Pathology insider on why PCR tests are taking so long: 'The game's changed'

·8-min read

An anonymous healthcare worker has provided a harrowing account of what is happening behind the scenes on the frontline of Australia's surging Covid cases amid huge testing delays and bungles

A lengthy and in-depth post has gone viral after being shared on Reddit's Coronavirus Down Under message board. The insider at a pathology unit at a hospital detailed why it is taking so long to process PCR tests for Covid-19 and lifted the veil on how torturous it is for health care workers at the moment.

The account was backed up by several other people who claimed to be healthcare professionals, as well as physician and health commentator Dr Norman Swan who tweeted that a source in the industry verified the account. 

It is also reflects the reality on the ground articulated by vice president of the Australian Medical Association, Dr Chris Moy, in an interview with Yahoo News Australia on Monday. 

A man receives a COVID-19 test at the Histopath pre-departure clinic at Sydney International airport on December 23, 2021 in Sydney, Australia.
The testing system is under immense pressure, struggling to keep up with demand. Source: Getty Images

With negative tests mandated for interstate travel, the testing systems in both public and private healthcare facilities just weren't designed to cope with such high demand.  

"The equipment used for PCR testing was not meant for the volumes that are required at the moment, and as such, we have had to find ways around these limitations," the anonymous worker explained.

High positivity rate making batch testing much harder

The healthcare worker, believed to be in NSW, says testing clinics were relying on batch testing which lumps a large number of tests together and only separates them out if there is a positive. The method was working efficiently but now due to the higher percentage of positive results, it's getting much harder keep up.

"This is all well and good when the percentage of positive results is low, however it all starts to fall apart when this percentage increases and every other batch we test is positive and requires individual testing," the wrote.

Staffing situation in healthcare 'dire'

The pathologist worker also said at any given time the staffing situation in healthcare is "dire", with most wards or clinics having just enough workers to get by.

"As the pandemic grew, so did the strain on clinical services," they wrote. 

"Many of my colleagues quit due to the impossible workload, stress, poor compensation and inhumane treatment by our management. Pathologies had barely just gotten over the hurdle that was the prior lockdown, with very few resources and dwindling staffing."

Speaking to Yahoo News Australia, Dr Chris Moy from the AMA said the testing system is simply not working at the moment.

"The game’s changed… probably for worse unfortunately. Omicron has taken off, particularly in NSW where the lack of controls has really allowed it to go completely out of control," he said.

"It’s like a health emergency-type situation where supply doesn’t meet demand."

Dr Chris Moy says NSW has sped up while going into the fog of Covid. Source: Channel 10
Dr Chris Moy says NSW has sped up while going into the fog of Covid. Source: Channel 10

Equipment and capacity at its limit

The Reddit post said testing capacity was at the "absolute limit" and there is no more equipment available, "let alone staff" to process test samples – which is why so many people are reporting waiting up to three or four days for their result. Is some cases having to miss out on their holiday. 

The testing system doesn't end after tests have been processed with data entry and the work required to send results "crippling" some labs.

It's a time consuming process and the pathologist warned people should not trust labs saying results will be available in a matter of hours.

"As far as I’m concerned the only reputable labs are NSW Health Pathology which is what you’ll come across in public hospitals," they claimed.

Harassing staff at clinics or labs will not mean you will get your results faster.

"I can guarantee you that no amount of phone calls will speed up the process. We are being bombarded with work and cannot make things go any faster, not for you or anybody else," they said, adding their own test has been sitting idle for days among other tests yet to be processed.

AMA and NSW health minister call for end to 'tourism testing'

With the rising number of Covid cases, testing requirements for travel and people wanting to make sure they're not passing on Covid to loved ones over the Christmas period, it's no wonder the testing system is overwhelmed.

Dr Moy says instead of testing travellers, attention needs to be redirected to those who are symptomatic and therefore more infectious.

"If supply is less than demand you have to deploy them to get the best bang for buck and benefit for the overall," he told Yahoo News.

"Switch it from using it in situations where you’re not going to get big bang for your buck, which is just testing for travel, to testing symptomatic people because you want to take them out of play."

In a statement to Yahoo News, NSW Health said it was "constantly monitoring the demand for testing".

"NSW Health ... works closely with private testing labs across the state. Private providers have been a vital support and NSW Health has been working with them to ensure turnaround times for tests are as quick as possible," a spokesperson said. 

"NSW has requested that the requirements for PCR testing by other states be terminated and, where necessary, substituted by a rapid antigen test."

That message was reiterated on Tuesday by NSW Health Minister Brad Hazzard who called on Queensland to drop the requirement.

As of Boxing Day, NSW had performed more than 24 million tests.

Hospitals are the 'real s**tshow'

The Reddit pathologist worker said hospitals are the "real s**tshow", arguing the idea pushed by NSW premier Dominic Perrottet that hospitalisations are indicative of the severity of the current Covid wave is "wrong".

"Yesterday, 1 in every 4 patients who presented to the emergency department and were tested with rapid PCR at the hospital which I work at returned positive for Covid," they said.

The pathologist said hospitals and some clinics have rapid PCR tests which are used in cases where a patient needs to be transferred into a different ward, into surgery or to have another procedure.

Supplies are running out to operate rapid PCR analysers and they say hospitals are not equipped to handle this.

"We cannot cope. Healthcare staff have been left a burden which we do not have the resources to manage," they said. 

Medical equipment performing COVID-19 tests at the Histopath Diagnostic Specialists pre-departure area at Sydney International Airport on November 28, 2021 in Sydney, Australia.
Interstate testing requirements have increased testing demand. Source: Getty Images

"The quality of patient care is suffering. I cannot speak for nurses or doctors on these wards, they must be going through unimaginable stress and hardship. 

"What I witnessed yesterday has left a terrifying impression on me. The hospitals are not equipped for this."

NSW has 'sped up while driving into the fog'

Many on the Reddit thread, who also work in health care, backed up what the anonymous pathologist was saying.

A registered nurse and midwife said the impact Covid will have on the "overworked" healthcare system will be felt for decades to come.

"Those who say 'just let it rip, we'll all get it eventually' have no idea how vulnerable the healthcare system is right now," they said.

Another person remarked that most people won't appreciate the "true cost" and said with a stretched hospital system even non-Covid patients suffer too.

Dr Moy said the actual rate of infection in NSW is most likely much higher than what is being reported.

"It’s double, maybe triple, quadruple I don’t know,” he said.

"The number is far higher, there is absolutely no doubt about it. It is completely out of control in NSW at the moment.

"Most people when they drive into the fog, even if they know the road they’re going to slow down. NSW has sped up going into the fog."

Before Christmas the state reintroduced a mask mandate and QR code check-ins while premier Dominic Perrottet also announced rapid antigen tests will be provided for free for NSW residents next year.

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