State laboratory service rapidly scales up Covid-19 testing
More tests at more sites expected to be available by the end of March as the government decentralises the process
The government is rapidly expanding the number of sites that can provide Covid-19 testing, aiming to cover 6,000 patients a day as soon as possible, according to National Health Laboratory Service (NHLS) CEO Kamy Chetty.
SA is the worst affected country in sub-Saharan Africa, and has seen its outbreak grow rapidly since the first case was announced by health minister Zweli Mkhize a fortnight ago. The tally of confirmed cases of Covid-19 stood at 150 on Thursday, and the figure is expected to be as high as 200 by Friday, the minister told the SA Medical Association on Thursday night.
Testing is a core aspect of the government’s response to the disease, which has rapidly spread around the world in the three months since it first emerged in China. By Thursday evening SARS-CoV-2, the virus that causes Covid-19, had infected more than 227,700 people and killed more than 9,300 in more than 150 countries, according to the Johns Hopkins University tracker.
Discussions were under way in the government to secure funding to increase testing, said Chetty, declining to provide details beyond the tests being significantly cheaper than the private sector’s. Mkhize has previously said private sector tests cost up to R1,200.
Roche CEO Severin Schwan warned on Wednesday that the global demand for Covid-19 tests is outstripping supply, urging countries to target high-risk patients who have symptoms of the disease. “Broad-based testing at this stage is simply not feasible,” he said on a press call hosted by the International Federation of Pharmaceutical Manufacturers & Associations.
SA’s current testing strategy is in line with the approach advocated by Schwan, as the National Institute for Communicable Diseases (NICD), a division of the NHLS, has set tight criteria for determining who to test for Covid-19. Most tests are still conducted by the NICD in Pretoria, but the government is rapidly decentralising testing to academic hospitals around the country, Chetty said.
Charlotte Maxeke, Tygerberg and Groote Schuur hospitals are already performing tests, while Universitas and Nkosi Albert Luthuli hospitals are in the final stages of validating their assays, she said. By the end of March, Walter Sisulu, Port Elizabeth, Polokwane and Tshwane hospitals will also be in a position to do testing, she said.
The NHLS is on sound financial footing and has been able to channel extra resources to the NICD to support its work on Covid-19, she said. “I am very confident of our capacity to meet demand,” she said, acknowledging that there have been delays in securing reagents. Significant stocks will be arriving next week, she said.
The NHLS has several different machines and assays for Covid-19, and aims to get results to patients within 24 hours, Chetty said. “The machines we have [are] Seegene, Roche cobas 6800 and 8800, and GeneXpert. The assays we use are Seegene, Roche Lite Mix, Roche Cobas, Thermofisher.”
Roche said its cobas 6800 and cobas 8800 systems could provide test results within three and a half hours. The cobas 6800 system could turn out 1,440 test results in 24 hours, while the cobas 8800 system could do 4,128 in the same period. Roche has supplied machines and assays to both the public and private sector in SA.