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Testing for COVID-19 in hospitals 'not a sustainable solution'

The goal is to open community assessment centres as the Region implements its Pandemic Response Plan
Grand River Hospital 2
Grand River Hospital in Kitchener. Blair Adams/KitchenerToday

COVID-19 was finally declared a pandemic on Wednesday as cases of the new coronavirus continue to increase globally.

That means Waterloo Region is implementing their Pandemic Response Plan from 2008, something councillors describe as similar to the Regional Emergency Response Plan.

The most significant part of that plan involves "community assessment centres," the need of which is greater than first appears.

The only place we can assess people for COVID-19 is in our hospitals at the moment, according to Dr. Hsui-Li Wang: Acting Medical Officer of Health for Region of Waterloo Public Health and Emergency Services.

"When this virus started to make an appearance, the Ontario Ministry of Health decided to put in very high levels of precautions, in order to protect health care workers and other patients. Because of that, really, currently, the only place that's able to assess and test clients under such stringent conditions are hospital environments," explained Wang in an interview. "The government recognizes, with the increasing number of cases, that's not a sustainable solution. We're currently in discussions with them to allow us to help move some of the testing into a community location. They are supportive of that."

People currently need an appointment to get screened at a hospital according to Cheryl Evans, manager of Communications and Engagement for Grand River Hospital.

"This is not a walk in clinic," said Evans in a statement. "We have worked with Public Health to develop a temporary solution to isolate screening and testing for COVID-19 to one area of the hospital as much as possible. Patients should first be screened and determined to need an appointment for testing by the emergency department, by public health, or through their family physician in consultation with public health. We are working with our health system partners, public health and St Mary's General Hospital to plan for a community clinic. No timeline for this yet but we should know more by Friday.

Wang said it made sense in the earlier days of the virus to take high precautions and screen in hospital, but now that the virus is more understood, it's an unnecessary strain on the hospital.

"We have a better understanding of how it spreads," said Wang. "We think, going forward, it makes a lot of sense to be able to assess and test these people in a community setting. We're working right now with the hospitals and our primary care partners to try to identify locations in the community where we can assess people. These are the people who come back from travel, they're the most at risk, and develop symptoms, but aren't well enough to be assessed in the hospital environment."

As if by fate, one of those locations presented itself at the meeting.

Rashid Mohamed, also known as "Rex," is the owner and operator of Waterloo Walk-in Clinic, Westmount Medical Centre and KW Walk-in Clinic.

He offered to completely shut down one of his clinics to walk-in services to convert the space to community assessment.

"One of our clinics is well-situated with ample parking spots," said Mohamed in an interview. "It could be a testing centre, it could be a screening centre, however they want to run it. To me, that would be an offer where I'm saying, 'Let's have a centre here, we take the load off the emergency room, and maybe we can also support it to run after hours. Eventually the goal would be to run it 24 hours if we can staff it."

Dr. Wang might just take Mohamed up on his offer.

"Absolutely, we're open to any and all ideas," said Wang. "We have had family physicians start to step up and offer ideas and we're very willing to hear from them, and to work with them. Those clinics will need physician resources, nursing resources, and if we can have our primary care physicians in the community pitch in and help us find a solution, that would be great."

The council meeting wasn't an entire picture of optimism, however.

Mohamed originally was a delegate at the meeting to tell council how strapped his clinics are for equipments such as facemasks.

Doctor Terry Polevoy also took to the podium, painting a similar grim picture.

In an interview, Mohamed told of his frustrating phone conversations with suppliers, saying that he was first told to "wait until you're within 10 days of losing supplies," then seven days, and finally being told that masks are for high priority areas only.

This all came despite his clinic burning through twice as many masks as usual.

"I don't know how they're describing 'high priority areas' versus low priority. We're three cities here. We see patients from anywhere and everywhere. Somebody who's sitting behind a desk is giving me the logic, telling me to 'direct the patients to make a phone call. Direct the patients to public health.' How do I do that? Do I stand outside my door? At all three clinics with the patients outside? This is a walk-in clinic. The patients who are sick, they don't look up on Google, they don't look up the news channel, they go to a doctor's office [the clinic]. People don't even stop at the pharmacy, they want to come here to hear it from the horse's mouth."

Dr. Wang said the Ministry of Health is working on the equipment shortage.

If the Region does take Mohamed up on his offer, it would take a bit of time to verify that all the resources are in place.

"It's probably not going to take weeks, more a matter of several days to start up these community assessments," said Dr. Wang. "We have to submit proposals to Ontario Health, and they obviously are going to take a look at this as quickly as they can."

One of the main messages that public health is trying to get out to the public: call first. That will help you to stay informed and get early instructions, and reduce the strain on our healthcare system.

You can also find helpful, easy-to-read resources on the Public Health Website.

Waterloo Region's 24-Hour Phone Line, and Public Health: 519-575-4400.




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