The testing fiasco

I don’t think people realise how much of a fiasco covid-19 testing is. You get some idea in this article:

Healthcare workers say coronavirus tests are being withheld because of limited supply, despite the prime minister’s insistence clinicians have both the resources and permission to test.

A new coronavirus testing criteria was released late on Wednesday, permitting the testing of patients with Covid-19 symptoms but no connection to overseas travel or another coronavirus case. 

Prime Minister Jacinda Ardern, who announced the expansion of the criteria the day prior, again said there was ample testing capacity at a Wednesday press conference — it just hadn’t been used by clinicians.

But a Wellington GP, who spoke to Stuff on the condition of anonymity, said there were not enough testing swabs for the number of patients presenting Covid-19 symptoms. His clinic had ordered 30, but received five as the laboratory was trying to preserve supplies.  

There have been numerous stories now about people who have Covid-19 yet were rejected for testing at an earlier stage. This is manifestly a failure if someone who has Covid-19 isn’t allowed to be tested for it.

The problem is that the Government is not co-ordinating between the different parts of the health system when it comes to testing. There are three main actors. They are:

1. Doctors/GPs
2. Testing Centres
3. Labs

Now you would think that if a Doctor or GP decides a patient should be tested, then they would be tested. That would be the sane outcome. Trust the GPs. This already happens with other tests – a GP has authority to order a test.

Some GPs have the ability to take a sample themselves, others refer them to a testing centre. The first problem is that a testing centre won’t test someone just because a GP has referred them. They will apply their own discretion.

But the bigger problem is that laboratories themselves are also applying their own decision making to testing. So you have the bizarre situation where GPs or testing centres have decided a patient should be tested, have taken a sample and sent it to the lab. But the lab them decides not to test it!!!!

To make the situation worse, there is no data on this. The Government has not even been releasing daily data on tests done, but generally only releasing average data for the last seven days which hides the most recent data.

There are only 8 – 10 testing labs in NZ. The Government should be releasing daily data for each individual lab showing how many tests were submitted that day and how many were actually tested. Then GPs and the public could see how many tests are being refused at each lab.

But most of all the Government should be instructing the labs to accept all tests that have been authorised by a doctor, unless they have reached their capacity. As the number of tests has been less than half the stated capacity this shouldn’t be an issue.

The WHO and even the PM now are saying test, test, test. But the health bureaucracy is preventing this. Maybe the Minister of Health could focus on sorting this out.