Should we be testing more, or less, what about the perspective from inside the laboratory?

There have been comments comparing the drop in COVID testing numbers between the start of the Delta outbreak to the Omicron outbreak we are now facing.
The question is, is it ‘COVID fatigue’ or is it even more simple than that and New Zealanders have taken on board the workplace science they have been hearing from those directly involved with the diagnostic testing laboratories.

Aotearoa New Zealand is no longer pursuing an elimination approach but a suppression approach that involves testing those who are symptomatic or are close contacts. Those intimately involved with our diagnostic COVID PCR testing response, the medical laboratory scientists and the medical microbiologists have been preaching the same tune for the last few weeks.

The mindset changes from testing everyone to a targeted approach will assist in managing what are a finite healthcare workforce that has been working on the edge for nearly two years.

There is a stark realisation that overwhelming our diagnostic laboratories with endless unnecessary COVID testing will cause a flow-on of major access issues within the entire health system.

The call for targeted COVID PCR testing has come from the evidence seen overseas where Omicron has run rampant and overwhelmed laboratory services for almost all but the most acutely ill patients. The best analogy to use is by using the current phase to stretch out the rubber band to prolong the time it takes before our case numbers start rising exponentially. The other public health measures of vaccination, mask wearing, social restrictions and hygiene measures are all part of the process to try to achieve this goal.

This time has, and is, being used by the laboratory providers to mechanise further with mechanical robots and train more staff from non-PCR testing parts of the laboratory. Once the daily cases start hitting the thousand mark then there will be a coordinated rollout of RAT testing to take the pressure off the anticipated skyrocketing PCR testing demand.

“The move from the test everyone approach to a targeted diagnostic pathway that won’t always involve COVID PCR laboratory-based testing will take getting used to for everyone” says Terry Taylor, the New Zealand Institute of Medical Laboratory Science (NZIMLS) President.

“The whole idea of this approach is to take the pressure off all parts of the testing cascade from the taking of the swabs, to transporting the samples, the diagnostic analysing, and reporting of the results. Obviously, bottlenecks are accentuated as numbers increase” says Taylor.

“This is to ensure that all the other diagnostic laboratory services that are provided can continue to be performed for most of our patients, who incidentally, won’t just be COVID patients needing medical care” says Taylor.

Although some of the projected testing numbers promoted are totally unrealistic for the diagnostic laboratory workforce, this group of talented and resilient health professionals will continue to provide the backbone for our COVID response. The task ahead remains a significant challenge for all those involved with laboratory services in Aotearoa New Zealand, but as the public has already seen, this group will give their best shot to get through this mammoth challenge. The David and Goliath battle is about to begin…….