While the total number of Covid-19 tests conducted is slowly approaching the 2 million mark in South Africa with confirmed cases nearing 200 000, experts have placed a magnifying glass on the discrepancies and the various challenges encountered by health professionals when administering the testing process.
The country’s ability to conduct sufficient tests in the most vulnerable communities has come under scrutiny with the focus being placed on the availability of testing resources in highly affected areas, as well as the credibility of results from the conducted tests.
Repurposing facilities
One interesting development in the health services sector is the quick-thinking displayed by various health technology companies and public health organisations who took it upon themselves to re-purpose their existing disease testing facilities into Covid-19 response services.
“Before Covid-19, we were an online medical lab focused on DNA based molecular diagnostics for sexually transmitted infections,” says Philip Mngadi, the Chief Product Officer at Zinacare, a health technology start-up.
Although Covid-19 in ‘its current form’ can be classified as a new virus, it has displayed a spreading pattern that is characterised by many other pandemics that health organisations have had to deal with previously, opening the door to the re-purposing of testing facilities.
The South African health system has over the last two decades responded positively to transmittable diseases such as Chlamydia, Gonorrhoea, Trichomoniasis, HIV, Syphilis, Hepatitis B & C, and Herpes Simplex Virus which all required customised testing resources.
“In light of the global Covid-19 pandemic, we have redirected all of our resources to fight the virus in South Africa by launching Drive-Thru Covid-19 Clinics where patients can go get tested for Covid-19 without leaving their cars,” says Mngadi.
“The tests are done by our associate laboratory and the results are available in 24-48 hours. We then communicate the test results to patients through their doctors. We also assign a doctor to patients that test with us directly without a medical practitioner as a go-between,” he adds.
The challenges of large scale testing
South Africa embarked on a large scale testing campaign since the first positive case was identified in early March of 2020.
Although the initial lockdown was staged as a response measure to the outbreak, the natural intention was to slow down the spread of the virus while mobilising resources from all corners of society in order to prepare for an inevitable escalation in infection numbers. This response unwrapped a unique set of challenges.
While the foundation of most of these challenges is anchored on the imbalances in the overall health system and the way in which it is structured, the joint effort of private and public health care facilities has been instrumental in gathering authentic insights about the crisis we are facing.
“Launching large scale testing was helpful because it helped the health practitioners to make sense of the pandemic and informed the allocation of the necessary response measures such as the isolating of infected patients and the tracing of contacts”
Many health practitioners have criticised the turn around time for tests conducted in the public sector, with fears that the delay in the delivery of results, might have counter-progressive outcomes.
“The speed at which we source results is critical. This is the most important part of what we do and credit goes to our laboratory partners for having some of the fastest turn around times for Covid-19 test results,” says Mngadi.
“The biggest threat with delayed results is that patients go around infecting others unknowingly.”
Improving the testing process
It would be irrational to ignore the impact of the cost factor when calculating the efficiency of the multi-stakeholder testing campaign currently being rolled out across the country.
Government-backed facilities are faced with an excruciating challenge of working through a huge number of tests as they are naturally positioned to be the first (and sometimes the only testing) option for the general public.
While their counterparts in private health service provide much more dedicated and quicker testing services with results expected within 48 hours of testing, they find themselves servicing only a smaller portion of the population that is filtered by the cost factor.
The re-purposing of testing facilities to be Covid-19 focused has helped to ease the burden of the testing backlog across the board. The redirecting of resources proved to be a critical step in supplementing the testing facilities needed in the fight against the pandemic.
This option has drastically improved the rolling out of testing campaigns and contributing immensely to the multifaceted effort towards taking control of the curve.
“One of the biggest obstacles for the government facilities is the large number of tests they have to get through, but it is hard to criticise the government because resources such as test kits are not in proportion to the number of people who want to get tested,” enthuses Mngadi.
“The Covid-19 tests are not cheap either so maybe the government can make a greater effort at subsidising these as much as possible,” he concludes.