The city's top doctor says Toronto Public Health’s ability to do COVID-19 case and contact management continues to be “challenged” by delays caused by the provincial system.

Speaking at a Toronto Board of Health meeting, Toronto’s medical officer of health, Dr. Eileen de Villa, recommended that the board and city council ask the provincial ministry of health to develop an “efficient system” to transfer COVID-19 case information from provincial laboratories to public health units.

“The way in which the results are reported to us, the delay that occurs within the laboratory system, there are a number of challenges that continue to need attention and need resolution from a system perspective,” de Villa said at a virtual meeting of the board of health on Monday.

She said her team has managed to come up with some interim fixes to deal with reporting delays but more needs to be done to improve the flow of information.

According to recent data released by Toronto Public Health, about 72.2 per cent of all newly reported COVID-19 cases are contacted within 24 hours.

That number was closer to 90 per cent prior to a reporting error that resulted in hundreds of confirmed cases going unreported by one lab in the province, de Villa noted.

Toronto Public Health has indicated that it takes approximately three days for a test performed at a hospital to be processed by the lab and it may take up to a day for the hospital to receive the results.

The test results are then sent to public health in a “non-digital bulk format” and public health staff has to “manually extract” the results from the system.

Once all of that occurs, which Toronto Public says has taken up to a day, an investigation begins and the case can be reached.

“Our case and contact management efforts are unfortunately currently challenged by a number of issues related to the transfer of information-- how information moves from laboratories to Toronto Public Health,” she said.

“The more efficient method of solving those challenges will be a system fix.”

She noted that if the province can solve the issue, it would allow public health staff to focus on preventing further transmission of the virus and put prevention measures in place, rather than trying to figure out how best to examine data from the “very complex morass” that is the provincial system.

Issues with the province's Integrated Public Health Information System (iPHIS) got so bad that in April Toronto developed its own data management system, CORES, to assist in contact tracing, a move Ottawa and Middlesex-London quickly followed.

'Clear' testing strategy needed

In her presentation to the board of health, de Villa also urged the province to “urgently” develop a “clear and consistent” approach to testing in Ontario.

“While ensuring that sufficient testing capacity and sufficient testing is occurring, most important is actually figuring out how best to deploy testing resources as a means to reduce transmission of COVID-19,” she said.

“This is a new virus (and) we are still learning a great deal about this virus, there is much that we do not know, but I think that speaks even more to the need of a clear strategy that is evidence-informed.”