The Team Of 4000. The Backroom Of The Weary COVID Testing Response

There have been concerns raised over the past few weeks about the turnaround times for COVID PCR tests in our northern diagnostic laboratories. The New Zealand Institute of Medical Laboratory Science (NZIMLS) stands firmly behind our beleaguered and weary workforce and will clear up some common misconceptions that have been raised in the public domain.

Pandemics and periods of extreme crisis have a very direct way of exposing both strengths and weaknesses of health services. This has certainly been the case for diagnostic laboratories having had to adapt very quickly in what is almost a war-like onslaught for our services.

“Throughout the motu on any given day there are over 200,000 diagnostic laboratory tests plus COVID, performed by our dedicated workforce” says Terry Taylor the NZIMLS President.

To understand our COVID testing response there needs to be clarification on how diagnostic laboratories are structured in Aotearoa New Zealand. Firstly, there is no formal national governance of laboratories. It is up to the workforce on the ground and the collaborative relationships that they have forged, to provide the coordination between regions and different providers.

“The NZIMLS has been very clear from the start of the pandemic that there needs to be a formal national governance structure with independent laboratory and clinical expertise to coordinate the COVID testing response. This was again backed up by the recent Murdoch review of the COVID testing response” says Terry Taylor.

Pathology services over the past 20 years in Aotearoa New Zealand have seen constant service strain due to funding disparities between DHB’s. There is significant regional variation in how pathology services are contracted by the DHB’s in each region. It has been up to the diagnostic laboratory providers to forge the interregional coordination and consolidation of services in the absence of any formal national service plan. It is a credit to the innovation and foresight of the providers that the service does function well on a day-to-day basis. However, as we have seen with the COVID pandemic and the need for a coordinated national response, this system is not fit for this purpose. It is a credit to all those involved with the diagnostic COVID response that we have manged to provide the required service for the past 20 months.

“There needs to be acknowledgement of the outstanding work that our Individual laboratory providers have done and continue to do, to ensure we are staying on top of the testing response. This is not an easy task for the management of these providers” says Terry Taylor.

The other misconception that is heard is that all DHB’s have direct control and coordination with the laboratory providers. This is simply not the case for several DHB’s as they have contracts with external providers who are not direct employees of the DHB so are not part of the DHB management structure. ‘Again, the informal relationships between the clinical and laboratory staff on the ground are how services are actually coordinated’ says Terry Taylor.

The northern laboratories are working around the clock to keep up with the demand. There has been no respite for this group and understandably fatigue and mental strain is taking its toll. The regions in which COVID testing demand is not so high have put their hands up and perform thousands of tests from the northern regions to assist. There is no magical Tardis, so it does take travel time to get these samples to the other laboratories. There is no external pool of qualified scientists waiting in the wings to call upon and obviously there is a worldwide shortage. Training new medical laboratory scientists takes four years of university study, followed by a period of internship working under supervision. These are not people that walk in off the street, they are highly specialised health professionals that are a critical cog in the wider health system.

“The years of underfunding and undervaluing pathology services have come bubbling to the surface during the COVID pandemic, not just here but also worldwide” says Terry Taylor.

“The hope is that the proven expertise from within the workforce is fully utilised and consulted as we move into the new era of Health NZ governance and the diagnostic laboratories are at the forefront of planning, not an afterthought as has happened in the past”.

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