Testing times: Easing the sample burden

21 July 2021 | Health

While many people know what it is like to be tested for Covid-19, only a few people know what happens to the samples once the swab has been taken.
Due to the recent surge in cases in Namibia, staff from the US Centers for Disease Control and Prevention (CDC) Namibia have been volunteering to assist the Namibia Institute of Pathology Limited (NIP) team at Windhoek Central Reference Laboratory (WCRL) to sort the samples received from testing sites across the country.
The NIP lab is open 12-16 hours a day, seven days a week, and the pressure on the permanent staff has been immense. CDC’s practical support has helped to ease the burden, allowing team members to have time off while not compromising testing turnaround times.
Samples come to the Windhoek NIP lab from clinics and hospitals across the country. When they arrive, the first step is to unpack the boxes. Inside are samples, accompanied by the case information forms. The forms are checked for any that are urgent and organized into alphabetical order to speed up the process of re-matching the forms to the samples. Each sample is then matched to its form to check that all documentation is in place. This is done because sometimes some samples can arrive without forms, or some forms can arrive without samples. Any urgent samples are quickly identified and prioritised for testing.
The sorting process is simple but is laborious and takes time. Once each sample is matched to the corresponding form, the sample is manually labelled with the unique patient information number on the form. The samples are then organized into a sample tray, ready to be loaded into the testing machine or for manual extraction.
NIP receives between 1 000 and 3 000 samples each day. Even if it takes just one minute to sort each sample, this still means it will take 16 and ½ hours to sort just 1 000 of all the samples received if this job was being performed by a single person. This is why having sufficient personnel is critical to ensure the results can be processed in a timely fashion.
“The laboratory staff are working long hours, every day of the week testing the Covid-19 samples. They are unsung heroes,” said Tuku Ndevaetela, one of the CDC Namibia volunteers assisting with the sorting of samples. “I am in awe of the laboratory staff who have been working in the Covid-19 laboratory for the last 18 months.”

Thousands of tests
Every week, Namibia tests over 20 000 Covid-19 samples.
At the start of July, around 40% of the samples tested each day were positive. While this does not mean that 4 in 10 people in the community have Covid-19, (the testing has a strong bias given that many samples are due to contact tracing from known Covid-19 positive cases), the number of positive results is still worryingly high, indicating that the virus is spreading unchecked in the communities.
“We must stop the spread of the virus,” says D. Suzanne Beard, Laboratory Team Lead for CDC Namibia. “We need to wash our hands, wear a mask, avoid gatherings and get vaccinated. In the laboratory, we are seeing an increase in samples, and an increase in the proportion of positive results. We are also seeing an increase in the number of urgent requests for patients who are hospitalized. We can see just how serious the situation is and we know what needs to be done. But we do not know if the public will take the steps needed to stop the virus from spreading. The laboratory technicians are delivering the results day after day, and the healthcare providers are caring for the sick, day after day.”

From day 1
At the start of the Covid-19 pandemic, like many countries in the world, Namibia did not have any capacity to test for the novel coronavirus. Eighteen months later, the country is meeting the testing demand despite an exponential third wave that has seriously challenged the country. The fact that Namibia is successfully keeping up with the demand for Covid-19 testing during this third wave is one of the success stories of the country’s response. People are being tested and receiving their results, often within 24 – 48 hours. This makes it much easier for people to know whether or not they have the virus and to make the right decisions on the next steps they should take.
“Namibia’s success in testing for Covid-19 is one of the reasons the country will see an end to this third wave,” says Jessica Long, Chargé d’Affaires of the US embassy. “We are able to understand how quickly the virus is spreading and the country can adjust its public health regulations accordingly. The laboratory technicians across the country are playing a behind-the-scenes role in helping us to reach better times. Namibia cannot fight this pandemic without them.”

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