Omicron is blurring true picture of COVID-19 cases. But experts say there are other ways to capture it

As demand drastically increases for COVID-19 testing across the country, experts say it will quickly become harder to get an exact picture of Omicron case counts in Canada.

And that means health authorities are likely soon going to have to rely more on hospitalization numbers as the main indicator of the extent of the impact of the new coronavirus variant.

"This is such a hyper-contagious disease that it was completely foreseeable … that the rate of spread would overwhelm the testing capacity that we have, as is already happening," said Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa.

COVID-19 case counts have never been perfect, but now with Omicron's highly contagious nature, polymerase chain reaction (PCR) testing has been maxed out in some provinces as people rush to get tested.

With some areas expected to limit who can get tested, health experts say that will lead to an undercount in cases.

Others say case counts become less important if symptoms are milder, and that tracking hospitalizations, death counts and the strain on the already maxed-out health-care system is more important at this time. 

"At the end of the day, we're trying to prevent people from getting severely ill and people from dying. So those hospitalization rates are important," said Dr. Stephanie Smith, an infectious disease specialist at Edmonton's University of Alberta.

"Many hospitals are just trying to recover from the last wave, the Delta wave, and really have not fully recovered. So even a small increase in hospitalizations due to Omicron is challenging."

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While most provinces have made rapid tests more widely available, PCR tests are still considered the gold standard of COVID-19 testing, with the main advantage being that the tests are much more sensitive and highly accurate.

But with PCR test sites clogging up in some provinces due to high demand right before the holidays, case counts aren't being fully captured. 

That's what's happening in Ontario, according to one doctor. 

"Typically in Ontario, if things are quite OK and the surveillance works, we assume that we detect roughly 40 per cent of the cases. But what we see now is that the surveillance system starts to struggle," said Dr. Peter Jüni, the scientific director of Ontario's Science Advisory Table.

He estimates Ontario is now detecting about 30 per cent of the COVID-19 cases. That means if there are 3,000 confirmed cases, the actual number could be closer to 10,000 cases.