By Baljit Singh, Director, Laboratory Quality & Process Improvement, Provincial Laboratory Medicine Service
Responding to COVID-19 has sparked an unprecedented level of collaboration among B.C. labs.
As we’ve learned, the results of mobilizing the provincial lab network have been incredible. Going from 200 to over 6,000 in daily COVID-19 testing capacity while still providing rapid and accurate results on many other tests around the province is unparalleled. Our testing capacity will expand even more in the coming weeks.
This historic effort, which continues to evolve and adapt to the movement of the virus and needs of our health system, was made possible by one key factor: our provincial partnerships.
“Previously, B.C. labs operated fairly separately, in different public health authorities and private labs,” explained Michelle Collinson, a Northern Health regional technologist for lab services. “This teamwork has been really great to see – we’re coming together on provincial committees to get this testing done as efficiently as possible.”
Our provincial laboratory emergency operation centre (EOC) convenes daily. I have the privilege of coordinating this EOC on behalf of co-chairs Pam Ramsay, interim chief administrative officer for Provincial Lab Medicine Services and Dr. Blake Gilks, chief medical officer for the COVID-19 lab response.
One significant aspect about the provincial lab EOC is that it is composed of representatives from all health authorities and private lab partners. LifeLabs, one of our key private lab partners, is currently contributing more than 600 samples per day of testing capacity in British Columbia.
“Like many, we want to do our part to help in the pandemic response, and that’s why we are stepping up as much as we can to be part of the solution,” said Thomas Marshall, director of government relations for LifeLabs. “Working in close partnership with PHSA and our regional health authority partners is allowing us to do our part adding critical testing capacity and delivering other important lab services across the province.”
Leveraging our existing relationships with key players like LifeLabs across the province and Valley Medical in the Interior Health region was one critical step in mobilizing and expanding our provincial lab network.
Combine the testing capacity of seven labs, a vast network of collection centres, our best medical lab professionals and the creative response of a nimble provincial labs EOC, and you get one mighty provincial laboratory network:
“Partnerships are at the core of our provincial lab network. Our public and private partnership is an outstanding achievement,” said Donna Wilson, executive vice president, people, diagnostic and treatment services, PHSA. “As we enter the new normal in the recovery phase, our testing focus has to expand.”
As we move past the initial wave of COVID-19 cases in B.C., our lab professionals continue to lead and thoughtfully forecast the testing needs of our population. To do this, we are actively creating and adapting solutions for questions like:
- How can we test for immunity?
- How can we further expand our testing for COVID-19 diagnosis?
- How can we speed up the delivery of accurate test results?
So, just as our lab professionals innovated and pushed new boundaries in the early stages of the outbreak, we are preparing for further advancements in the near future.
As the pandemic has progressed, the criteria for testing have been broadened so that all people with symptoms are provided access to COVID-19 testing.
A nucleic acid test (NAT) is a technique used to detect and identify a particular species or subspecies of organism (often a virus) that acts as a pathogen. NATs are different from other tests as they detect genetic materials (RNA or DNA) rather than antigens or antibodies. This allows for an early diagnosis of a disease because the detection of antigens and/or antibodies requires time before they appear in the bloodstream.
While there is capacity for NAT in the province, and there are no specimen backlogs, our network continues to work to maximize testing efficiency and prioritize testing for high-priority populations like healthcare workers, those living in rural and remote communities, hospitalized patients, residents of long-term care facilities and vulnerable populations.
In order to do this, our team is acquiring and deploying leading-edge testing technology across the province.
The GeneXpert system received Health Canada approval for emergency use. Xpert Xpress SARS-CoV-2 is a cartridge-based technology for the qualitative detection of severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, the virus strain that causes coronavirus disease 2019 (COVID-19).
Xpert Xpress SARS-CoV-2 provides COVID-19 results in approximately 50 minutes.
Dr. Blake Gilks, chief medical officer in the provincial medical lab COVID-19 response, has been working with the group responsible for rolling out Xpert Xpress SARS-CoV-2 across the province since early April.
“This test allows for a rapid turnaround time,” said Dr. Gilks. “We have been working with medical microbiologists across the province to validate GeneXpert tests and activate systems. This process will continue into May, when we expect to increase our daily testing capacity.”
Designed for high-volume applications like blood screening, microbiology testing and women’s health, the Cobas 6800 can (manufactured by Roche) can run up to 384 tests in an 8-hour shift or approximately 1,440 per day.
The system, which is currently being validated by the Surrey Memorial Hospital laboratory team, will allow high throughput COVID-19 testing by the end of May.
“At Fraser Health, we are starting to roll out our COVID-19 testing strategy this week, with the GeneXpert system going live at Surrey Memorial Hospital and a second system arriving and being set-up at Abbotsford Regional Hospital,” said Attila Almos, director, laboratory operations, Fraser Health. “The Cobas 6800 will provide a significant testing volume boost, which will mean faster results for the people who need it most.”
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