31 Dec 2021

Covid-19: Urgent need for a reset on volume of lab tests - medical institute

8:25 pm on 31 December 2021

The Medical Laboratory Science Institute says the government needs to rethink who and how it tests for Covid-19, or it risks overrunning the country's labs.

Novel coronavirus 2019 nCoV pcr diagnostics kit. Hand in glove with automatic pilette. RT-PCR kit to detect 2019-nCoV or covid19 virus in clinical samples.

Photo: 123RF

President Terry Taylor said the measures to combat Covid-19 spread were designed to prevent frontline hospital services from being overrun.

However, he said international examples show diagnostic services could also be swamped.

"The past 21 months have highlighted the dedication and drive of our medical laboratory staff but have also exposed the lack of national coordination and future proofing caused by years of underfunding and neglect," Taylor said.

"It needs to be remembered that our diagnostic laboratories routinely perform a full spectrum of hundreds of different tests every day.

"For example, Covid testing may only make up 10-15 percent of our total daily workload at present. The irony is that our laboratory performance is almost exclusively judged by numbers and turnaround times for Covid testing alone."

Taylor said leaders needed to create a Covid-19 test prioritisation plan to help manage workloads, and added that while PCR testing capacity was about 60,000 tests daily, this came at a cost to other lab services.

He said the current blanket approach worked in the early days of the pandemic, when labs were processing about 5000 Covid-19 tests daily, but a new testing regime would need to be considered for when Covid-19 is widespread in the community.

He said it must be decided if it was worth testing asymptomatic patients with nasopharyngeal swabs rather than the symptomatic patients that should be the focus.

"The other thing will be where they are, are they in the hospitals, are they acutely ill?

"Then, of course, we're going to have the role of the rapid antigen tests as well, and how can we bring them in to alleviate the load that we're going to get in our diagnostic laboratories."

Taylor said reducing the load on labs would be key to reducing the likelihood of errors such as the one in Sydney recently, where an incorrect PCR result text message was sent from St Vincent's Pathology affecting hundreds of people who were wrongly told they were negative.

"To suddenly put excessive pressure on and exceed our testing capacity in the current environment is a potential perfect storm that will ultimately lead to mistakes and pressures that everyone will find difficult to deal with," he said.

"We only need to look overseas for the bedlam that this will cause for our wider health system.

"There needs to be a clear testing plan for how to deal with the spread of the virus into the community. Omicron has clearly brought a new edge and urgency to this. How and who we test must be front and centre and clearly communicated by health and political leaders to prevent service bottlenecks."

A queue for Covid-19 testing at Bondi Beach, Sydney, as Covid-19 cases keep on the rising across the state.

Massive queues for Covid-19 tests in Sydney, including this one at Bondi Beach, is putting pressure on laboratories in New South Wales. Photo: AFP

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