Missed appointments causing headaches for local COVID testing centres

As demand remains high for PCR testing of symptomatic and high-risk exposure contacts, Region of Waterloo Public Health is sharing some perspective on the challenges facing local testing centres, including staffing challenges and issues with no-show appointments. 

Stephanie Pearsall is the Vice President of Clinical Programs at Cambridge Memorial Hospital, and our Regional Testing Lead.

She said demand for COVID-19 testing at Waterloo-Wellington centres has been high for a number of months, while public health has been working since September to increase staffing.

The demand is particularly being seen with kids returning to school and the gradual lifting of COVID restrictions.

Pearsall said staffing shortages in healthcare have been felt across the system, including in local assessment centres, with testing centre workers held to the same standard as those working in local hospitals. 

“If you're sick, we really don't want you to come to work,” Pearsall said. “Depending on what your symptoms are, we would want them to get a COVID test as well.”

“A lot of our assessment centre staff have children that are in school and that certainly can have an impact, so what we're trying to do is keep people healthy who are at work, but we're also trying to increase appointments where we can.”

Pearsall noted that the “biggest barrier” impacting local testing centres right now is individuals who fail to show up for their appointments, and provide no advance notice or cancellation, essentially leaving testing staff in the lurch.

With regards to the downtown Kitchener Charles Street drive-thru assessment and testing centre operated by Grand River Hospital, Pearsall said the numbers fluctuate.

She said they typically deal with 50 to 100 no-show appointments per day, which is roughly 15 to 20 per cent of the capacity of that centre.

“That has been going on really since the pandemic began… but when the burden isn't high in the community, it's not as important,” said Pearsall. “When the burden is this high and every single appointment is being utilized, that's 50 or 100 people that are now trying to get an appointment the next day that we could have tested on that day.”

The regional testing lead also emphasized that there's a degree of risk associated with prolonging that testing, as she said that those assessment centres offer appointments to symptomatic individuals that require a test, or individuals deemed high-risk contacts by public health that have been instructed to get tested.

“We want to get these people in as quickly as we can to be tested.”

When it comes to staffing assessment centres, Pearsall said our health unit tends to “flex” available staff to meet demand.

While assessment centres saw a large degree of “redeployed staff” in the early days of the pandemic, Pearsall said those clinics are now largely staffed by individuals hired specifically for that job, with a mix of registered nurses, physicians and housekeeping staff employed to keep testing running smoothly.

She also noted that some staff may work between the hospital and local assessment centres, shifting to where they're needed given demand. 

“Sometimes, if there's a shortage and we have the ability to pull from our hospital into our assessment centres, we'll do that,” Pearsall said. “We're flexing and moving staff around as much as we can so it has the least amount of impact on any type of service.”

Pearsall also mentioned our hospitals have access to “mobile vendors” made available through Ontario Health, typically utilized to provide focused testing in the case of various community outbreaks – though those staff members have been used in the past to shore up shortages at local clinics to ensure testing could be completed on a given day. 

When asked if our local hospital's recent finalization of vaccine mandates played any roll in issues with staffing, Pearsall was clear that the impact of those dismissals were spread across multiple programs – making a “minimal” difference in the overall system.

“We understand that appointments need to be cancelled for a variety of reasons,” Pearsall said. “But if you could just please cancel in a timely fashion, that allows us to open that appointment for someone else.”