Since four new community cases were confirmed in Auckland on 11 August, Labtests has been inundated with COVID-19 tests. General manager Chris Davey, medical director Gary McAuliffe and Susan Smith, head of department of microbiology and molecular talk to reporter Zahra Shahtahmasebi about meeting this demand and what their experience of the COVID-19 pandemic has been like. Visuals by Simon Maude.
“That’s the whole point of having a national coordinated response, being able to move work around, knowing where the pressure is and having visibility of where all the pressure points are”
It was a record day for Auckland’s Labtests laboratory on 14 August when over 12,000 COVID-19 swabs came through the door.
Cardboard boxes had to make do to contain all of the individually bagged swabs while they waited to hit the molecular laboratory, says general manager Chris Davey.
But after New Zealand’s national lockdown from March through to May, they felt well prepared to deal with the upsurge in tests which followed four Aucklanders testing positive for COVID-19 on 11 August and the city being plunged back into Alert Level 3.
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Coordinated response
Labtests is just one part of the regional COVID-19 response, explains Ms Davey, with the laboratory in Mount Wellington responsible for receiving and processing swabs taken at GP clinics in Auckland and Northland.
And they’re in constant contact with DHBs who process swabs taken at community testing centres and in managed isolation facilities.
“We all work together, all of the country, there’s a national laboratories response group which meet daily on Zoom… where we can discuss issues with supply, manpower.”
‘Herculean effort’
On any given day swabs arrive at the laboratory and need to be registered, says Ms Davey.
“So that’s a count of how many you’ve got in… then you’ll be processing some – it’ll be some you got the day before, some you got that day, and then you’ll be reporting them the following day.”
From 13 to 15 August, some 26,000 swabs came through the doors of the Labtests laboratory.
“So the backlog, by the time we got to Saturday, was between 12 and 15,000.”
So on Sunday, 16 August, Labtests sent 2000 to LabPLUS at Auckland City Hospital, 1000 swabs that were received that day to a Southern Community Laboratories centre in Wellington, and processed 8000 themselves.
“By some Herculean effort, on Monday we had none,” says Ms Davey.
“And that’s the whole point of having a national coordinated response, being able to move work around, knowing where the pressure is, and having visibility of where all the pressure points are.”
Daily reporting
Labtests, along with all other labs that are conducting COVID-19 testing, reports to the Ministry of Health every morning, says Ms Davey.
This update provides the ministry with a snapshot of how many tests each lab did, what its capacity is, how many it could do today and how many it could do for the week.”
“They want to know early if there are any potential capacity issues.”
The number of tests coming from GP clinics is always the unknown with clinics having the potential to provide a huge number of swabs.
“We have to give them time to collect, we send out a courier fleet multiple times a day, starting at 10.30am. They start picking up a lot around 2pm but the witching hour is between 6 and 8pm.
“We can’t process until it gets here, so we have to plan optimum rosters and shifts around this.”
Requires a nationwide effort
Prior to COVID-19 reaching New Zealand’s shore, not a lot of molecular testing went on in the laboratory, says medical director Gary McAuliffe.
“We didn’t include molecular or genetic, PCR testing, we didn’t have the platforms to support this.”
It was on 23 January when the situation became “exceptionally real” and Labtests had to hustle to get sorted.
“What we could see was that when [COVID-19] was coming, it was going to require a massive effort on behalf of the whole country, as opposed to bespoke testing in a small number of laboratories.
“That’s why, along with the DHBs, we made the decision that we needed to get testing in here as well.”
Inundated by providers
So Labtests started looking at what sort of instruments it could get hold of, that would be suitable for COVID-19 testing, appropriately trained staff as well as space in the laboratory to put them, says Ms Davey.
The company was in constant talks with the ministry, as well as being inundated with providers advertising their products, which all had to be validated to ensure it was good quality.
“We were lucky enough that one of them had an instrument, there was no global allocation available for Asia Pacific at that point in time, but they managed to get their mitts on one from Europe.”
In the end Labtests ended up with three different instruments, or platforms, capable of processing COVID-19 swabs…“which we get from three different providers. We had to diversify and go to different manufacturers to mitigate the risk that one supplier might let us down.”
It’s been an effective strategy, especially with supply chain pressures not just nationally but globally as well.
Redeploying staff
Labtests stopped its prenatal health screening and this team was redeployed very quickly to deal with COVID-19 swabs, says Susan Smith, head of department of microbiology and molecular.
“We stopped testing on 24 March, and processed our first COVID test on 31 March,” says Ms Davey.
On any given day, 12 to 15 staff are working on COVID-19, says Ms Smith, doing anything from removing the sample from the bag, called “de-bagging”, to processing them.
De-bagging might not be the most technical job, but when there’s 10,000 swabs to be removed in a day, “you need a lot of hands to do that”, she laughs.
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