Ontario’s daily COVID-19 information — the number of confirmed and negative cases in the province — is roughly four days old or more due to a lag in test results officials are struggling to overcome.

That means provincial and city leaders and the general public are relying on relatively old information on the severity of the fast-moving pandemic when making decisions.

In addition, a Star analysis of the last 10 days of provincial data reveals the number of tests for which the province is awaiting results is steadily increasing. It appears from the numbers the current testing system in Ontario is being overwhelmed by demand. Tuesday, 2,728 samples were taken from Ontario residents, almost three times the number of samples taken the day before. Based on current data, the results of those tests will not be known for four or more days.

In Ontario, the majority of tests are performed by Public Health Ontario’s laboratory.

Dr. Brian Schwartz, vice-president of Public Health Ontario, confirmed to the Star Wednesday there is now a significant delay in testing compared to the start of the outbreak.

“The high volume of COVID-19 tests being conducted at the Public Health Ontario Laboratory is having an impact on our turnaround times,” Schwartz said. It has changed from 24 hours to up to four days, he said, adding that the “most vulnerable including in-patients and hospital staff will be prioritized first.”

A provincial official told the Star that efforts are being made to have hospital laboratories increase their testing capacity.

“The goal is to increase the volume of testing (for COVID-19) in the Ontario health system to 5,000 tests a day,” said the official, who was not authorized to speak publicly on the matter. That figure was echoed late Wednesday afternoon by senior public health officials at a government briefing. However, officials including Ontario’s chief medical officer of health Dr. David Williams indicated it could be another two weeks before capacity is at 5,000 tests a day.

A current Public Health Ontario document also lists the turnaround time as “up to 4 days” and longer if they need to send the sample for additional testing to the National Microbiology Laboratory in Winnipeg.

At a press briefing Tuesday, Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, acknowledged the increase in tests being requested but said “the good news is the lab capacity is going up.”

The lag may actually be five days or more, according to members of the public who have been tested and been told of a five- to seven-day delay. One Toronto resident who was tested in Toronto on Sunday contacted Toronto Public Health on Tuesday and was told to check back on Friday for the results. The man, who asked not to be identified for healthy privacy reasons, had been on a New York flight and was told he might be at risk due to another passenger and should be tested.

“I believe we are completely underestimating the number of cases in Ontario and at worst we are five to seven days behind,” the Toronto resident told the Star in an interview.

Health experts say the problem a delay in testing can cause is that leaders and the public need up-to-date information to make decisions. Over the last two weeks there have been a number of decisions and statements made one day, then overridden by events a few days later, coinciding with the rising number of positive cases from completed tests.

The actual scientific test (where cells from a nasal or throat swab is compared with the genetic code of the coronavirus) should only take about six hours to complete, once the testing is begun.

In addition to a delay in getting to the test due to the high volume of requests in the province and the scarcity of testing kits, there can be an additional lag as the results are then communicated to the health care professional who authorized the test and to the public health office in the jurisdiction where the sample was obtained. The public health office then contacts the patient and provides the test results to the individual.

The Star asked Toronto Public Health to respond to complaints from individuals who had been told of the test result lag. Lenore Bromley, a spokesperson for Toronto Public Health, said only Public Health Ontario, which is “the lead for testing,” could answer questions about the time it takes for a test to be completed. “We cannot speak to their area regarding test results,” Bromley said.

Earlier this week, the Star also set about to do an analysis of all of the testing results the province has provided to date. Looking at the last 10 days of reported provincial results, the Star discovered several disturbing trends.

First, compared to 10 days ago, the percentage of total test results coming back negative for the virus is decreasing and there is a corresponding increase in the percentage that are coming back positive.

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Second, there has been a sudden jump in tests ordered and a dramatic increase in the backlog as a result. The ministry of health refers to these backlogged tests as “currently under investigation” but the reality is these are tests that have yet to be processed, according to Ministry of Health information.

The third finding from the data is that the number of cases listed as “resolved” has not changed in the past eight days. “Resolved” refers to a patient who tested positive, and then has had two negative tests at least 24 hours apart. That number of patients who have recovered in Ontario has been listed as “five” since March 10.

Despite the sudden jump in people being tested, Williams, Ontario’s chief medical officer of health, said he is hopeful the province will successfully ramp up its testing capability.

“With the number of tests pending there is a load issue,” Williams said.

He said they are in the process of opening up satellite centres for testing and obtaining all parts of the testing process, including the swabs used to collect the sample, and hiring staff. As to the testing kits, he said from conversations with other officials “we understand there may be large orders coming in.”