Testing "the science": A comparative analysis of COVID-19 testing policy across four Canadian provinces

Following the COVID-19 pandemic, scholarship has focused on the intersection of politics and scientific evidence in the development, distribution and uptake of vaccines; border closures; and interventions such as public space closures or masking. But there is a significant gap in the examination of the political choices which informed how discrete jurisdictions chose to undertake and support COVID-19 testing. Using a qualitative, multiple-case study nested in a larger comparative, mixed-method explanatory case study, this research addresses this gap in the literature through a qualitative analysis based on 103 key stakeholder interviews to inform the narrative of testing strategy across four Canadian provinces. Despite the perception that testing is a largely "scientific" process relatively insulated from political choices and pressures, this study shows that jurisdictions had to address an array of variables, often specific to their region, which strongly influenced policy choices in this area. Testing policy, rather than a simple and straightforward clinical exercise, is a highly complex and nuanced process that must take into account a wide variety of non-clinical variables.