Challenges in sourcing sufficient swabs to take samples as coronavirus testing is ramped up “will soon settle down”, according to Dr Cillian de Gascun, head of the National Virus Reference Laboratory (NVRL).
The priority is building capacity to enable between 10,000 and 15,000 Covid-19 tests per day to be conducted by getting a network of acute hospitals to test locally, he underlined.
The laboratory, which is the largest testing facility in the country and based in UCD, has been doing most testing up to now. However, as hospital labs come on board it is switching to analysing mostly samples from hubs and drive-in centres in communities, working in conjunction with the National Ambulance Service.
Dr de Gascun said swab availability problems were a European and global supply chain issue, and “not of any major concern locally”, but manufacturing issues were being resolved.
He said healthcare workers taking samples have been advised one swab is sufficient rather than the standard two.
With separate reports that lack of availability of testing kits for use in labs was adding to delays in testing – 30,000 kits are due for delivery in Ireland on Thursday – he said he was not aware of any major difficulties in that supply chain.
With the change last week from focusing on those who had travelled from an area with Covid-19 to wider community testing, increased demand for testing was fully anticipated, Dr de Gascun said.
Key approach
He stressed that tackling coronavirus was still in the containment phase, which meant testing, finding cases in the community and self-isolation remained the key approach.
Five acute hospitals have in recent weeks began testing: Cork University Hospital; Galway University Hospital; Waterford University Hospital; St James's Hospital; and Beaumont Hospital.
The hospitals in the process of coming on stream are St Vincent's in Dublin; the Mater in Dublin; University Hospital Limerick; Connolly Hospital in Dublin; and Cherry Orchard Hospital in Dublin.
The NVRL is also trying to get access to other labs such is the need for physical space to do testing.
Dr de Gascun said taking samples was no different to testing for flu, while availability of commercial kits meant there was no great expertise required to perform the test.
He said the NVRL had been using a lab-developed test as advised by the World Health Organisation, which was more demanding, but had switched to commercial kits which were proving to be more sensitive in detecting coronavirus.
Hospitals would concentrate on testing for those who were sickest and on their own staff, which would take 12 to 36 hours to fully process. The NVRL community testing with the ambulance service would take three to five days, and concentrate on otherwise well individuals.
He said while some may feel this was a long time self-isolation by those who have symptoms and believed they have Covid-19 was the most important action in that scenario. Once tested and having got the all-clear, they have to continue self-isolation until they were symptom-free for 48 hours. Whereas without testing they would be required to self-isolate for 14 days.
Symptoms
Given projections on Covid-19 spread, Dr de Gascun expected there would come a time when testing would pivot again; from testing everybody with symptoms to only vulnerable groups and hospital cases.
The NRVL is operating on a seven-day basis, with two teams working 12-hour days. This has enabled coronavirus testing to be scaled up from 30 samples a day in early February to 900 a day.
“They have been fantastic,” said Dr de Gascun. “We have been trying to manage the burden on staff so they don’t get sick.”
The facility conducts up to 15,000 tests during a typical flu season, with an annual throughput of 360,000 samples a year. The widespread use of “high throughput automated analysers” allowed a lot of tests to be conducted at any one time.
Dr de Gascun said the coronavirus test was more cumbersome, requiring more manual input. However, high throughput technology for it was expected to become available in four to six weeks.
