No COVID-19 testing for cluster of illness after Vancouver memorial service

By hour three trying to get through to B.C.'s 811 health line on the weekend, Rob Taylor had run through the batteries of three cordless phones blaring hold music.

The Vancouver engineer, 68, had a fever for days — reaching 39.1 C, according to his spreadsheet — as well as a cough and headache. His wife was sick, too. But their illnesses weren't the problem.

He was concerned because at least 11 people who attended a Vancouver memorial service for his mother-in-law the week before — when gatherings and travel were still allowed — were also sick.

He thought the possible cluster of COVID-19 cases on Vancouver's West Side warranted a test, to alert the 100 or more guests of possible exposure.

After six hours on hold, he was told to visit an urgent care centre, where he got a careful exam and was told coronavirus was likely, but he still didn't qualify for testing.

"[I'll] assume I have it, isolate rigorously," Taylor says.

This is not a story of outrage, or a system gone wrong. It's just the reality of British Columbians trying to figure out what to do — and where they're on their own — amid a changing strategy in the fight against COVID-19.

'Reek of Lysol'

Today, having 100 guests at an event isn't just unwise, but against the law. The memorial service was March 13, before gatherings of 50 or more people were banned.

In hindsight, "we should have cancelled the thing," said Taylor. "We were using the care that was considered appropriate then."

More than 100 guests came to the Unitarian Church of Vancouver on 49th Avenue at Oak Street including some from Washington State and international locations — again, activities banned now, but allowed then.

Rob Atkin/Vancouver Heritage Foundation

"We totally sterilized that church, before, during and after the event. Every doorknob, every window, every surface," said Taylor.

"There was a bit of a reek of Lysol actually."

During the service, people sat far apart, he said, but there was mingling afterward at a smaller reception of about 50 people — at least 11 of whom have since come down with symptoms including fever, cough and extreme tiredness.

Who gets tested?

Last week, the director-general of the World Health Organization urged nations to "test, test test every suspected case," as the backbone of a COVID-19 response.

But that is not what's happening in B.C., even though this province has been hailed as a leader with 17,912 tests as of Friday. 

The bottom line here, reiterated by Dr. Bonnie Henry, is that not everyone with symptoms needs a test, especially if the resulting advice would still be to self-isolate.

The self-assessment guide says people with symptoms mild enough to be managed at home won't be tested, with some exceptions:

  • Health-care workers.

  • People in hospital or likely to be hospitalized.

  • Residents of long-term care facilities.

  • Part of an investigation of a cluster or outbreak.

That last point stood out for those who attended the memorial, including Melanie Henderson, who is sick along with her husband. She tried 811 for five days, and finally called an urgent care centre which did not offer her testing.

"I said I'm starting to realize that this might be part of a bigger cluster outbreak here on the West Side because of one event that happened," said Henderson. "They said that we still don't qualify for swabbing, basically. Go home and isolate" 

John Minchillo/Associated Press

Changing testing strategy

At her daily briefing on Saturday, Henry didn't have specifics on how many tests B.C. can do in a day, but said capacity is in the "several thousands."

Still, she said there have been challenges, including a global shortage of the reagents, or chemicals, needed to process the tests, leading to a backlog.

"I expect to have the backlog … completed by the end of this weekend, early next week, and we've brought online other laboratory capacity," she said.

But last week, B.C. also changed its strategy around tests, she said.

Initially, they were testing every suspected case, trying to trace outbreaks and understand whether community spread was occurring.

Now that it clearly is, Dr. Henry said the primary focus is to "flatten the curve," or limit the number of cases through social distancing. 

"Once we get to the point where we have flattened the curve enough, then we need to start widely testing again to make sure that we're not getting more introductions," she said.

"That is down the road, hopefully in a matter of weeks."

She has previously said the revised strategy was due to targeted use of existing resources, not a shortage of supplies. She wasn't asked about the possible cluster from the memorial.

As for that group, Henderson said the family and friends will try to contact and warn everyone who attended, which means going through the sign-in book from the church and looking for phone numbers.

"They said go ahead and call everyone. So that's what we're doing."

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