check is to test as many symptomatic, vulnerable or exposed people as possible, isolate the infected patients quickly and then identify and test their close contacts.

That is a Captain Obvious observation to anyone who has paid close attention to the pandemic. So far, Manitoba appears to have done well when it comes to the lab testing and contact tracing.

The inability of Manitoba to make it easier get a swab in Winnipeg — where there were 591 active cases of COVID-19 as of Saturday — has confounded our pandemic leaders.

"It's definitely an important issue and so we are addressing it. I think that it's vital," Chief Provincial Public Health Officer Dr. Brent Roussin said Thursday, referring to the need to swab more people.

Adding testing sites like the one Dynacare started operating in Winnipeg on Wednesday is not a simple task, Health Minister Cameron Friesen suggested.

"You have security, you have logistics, you've got the mobile vans themselves providing the services. You have to determine where a site is available. There is the issue of supply, the issue of co-ordination with the system," Friesen said.

Neither Friesen nor Roussin could explain why the hours are not extended at Winnipeg's four government-run swabbing stations and the Dynacare mobile site.

Staffing doesn't explain bottleneck

The availability of nurses to conduct the swabbing does not appear to be an insurmountable obstacle.

Two nurses at a time work at the Dynacare mobile site on Portage Avenue, the company said. There are six nurses at a time working at each of the Main Street drive-thru centre and the St. Mary's Road walk-in site, five at the Pembina Highway walk-in station and four at Thunderbird House on Main Street, according to the province.

In other words, there doesn't appear to be any validity to the notion the province is moving slowly because the Progressive Conservative government doesn't want to hire more bodies to assist with the COVID-19 fight. Staffing issues alone can't explain why Manitoba appears to have been caught flat-footed in Winnipeg.

Roussin has suggested Manitoba simply did not expect to be in this pickle so early in the fall, before the expected start of the flu season, and certainly not in Winnipeg, which had few significant problems prior to September.

Friesen is promising more mobile sites within weeks, along with a review of testing in general.

"We want to know right now, in early fall, where do we have capacity? Where do we need more capacity? How can we work more efficiently to do that? How quickly can we step up the kind of capacity that we need?" he asked on Thursday.

It is fair for Manitobans to ask why these questions were not asked during the summer, when the capacity for lab testing was increased without a corresponding boost in swabbing capacity.