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Toronto-area startup Switch Health accused of fumbling Canada’s COVID-19 border testing

When Greg Skinner returned to his Invermere, B.C., home after visiting his 10-year-old daughter in the United States, he says he tried for 10 consecutive days to set up an online video call with a registered nurse.

(C) Provided by Global News Tyler Harvey took a screenshot of the virtual line up he found himself in when he logged on to the Switch Health portal to connect with a nurse.

Canada’s COVID-19 testing and quarantine protocols require travellers like Skinner to get tested twice for the novel coronavirus after they arrive. Travellers also need to ensure a healthcare professional supervises them taking a swab, while in isolation. This is why he needed to set up the video chat.

But from the day he returned on Feb.

28, Skinner says he tried to log on to the online testing portal and kept getting bumped off before he could make it to the top of a waiting list. Finally, on March 10, Skinner says he got someone on the phone to answer his questions. They weren’t from the government.

“He said, ‘Take the test yourself and send it in, they won’t know the difference,’ ” Skinner said, recalling the phone call. “And he said, ‘I’m not supposed to tell you that.'”

Skinner said he didn’t record the conversation, but he provided Global News with call records, emails and screenshots corroborating his claims that he made numerous attempts to set up an appointment.

He said the person who advised him to take the test without supervision was someone doing customer service for Switch Health, a Toronto-based startup company.

Federal contract worth almost £100 million

The Public Health Agency of Canada awarded Switch Health a contract in early 2021 worth nearly £100 million to manage hundreds of thousands of coronavirus tests for travellers arriving in the country at land-border crossings and at airports in Toronto, Montreal, Calgary and Vancouver. Switch Health uses a remote two-step process that includes an initial test within 24 hours of arrival. The government requires a second test seven days later.

Prior to April 23, the second test was required nine days after arrival. Under Switch Health’s system, travellers who arrive in Canada can rely on couriers, including Uber and Purolator, to deliver home-testing kits where they are needed, and pick up completed tests for delivery to labs. The government awarded the contract to Switch Health in support of new requirements that took effect on Feb.

22 for non-essential international travellers to get tested in Canada upon arrival.

Read more: 86 per cent of Canadians support new international travel restrictions, poll finds Federal Transport Minister Omar Alghabra said on Feb.

12 that the new requirements were among the “critical measures” needed “to help prevent the spread of COVID-19 and the introduction of new variants of the virus into Canada.” Skinner told Global News he wound up taking his swabs without supervision and that they were approved after the test results came back negative.

“This is supposed to be the safety net that is protecting Canada from COVID-19, but the government is not getting what it paid for,” said Skinner, one of more than a dozen people who spoke to Global News about their experiences in recent months, describing in detail a dysfunctional and inefficient testing system. Switch Health declined to comment directly on Skinner’s allegation that he took swabs without supervision, explaining it could not comment on any individual cases. It said it has advised its call representatives that all home tests must be nurse-monitored and added that nurses must confirm monitoring occurred on its online testing portal, before a user can mail a sample to be tested.

While the company added that it was working hard to prevent delays, much of the early feedback from travellers like Skinner has been scathing. Global News has identified more than 100 Facebook and Twitter complaints and at least 150 Google reviews containing allegations of poor quality in relation to Switch Health’s online services and excessive delays. Many say the company has fumbled its management of the program, potentially opening the door to new COVID-19 outbreaks originating with travellers who didn’t know they were infected.

Several dozen reviews on Google also gave the company a five-star rating. Global News has not verified the identity of all of the users who posted reviews. The Public Health Agency of Canada said it was aware of “long wait times” and that a “small number” of travellers were unable to book their virtual testing appointments on time.

The federal agency explained it was working with Switch Health and other federal partners to resolve these issues. The agency also said it was not aware of specific complaints in which the company advised users to complete their tests without nurse monitoring, or any resulting inaccurate tests.

Patchwork and porous border testing

Two public health experts told Global News that the list of complaints could highlight how the federal government’s border testing policies haven’t worked out as planned. They say the weak oversight and absence of accountability may also be a factor in the third wave of COVID-19 in Canada as new variants carried by travellers trigger significant outbreaks that are overwhelming hospitals and increasing the death toll of the virus from British Columbia to Quebec.

“We’re in a situation now where we have a patchwork, partial and very porous measures for international arrivals from air, land and sea,” said Kelley Lee, a professor of public health at Simon Fraser University.

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Colin Furness, an epidemiologist at the University of Toronto, suggested that the situation could get worse if Canada doesn’t improve its testing regime for travellers. “We may have had tens of thousands of new cases (of COVID-19 variants) landing at Pearson airport, making their way into the Greater Toronto area. And if we are wondering where the third wave came from, looking at those tens of thousands of cases that we could have let in is a good place to look,” Furness said. “So there is a lot of concerns if you are going to send people home (to complete COVID-19 testing), when you distribute that responsibility.”

In an April 22 letter to Prime Minister Justin Trudeau, Ontario Premier Doug Ford and Quebec Premier Francois Legault urged the federal government to tighten up COVID-19 testing measures at Canada’s borders, expressing concerns about a range of issues, including travellers who are opting to accept fines rather than comply with quarantine requirements.

Read more: Provinces want tightened travel, land border restrictions to limit COVID-19 variants: Legault Switch Health executives declined repeated requests for an interview. Switch Health told Global News in an email that it has scaled up its operations and continuously hired new employees to upgrade its systems and reduce waiting times but was going through some growing pains.

“Much like Canadians have had to be adaptable and patient with governments as they get us through this pandemic, we also need time to adjust to the exponential demand for our services,” the statement said. “We are continuously adding and training more customer service agents and nursing staff to process requests in a timely manner, adding to our workforce daily. … We are disrupting current delivery models with technology to address the challenges of COVID.”

More than 300,000 tests

The company has grown from about five employees in early 2020 to over 1,200 full-time and part-time employees one year later, including about 900 nursing staff, making it a “great Canadian success story” in the middle of a pandemic, spokesman Jordan Paquet wrote in an email to Global News. Paquet also wrote that the company provided testing kits for travellers arriving at 100 land board entries and international airports in Montreal, Toronto, Calgary and Vancouver within days of winning its federal contract in February 2021.

By April 21, Switch Health had tested about 314,000 specimens from airport and land border arrivals and at-home collection kits, he said, with the company identifying over 2,700 cases of COVID-19. But many of the user complaints reviewed by Global News have persisted in April. A number of users said they waited in 1,000-plus person lineups for a nurse on Switch Health’s online portal and got disconnected.

As a result, some said they didn’t take their tests on time and were considering leaving quarantine after being unable to get a test within 14 days. Libya Vogt said she was stuck in quarantine for 16 days upon returning to Vancouver, B.C., following a visit to an elderly, palliative family member in the United States. She said she was given a Switch Health kit at the border on March 16 with an incomplete serial number and waited nine days before someone sent her a replacement.

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She said when she called her provincial government health information line, she was told they were getting a lot of complaints.

The provincial health ministry confirmed receiving complaints from Switch Health test-kit users but referred questions to the federal government’s Public Health Agency.

“I’m infuriated and embarrassed at this waste of time and tax dollars, and don’t understand why this company was granted a government contract with zero accountability,” Vogt complained in a March 25 email to Liberal MP Hedy Fry.

Vogt shared the email with Global News. She explained that following her first email on March 16, Switch Health told her to expect a kit in two days. She says she didn’t get it and went on to contact the company repeatedly, receiving a total of seven confirmation emails, before receiving two kits.

“I forwarded your concerns and reached out to the Health Minister’s office,” Fry’s constituency assistant responded in a March 26 email shared with Global News, which said Fry’s office would flag the issue with the company and make sure it was resolved. Switch Health told Global News it has since added mailing tracking numbers for replacement home-testing kits due to client feedback. And PHAC said it reviews documentation for lab testing and specimen collection services invoiced by Switch Health.

In response to questions from Global News, Public Services and Procurement Canada, the federal department that oversees public contracts, declined to comment on specific allegations about Switch Health, but explained it could conduct a discretionary audit of the company’s performance “if deemed necessary.”

‘Out of nowhere’

There is limited public information available about Switch Health and its founders. The company describes itself as the brainchild of several Toronto innovators who say they have disrupted Canada’s healthcare model by reducing the amount of medical staff and clinics needed to administer coronavirus testing. It also says its 31-year-old CEO, Dilian Stoyanov, has experience in “big data” and technology.

Switch Health’s website says it was formed in 2017, but the company’s incorporation documents say it was registered in April 2020. When asked to explain the conflicting dates, Switch Health told Global News that Stoyanov originally founded the company as a healthcare consulting business in 2017. Later, he came up with the idea of facilitating “decentralized” home and mobile COVID-19 tests in early 2020, the company said.

As the danger of the coronavirus and impacts on borders and travel emerged, the company says Stoyanov brought on several like-minded innovators and rapidly devised Switch Health’s COVID-19 business strategy. According to a feature article published by the Financial Post last September, Stoyanov described the early months of 2020 as both “exhilarating and terrifying.” The company did not say whether it had any healthcare clients prior to 2020.

Co-founders Stoyanov and Marc Thomson’s LinkedIn and Google accounts say they were both writing ad campaigns for companies in Canada’s nascent cannabis industry in late 2019 and early 2020. Thompson’s wife Mary Langley is Switch Health’s chief strategy officer and a former Ontario government communications staffer. Langley also worked for Thomson’s company, Baldur Media, which was in the marijuana advertising business.

Baldur Media shares a Toronto registered office address with Switch Health. But Switch Health says that due to its rapid growth, Thompson and Langley “are no longer carrying out any activity with Baldur Media.”

Read more: At-home COVID-19 test system endorsed by feds won’t let rural Saskatchewan family register According to the Financial Post article, Switch Health clients have included NHL players in the 2020 playoff bubble, actors and the CBC.

It has also attracted former federal health minister and ex-Conservative Party of Canada leader Rona Ambrose to sit on its board of directors. Ambrose did not immediately respond to a request for comment. CBC confirmed to Global News that it used Switch Health to test non-CBC employees coming into its Toronto Broadcast Centre in order to ensure the safety of its employees.

The CBC said that independent productions such as Battle of the Blades, the Junos and the New Year’s Eve special also did their own testing, using Switch Health. In an email to Global News, an NHL spokesperson said the NHL did not engage the company “for testing services in connection with the bubble.” Apart from its federal contract, Switch Health also won “mobile” COVID-19 testing contracts from the provincial government in Ontario, which refused to disclose the value of these deals.

In July 2020, months after the company incorporated, Switch Health was contracted by Ontario’s government to provide COVID-19 testing for hundreds of migrant farmworkers in southwest Ontario, after a coronavirus outbreak in their living quarters. Windsor NDP MPP Taras Natyshak, who openly questioned the contract and the company’s ability to scale up, says he started to probe because the “company seemingly came out of nowhere.”

“I asked, ‘Who are they? And what is their track record?’ And I couldn’t find the answers,” Natyshak told Global News.

One of the key questions, he said, was whether lobbyists with ties to Premier Ford’s government helped Switch Health.

Ontario’s auditor general has since decided to look into the company’s Ontario deals.

‘Very competitive process’

By December 2020, Switch Health’s home-testing kits were approved by PHAC. The government awarded the border testing and home-kit testing contracts in February 2021 after what the company described as a “very competitive process.” Canada’s request for proposal says the winning bidder needed to demonstrate the capacity to complete at least 10,000 COVID-19 lab tests per day across Canada, and to scale up to 100,000 tests per day.

But the proposal also asked applicants to present innovative testing solutions that would use as few medical professionals as possible. Paquet, the company spokesman, told Global News in an email that Switch Health was a trusted partner of both the Government of Canada and the Ontario Government, working “very closely and collaboratively” with them to continue scaling up to meet demand. He also said that all of its federal and provincial contracts were awarded following “rigorous government procurement processes.”

Tyler Harvey of Calgary, who returned to Canada after a work-related trip to Washington state, says he also experienced long wait times on the Switch Health website and he believes the company didn’t have enough nurse monitors ready to meet demand. “It really seems like there could have been a little more oversight on the part of Public Health Canada. Were (Switch Health) really ready for this level of usage?”

Read more: At-home COVID-19 test system endorsed by feds won’t let rural Saskatchewan family register

Janie McNichol, a Saskatchewan woman who travelled to the U.S. due to a medical appointment for her daughter, told Global News that her family had to do all of their tests on the same day — instead of the first and 10th days — due to glitches in the Switch Health system that caused delays. “If Switch Health doesn’t work, why are people not allowed to drive to a test site, go through and come straight home?” she asked.

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Other users said that even when they succeeded in completing nurse-monitored tests, Switch Health lost their samples or failed to return the results ahead of important deadlines, like flights from Canada. “Your company’s advertisement for the testing is wrong, people are missing flights and have to pay more at the hotels because the results are coming out late,” said Anjali Jestine, a student who complained in a LinkedIn post in late March, and confirmed her concerns to Global News.

And comments on social media suggest frustrated Switch Health portal users considered breaking Canada’s quarantine rules rather than suffering a broken testing system.

“If they think that people will be quarantined even after their 14 days … well they can do whatever they want, but no fine will be paid,” said one user, who complained about disconnections on Switch Health’s portal and 1,000-plus user line-ups.

“This is the only game in town for the Government of Canada video-monitored Day 10 PCR test (and) I cannot do the test without Switch Health supervision,” another user complained online. “If you are going to get a big government contract, at least make sure that you have enough nurses and knowledge of technology to do the job.” When asked to comment on the feedback from travellers, James Cohen, executive director of Transparency International Canada, said that the government should be able to provide proof that Switch Health demonstrated its capacity to handle COVID-19 testing. “Given the single contract for so much responsibility during a pandemic, and the need for the public to have confidence in important public health guidelines, if allegations are true … it does undermine trust,” Cohen told Global News.

Read more: Will these new travel restrictions work? Doctor answers our COVID-19 questions In a response, the federal government said Switch Health applied to Public Service Canada’s Jan.

18, 2021, call for bids “in line with … open, fair and transparent procurement processes.”

By email, Paquet told Global News that Switch Health has faced challenges due to the requirements of operating in a country as large and as diverse as Canada, but that it continues to fix “many gaps along the way.” The company’s recent efforts include finding fast courier services for remote regions as well as setting up phone appointments in regions that lack broadband internet services, he explained.

“Of course, with any program like this there are bound to be a few bumps in the road, but we are continuously making improvements and adding to the team,” Paquet wrote.