'Time to rethink mass testing strategy'

01 June 2020 - 09:04
By Tankiso Makhetha and Kgothatso Madisa
Health officials have been actively testing  for the virus./  ESA ALEXANDER
Health officials have been actively testing for the virus./ ESA ALEXANDER

Only people who are sick, in hospital or showing visible symptoms of Covid-19 should be tested for the virus, national health laboratory services head Sipho Dlamini has warned.

This is one way to ease the pressure on the country's laboratories which are unable to cope with the volume of samples coming through daily.

Dlamini said the NHLS was trying to convince health minister Zweli Mkhize to change government's ambitious mass testing strategy, given practical limitations.

The government recently undertook to proactively search for the virus where all those whose screening results meet the broader testing requirements were swabbed, even if they showed no symptoms.

The requirements include people who had been travelling or had been in contact with infected individuals.

There are about 100,000 people who are still waiting for their results. Some have waited for nearly two months.

This move to do mass testing has proved to have been premature as the NHLS has not been able to acquire enough special testing kits with the ones they have being slower in producing results and cannot meet the demand.

Instead of mass screening and testing, the NHLS wants testing to be prioritised.

"That's why we are asking the minister, to say, let us revise the strategy and we have been asking for it that let us revise the strategy and manage the number of tests that are coming to the laboratory until such a time that the country has got enough kits to be able to do what needs to be done," Dlamini said.

Dlamini said they have asked Mkhize to review the mass testing strategy as, currently, the identified positive cases were way too low for the number of tests that are being done.

He said only in the Western Cape and the Eastern Cape where they currently getting a sufficient number of positive cases per number of tests which was between 18% and 20% as opposed to everywhere else where that number drops to below 1%.

"We are saying let us prioritise them, we are not saying let us stop testing. We are saying that let us be smart about it.

"Let's just not go fishing and say we want to go to Soweto and test 100,000 people. Let us choose the ones that are most likely infected.

"The ones who are in hospitals should be tested first, the ones who have pneumonia, the ones who are very sick should be tested, confirmed and treated immediately."

As it stands, the NHLS receives up to 40,000 samples for testing a day but can only process up to 25,000 in 24 hours.

"There's a global shortage of kits, there's an increased demand in testing. We moved much earlier to community testing at the same time there was a sudden global shortage of testing kits.

"So once you have that mismatch, you cannot cope and all that you can do is to try and find alternative ways of how you can fast track how you can do, you can increase the number of staff but remember these tests are done in a very manual sampled process," Dlamini said.

A 65-year-old Sandton man has been hit by the backlog, after having waited for his results for close to six week.

He tested for Covid-19 in April and is yet to receive the results. The man, who wished to remain anonymous, said it was worrying that six weeks have elapsed without a word from the health department.

"I did a throat swab in the middle of April at a government facility in Sandringham. They told me that if my results would be sent to me within 24 hours if I was positive and it would take about three days if it was negative," he said.

"I went to get tested because I had a bit of a fever and was concerned because I am a pensioner and I was worried."

DA Gauteng member of provincial legislature on health Jack Bloom said the number of infected people provincially could be higher due to the test backlog.

"As the average positivity rate has been a bit below 2%, this means that more than 400 Covid-19 infected people have not been diagnosed in Gauteng because of the test backlog. Many of them are probably asymptomatic but could still pass on the infection," Bloom said.

He said 24,076 Covid-19 tests in Gauteng have not been processed.

"The Gauteng infection figures have leapt in the past seven days from 764 active cases on 23 May to 1,707 active cases on 30 May. Another worrying sign is that hospitalisations of Covid-19 patients have more than tripled in this time period from 73 to 332 patients."

Department of health spokesperson Popo Maja said Mkhize would address the backlog during the week where he is also expected to speak on the discussions with NHLS about reprioritisation of testing. Mkhize is expected to announce a strategy that, according to Maja, will ensure the backlog issue is dealt with.