A Canada Goose is the only visitor outside at a COVID-19 testing centre in Toronto on Monday. - Frank Gunn / The Canadian Press Now the change puts Ontario in line with British Columbia.This an odd change? To make at all? To make at this time? Why is the province changing the way data is tracked? Doesn't look as if it meets the approval of epidemiologists. There’s been a huge problem with data all along. Throughout this entire episode a multitude of decisions have been made on pithy data. And now, the parameters are changing yet again?Link
Ontario has changed the way it’s reporting COVID-19 testing data in the midst of the pandemic in a move experts say may skew the true picture of how the virus is spreading in people across the province.
Why does the province want to skew the information regarding the way this "pandemic" is or has been spreading across the province? How many have been exposed? How many have potentially gained immunity? Naturally.
Until this week, the Ministry of Health had been reporting the total number of patients tested for the coronavirus each day. On Wednesday, the reporting changed to include only the number of samples tested per day, and because more than one sample is taken from some patients, it was no longer possible to know how many people had been tested.This means it is now harder to know the important measure of Ontario’s test positivity rate, said Todd Coleman, epidemiologist and assistant professor in health sciences at Wilfrid Laurier University.
What's this "test positivity"?
According to the Tracking Project’s figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a “test-positivity rate” of nearly 20 percent.
That is “very high,” Jason Andrews, an infectious-disease professor at Stanford, told us. Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection.
People with milder symptoms, to say nothing of those with none at all, are going undercounted. Countries that test broadly should encounter far more people who are not infected than people who are, so their test-positivity rate should be lower.
The positivity rate is not the same as the proportion of COVID-19 cases in the American population at large, a metric called “prevalence.”* Nobody knows the true number of Americans who have been exposed to or infected with the coronavirus, though attempts to produce much sharper estimates of that figure through blood testing are under way. Prevalence is a crucial number for epidemiologists, in part because it lets them calculate a pathogen’s true infection-fatality rate: the number of people who die after becoming infected.
The number of Americans tested for COVID-19 has changed over time, the U.S. test-positivity rate can’t yet provide much detailed information about the contagiousness or fatality rate of the disease.
Coming back to Ontario...
Switching how tests are reported changes the positivity rate “very significantly,” he said, adding that the province should report both the number of samples tested and patients “to give us an accurate representation of what’s happening.”The positive rate — the percentage of people tested for a disease who are found to actually have it — can give a picture of an epidemic’s spread, experts say. Over time, as more people become infected, the positive rate should be expected to go up.But after the switch to the reported data, Ontario’s positive rate has fallen sharply. Nearly 10 per cent of patients reported tested Tuesday were positive; that number was less than 6 per cent for samples reported Thursday.Why does this matter? “Because that’s how the disease works,” Coleman said. “It’s not dependent on each test. Each test that comes back positive doesn’t mean a new case.”The reporting change came on the same day that Premier Doug Ford pledged testing in Ontario would hit the 8,000-per-day mark after weeks of falling short of that number, even as provincial labs expanded capacity to meet increasing demand. On Thursday, the Health Ministry reported that 9,001 tests had indeed been completed — up significantly from previous days. But because of the reporting change, it was unclear whether many more people had actually been tested, or if the jump was merely the result of the switch.“Well, today we’re at over 9,000 COVID-19 tests. We’ve hit our first target,” Ford said at his daily news conference Thursday.The premier did not explain that the provincial tracking data — publicly available online — had been quietly changed until he was pressed by a reporter.“First of all, they’re accurate numbers and I’m going let the minister explain it,” Ford said, turning to Minister of Health Christine Elliott.“We’re testing some people a couple of times, maybe a week later. But they should still count as a test and that all depends on their situation but I’ll pass this over to the minister,” he said.Elliott downplayed the data change.“The number of people who have been tested more than one time are not significant,” she said.“What’s more important is we’ve really expanded the number of people we’re testing in different locations; in long-term health care homes; front-line health care workers; working with Indigenous communities, working now with essential service workers.”
Expanding the testing among those most likely to be infected doesn't really give us accurate data? Testing these people one, two or three times, really doesn't tell us much of anything about the "pandemic"
Colin Furness, an infection control epidemiologist at the University of Toronto, said Ontario’s data flip-flop was a “political decision” to showcase its newly increased testing ability.“It’s odd because what you are actually presenting, in a sense, is less data by saying we’re going to count the number of tests but not the number of people tested,” said Furness, who has expertise in vulnerable populations and systemic issues in long-term-care facilities.“You’re deliberately saying, ‘We’ve got these two data points and we’re only going to hand you one.’ Less information is never a good thing,” he continued.“It seems to me it’s a political decision to report the larger of the two numbers, to say, ‘Look at all the testing we’ve done,’ because there’s been a lot of discussion around testing capacity. So I think the premier’s office may want to demonstrate, ‘We’ve built this testing capacity and now we’re using this testing capacity,’ and I think it’s a political consideration.”
Playing politics during a pandemic doesn't strike me as moral or ethical.
"Ethics and morals relate to “right” and “wrong” conduct. While they are sometimes used interchangeably, they are different: ethics refer to rules provided by an external source, e.g., codes of conduct in workplaces or principles in religions. Morals refer to an individual's own principles regarding right and wrong.
But then politics, morals & ethics are not synonymous with one another.
At the news conference, Elliott also said the data change brings Ontario “more in line with what most other provinces are doing and the way they’re reporting, principally British Columbia.”Canadian provinces are not uniform in their data collection. Some use totals for people tested, some use total samples tested. Alberta and Saskatchewan track both.“Both are important,” said Isaac Bogoch, an infectious disease expert based out of Toronto General Hospital.“I bet that data (in Ontario) is available and I think it would be helpful to have both, because some people are testing multiple times a) because they tested negative but they still have symptoms so they get tested again; b) some people are health-care providers and need to get tested more than once to make sure that they test negative so they can go back to work,” Bogoch said.
*“People tested is important because we want to know how many people have this infection"
*Samples tested is important because that gives us an understanding of what the lab capacity is. So I think they’re both important and I’d want both data points.”
During a pandemic isn't the most important,the most relevant fact the number of people who were actually exposed to this virus. This would speak to wider immunity in the population. This would knock down the idea of virulence and perhaps result in lowering the threat/fear levels.It's doubtful anyone of us is really concerned with lab capacity vs mass immunity and knowing that this virus is likely not as harmful as has been widely claimed.Ontario is being dishonest with it's citizens. That's how it appears to me.Related interviews: