Ontario needs to speed up contact tracing since 'every minute counts,' physician warns

"Every minute counts" when it comes to tracking down the contacts of people infected with COVID-19, says Dr. Michael Warner.

And he would know.

As the medical director of critical care at Michael Garron Hospital, Warner has treated dozens of patients hardest hit by the illness. So many, in fact, that he now feels confident diagnosing them without waiting for their swab results.

But as the weeks have passed in this pandemic, with Ontario now reopening various businesses, the Toronto physician has grown concerned people who've been in contact with COVID-positive individuals aren't hearing from public health officials in a timely fashion.

"I've spoken to family members of patients who have COVID in my ICU, two or three days after they have been diagnosed, and they are asking me when public health is going to call them," he told CBC News.

Warner's public plea for faster contact tracing comes as Toronto Public Health, the unit handling the epicentre of Ontario's case count, is putting hundreds of people to work tracking down everyone COVID-positive individuals have interacted with — while provincial officials are pushing to maintain a target of at least 90 per cent of contacts identified within 24 hours.

500 staff handling Toronto contact tracing

On Thursday, Ontario Health Minister Christine Elliott said the province has actually surpassed that goal, hitting at least 93 per cent, and hopes to continue that trend as businesses slowly reopen.

In Toronto specifically, there are also now more than 500 Toronto Public Health staff working on case investigations and contact tracing, with around 100 staff working on a hotline system, spokesperson Dr. Vinita Dubey, the city's associate medical official of health, told CBC News in a statement.

"We also have 45 volunteers supporting these very detailed investigations," she added. "This is always being assessed and reassessed to ensure that we have enough staff resources to meet the evolving needs of this important work."

Meanwhile, the province has recently missed its targets for the number of daily tests, even as officials are confirming hundreds of new cases each day.

Ontario failed to meet its benchmark of 16,000 tests processed per day for four days in a row this week, CBC News previously reported.

The province's network of labs processed 10,506 tests for the novel coronavirus on Wednesday — which followed three consecutive days of fewer than 10,000 samples processed, with only 5,813 on the holiday Monday. 

"We're going to make sure we ramp it up ... I'm pushing the table as hard as I can," Premier Doug Ford told reporters on Thursday.

As testing continues to lag, Warner questioned why physicians can't help public health officials kick-start the contact tracing process sooner, since many clinicians are now diagnosing patients directly in hospital settings — without waiting for the day or more it often takes for results to come back.

'We'll have a slow, steady burn'

"COVID-19 hasn't gone away, and we still see cases trickling in every day in the ICU," Warner said.

"Unless we have proactive public health measures — to test, isolate, contact trace, and support patients and contacts with COVID-19 — we're not going to put this in a rearview mirror. We'll have a slow, steady burn."

Dr. Craig Janes, director of the school of public health and health systems at the University of Waterloo, said given the possibility of a second wave of infections hitting Ontario at some point down the line, contact tracing needs to be a key focus alongside testing, but he's "concerned" the province may not have capacity to maintain it.

"We really need to understand infection in the community," he stressed.

Warner said the province's goal should really be contact tracing "100 per cent" of contacts immediately, not allowing for any delay.

"A lag in time ... can lead to lives lost," he said.