‘Trying to make sense of the daily reported COVID case numbers in Ontario is a source of great frustration right now’ – Ashleigh Tuite, University of Toronto

The following Twitter thread is from Ashleigh Tuite @AshTuiite who is an Infectious Disease Epidemiologist and Math Modeler @UofT_dlsph (Dalla Lana School of Public Health, University of Toronto)

Ashleigh Tuite writes (Oct. 24, 2020):

Trying to make sense of the daily reported COVID case numbers in Ontario is a source of great frustration right now. Particularly in the face of changes in who can get tested and how we access testing. 1/

We all want to know if the policies put in place in the last little while are making a difference. But the truth is we really can’t use the available data to answer that question with confidence. 2/

At this point, the best we can do is try to triangulate all of the different data points we have: reported cases, testing volumes, hospitalizations, deaths, outbreaks in congregate settings, etc. to come up with a best guess of what’s happening with transmission. 3/

This is unsatisfying. But the best we can do right now. It’s important to remember that the diagnostic test data are not meant for disease surveillance. We used them at the start of the pandemic because they were what we had available. 4/

But at this point we can and should be doing better. Since the spring, we’ve had the time to set up actual surveillance systems to monitor COVID activity in a way that would provide us with near real-time situational awareness. 5/

Some examples of what this would look like:

Huge expansion of ONS-led testing study will provide new insight into spread of COVID-19 across the UK

6/

And: Real-time Assessment of Community Transmission (REACT) Study

7/

I think this would fall under the purview of the immunity task force in Canada. Perhaps such a project is underway but I’m not aware (and happy to be corrected). 8/

The important thing is that this type of system exists outside of the public health lab system, so is not taking away needed resources for diagnostic testing and can leverage research lab capacity and expertise (though issues around reagents and other equipment may remain). 9/

And would provide consistent, representative, actionable regional data on case occurrence. The fact that this doesn’t seem to have been prioritized in Ontario/Canada as we prepared for the fall makes no sense to me. End/

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