Share

Covid-19: NHLS claims it can do 15 000 tests a day

accreditation
From left: Gauteng health MEC Bandile Masuku, Health Minister Dr Zweli Mkhize, NHLS CEO Dr Kami Chetty and Prof Eric Buch, Board Chair of NHLS. Picture: Supplied/ Gauteng Health Department
From left: Gauteng health MEC Bandile Masuku, Health Minister Dr Zweli Mkhize, NHLS CEO Dr Kami Chetty and Prof Eric Buch, Board Chair of NHLS. Picture: Supplied/ Gauteng Health Department

The National Health Laboratory Service (NHLS) has the capacity and test kits to conduct 15 000 tests a day, according to NHLS board chair professor Eric Buch.

“The NHLS has secured supplies to maintain the 15 000 testing capacity in the next three months and could increase it further if required,” he said in written answers to questions sent by Spotlight.

Buch said the number of tests the NHLS conducted was determined by provincial health departments, which had to screen, trace and refer patients for samples to be taken either by a clinician or by the NHLS.

“The NHLS cannot generate demand. It would welcome an increase in the number of patients who are referred for testing,” he said. “Our mobile laboratory strategy was put in place to increase the number of samples taken and tested.”

Expanded testing, contact tracing and isolating people who were infectious was a critical dimension of the country’s strategy to limit the spread of Covid-19.

How effectively people with Covid-19 could be detected and isolated was likely to contribute to the government’s decisions regarding the possible extension of the lockdown and the set of measures that would follow the lifting of the lockdown.

The health department released a statement on Wednesday, in which it said just fewer than 64 000 Covid-19 tests had been conducted in the country so far.

Based on figures provided by Zweli Mkhize, the health minister, the NHLS calculated that the country had been averaging fewer than 5 000 tests a day in the past few weeks. Earlier figures released by the minister indicated that fewer than 20% of tests are being done in the public sector.

If this ratio is still accurate, it suggests that the NHLS was performing only about 1 000 tests a day.

Read: Covid-19: Ramaphosa announces mass screening project as SA death toll rises to 3

When asked about the differences between private and public sector testing rates, Kamy Chetty, the NHLS chief executive, said that “the private sector has done more tests as the case definition previously included international travel as a criterion for testing”.

“Most of this group are on private medical aids and go to the private sector for testing,” she said. “The private laboratories face similar constraints and there is constant liaison between the private laboratories and the NHLS.”

How prepared is the NHLS?

A statement circulated on Wednesday by the Progressive Health Forum – a loose but influential advocacy group including many of the country’s top health professionals – and endorsed by the SA Medical Association, raised questions about the NHLS’ preparedness.

“Despite having ample warning that the pandemic would inevitably reach our shores, the NHLS has only now started optimising its operations. Worse still, a failure in the timely procurement of appropriate testing kits has sparked a proliferation of private entities and interests peddling dubious testing kits,” the association said.

The statement followed similar concerns expressed by Medical Research Council vaccinology professor Shabir Madhi, who told the Sunday Times that even though the health department was scaling up testing, mass testing was only likely to happen in May, which “is too late as the country will be dealing with the worst part of the pandemic”.

“The NHLS’ preparedness for Covid 19 has not been lacking; in fact, it has been rapid and effective despite many challenges,” Chetty said in response to the Progressive Health Forum comments.

“The NHLS has been gearing itself up since January when the National Institute for Communicable Diseases [NICD] informed them of the need. This was done through the rapid procurement of new equipment and test kits. When the instruction was issued by NICD, the NHLS was immediately able to start testing.”

c
Mobile testing units. Picture: Supplied/Gauteng Health

. See Chetty’s full set of answers to our questions

The Progresssive Health Forum and its co-signatories also called on the health minister “to act decisively to end any board and management dysfunction at the NHLS”.

But Buch said there was no board and management dysfunction at the NHLS. “The board has led a process in the past three years to deal with corruption and improve inefficiency and stabilise the finances; it had put us in a position where we could respond at the scale and cost we have done,” he said.

Chetty denied that there was management dysfunction at the NHLS. “The management team and staff have been outstanding in responding to this epidemic. They have been working tirelessly and with dedication to ensure that the NHLS is capacitated to contain the epidemic,” she said.

Buch said Chetty had turned around the NHLS’ finances. “In January, the board made it clear to the CEO that she should take responsibility for ensuring that the NHLS response was at the capacity and scale required to match the demands expected from SARS-CoV-2,” he said.

“As the accounting officer and CEO of the NHLS, of which the NICD is an entity, the board expects her to take charge of the campaign and drive it from her office. An effort of this nature needs a directive management style.

This has put us in the position whereby the NHLS has the capacity to meet current and future demand for tests referred to it, having procured in a manner consistent with the Public Finance Management Act.”

Buch said “concerns raised by staff members about the management of the Covid-19 programme had been explored and guidance had been given to management” and “propositions raised by individual staff members that they could be more effectively used have been taken up with management”.

Buch said the number of tests the NHLS conducted was determined by provincial health departments, which had to screen, trace and refer patients for samples to be taken either by a clinician or by the NHLS.

This confirmed information that Spotlight received indicating that unhappy staff at the NHLS had raised their concerns with the board.

. See Buch’s full set of answers to see these quotes in context

Ramping up testing

An important element of the country’s expanded testing capacity would be the use of GeneXpert machines (widely used in TB testing) to detect SARS-CoV-2 infection.

Chetty said 325 GeneXpert machines in 166 sites were available for use.

“The test kits are expected to be validated this week. Once validated they will be used. The NHLS has pre-ordered the test kits and South Africa will be one of a few countries where it will be made available,” Chetty said. “There are none in use until the test kits are validated. The NHLS has moved fast to approve the tests (referring to approval by the US Food and Drug Administration).”

Chetty said that, as previously statement reported, the NHLS “has proactively acquired 60 mobile labs to increase accessibility for those who are referred for sampling”.

“These mobiles are being deployed where they are needed most, ensuring that people do not have to go to clinics and hospitals to be sampled,” she said.

Madhi was quoted in the Sunday Times as suggesting that university laboratories be used to increase daily testing capacity. He reportedly said that “these labs could easily do 5 000 daily tests collectively”. When asked why academic labs had not been roped in, Chetty said that “academic and other laboratories have been contacted to use capacity that they have”.

“The NHLS will fully use its own capacity and complement it with capacity from other laboratories.”

c
The inside of the NHLS mobile testing units. Picture: Supplied/ Gauteng Health

The NHLS shared a useful document yesterday, titled Covid-19 implementation progress 080420, in which it set out its testing capacity and plans in more detail and provided information on what testing machines they had and in which areas of the country. “Our reading of this document is that academic labs will be called upon only if the NHLS can’t meet the demand for testing.

Serological testing

Spotlight asked Chetty about the potential use of serological, or antibody testing, in South Africa. The polymerase chain reaction (PCR) tests in use look for the virus; serological tests look for antibodies. This makes serological tests less suited for detecting active infection since antibodies might be present for some time after someone had recovered.

Chetty confirmed that “the NHLS used only PCR for testing Covid-19” and said that “the serology test is an antibody test which shows if a person has been infected. It is not used for assessing when the person is infectious”.

She said that the rapid serological tests had to be registered with the SA Health Products Regulatory Authority.

  • This article was produced by Spotlight – health journalism in the public interest

www.spotlightnsp.co.za


We live in a world where facts and fiction get blurred
Who we choose to trust can have a profound impact on our lives. Join thousands of devoted South Africans who look to News24 to bring them news they can trust every day. As we celebrate 25 years, become a News24 subscriber as we strive to keep you informed, inspired and empowered.
Join News24 today
heading
description
username
Show Comments ()
Voting Booth
Do you believe that the various planned marches against load shedding will prompt government to bring solutions and resolve the power crisis?
Please select an option Oops! Something went wrong, please try again later.
Results
Yes
20% - 103 votes
No
80% - 403 votes
Vote