OTTAWA—It’s the question we’ve all been asking.

When can life in Canada return to something resembling normal?

Public health experts have been categorical: countries should not stop social distancing and self-isolation until they can conduct widespread testing for COVID-19. Another key component is improved “contact tracing,” the practice of identifying infected Canadians and tracking back to others who they may have interacted with.

It’s unlikely governments will allow most citizens to be phased back to public life until those measures are in place and working. And both are areas where provincial and local health officials have struggled to keep up with the pace of the pandemic’s spread.

How soon the lockdown is lifted may depend on how quickly governments can build capacity in these two areas.

Contact tracing

Some countries have employed aggressive – and invasive – methods of tracking their citizens’ contacts, including the use of cellphone location data. The idea is if you can identify those who came in contact with the virus, you can directly intervene – warn them to self-isolate and target your testing.

As of Friday afternoon, 36,000 volunteers had signed up to a federal program to support provinces and territories with contact tracing efforts.

“(Provinces and territories) have identified contact tracing and case recording as areas where they require assistance,” wrote Natalie Mohamed, a spokesperson for Health Canada, in a statement on Friday.

“As needs evolve, support in other areas requiring assistance will be provided.”

The federal minister of science and industry, Navdeep Bains, said that the federal government is already talking with companies promising technological solutions for contact tracing.

“We’re looking at other jurisdictions, we want to make sure that if we are moving forward in that area that we also deal with issues with respect to privacy in a meaningful way,” Bains told a press conference in Ottawa.

“It’s still early stages, and we’ve been engaged with a robust group of people across the country that are working on some early stage technology projects, but we haven’t made any final determination in terms of what we want to support and move forward with.”

Contact tracing has been employed by some countries in order to limit the spread of COVID-19. In a handful of Asian countries, the practice has been a marriage between tech – such as an app that uses Bluetooth technology to measure the distance between people and track contacts – and a level of government intrusion Canadians aren’t used to.

But the use of cellphone data has raised privacy concerns in democratic states.

The federal privacy commissioner, Daniel Therrien, told the Star Friday that while citizens might be more accepting of invasive methods of surveillance during a crisis, those exceptional measures should be limited to the crisis.

“Privacy is not an impediment to saving lives,” Therrien said.

“Even though we’re applying what we’re calling a flexible and contextual approach to the interpretation of privacy laws, the context does not said aside privacy altogether.”

Therrien’s office released a “framework” for governments on respecting privacy rights despite provincial declarations of emergencies and the interest in surveillance to combat COVID-19.

It includes making sure proposed policies have a clear legal basis, that they’re necessary and proportionate, and to have a time limit for “exceptional measures,” with the collected data being destroyed when the pandemic passes.

Some tech companies are already turning to the next set of questions facing the government after the peak of COVID-19’s first wave recedes in Canada – how to safely get people back into public spaces.

Leah Hanvey, the business development manager at Urban Logiq, said the company is working with municipal and provincial governments to combine government-held data with publicly-available information to map out a post-pandemic plan.

While most attention has been focused on government collecting cellphone data like locations visited and contacts, Hanvey’s company is looking at things like traffic patterns to map out what a recovery could look like.

Urban Logiq is currently in talks with the B.C. government to provide analysis of mapping data – how people move around cities like Vancouver or Surrey – to inform plans on how to re-introduce citizens to spaces outside their homes.

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“The conversation has moved decidedly to recovery,” Hanvey, a former federal Liberal staffer, said in an interview.

Widespread testing

Testing has been the topic of much debate throughout the COVID-19 battle and some argue a national consensus is needed before strict public health measures can be eased.

Each province and territory seems to define “widespread testing” in different ways — each employs its own testing strategies targeting certain high-risk populations, such as front-line health workers and residents of long-term care facilities.

Reporting of test results is also not uniform; for example, Alberta reports both the number of samples collected and persons tested, whereas Ontario this week switched from reporting the number of patients tested to simply the number of samples tested.

Experts agree more testing is required. But some argue that no feasible amount of testing of the population at large would be widespread enough.

Testing everyone is an unrealistic goal, said University of Montreal epidemiology professor Jack Siemiatycki.

Siemiatycki and others say there may be another solution: random sampling that is representative of the Canadian population on a national and regional basis.

The approach, akin to scientific polling, could give a more accurate assessment of COVID-19 infections and help offset shortages of testing equipment.

“It would actually take very few tests per day to provide a quite accurate estimate of the prevalence of the virus infection in Ontario, and its trajectory over time,” Siemiatycki said. “If the authorities choose a representative sample of about 100 to 400 people in total – and I think this should be initially limited to residents of the urban centres in which current testing procedures are conducted – and if this were repeated with a new sample every day for as long as the epidemic lasts in Ontario, then we would have an excellent estimate of the extent of the epidemic and its trajectory over time.”

Siemiatycki added that the widely published daily counts of confirmed cases, deaths and hospitalizations are “vulnerable to all kinds of biases and distortions.”

“The number of cases that are confirmed is just a function of how many test kits there are in the country or province,” he said, adding that varying criteria among provinces for testing can also make the data problematic, as well as the fact that the criteria change frequently.

“In some places you have to be deadly sick to get tested. In other places, mild symptoms can get you tested,” he said. “So those counts are pretty useless actually for this purpose.”

Colin Furness, an infection control epidemiologist at the University of Toronto, said “testing strategy is what’s important, rather than the sheer number of tests.” Furness said jurisdictions like Ontario appear to design their testing approach around those who show virus symptoms even while a segment of the infected population shows none.

“The single-minded focus on a number of tests without articulating a strategy to combat asymptomatic transmission is a problem,” Furness said.

“The appropriate strategy for asymptomatic spread is to target those who are most likely to get (or be) infected, based on sheer amount of contact with people (such as grocery store clerks) and those who have contact with vulnerable populations (such as long-term care staff and homeless support workers),” he continued, adding he would “test these kinds of workers frequently, as often as every other day.”