Covid-19: Border worker testing regime 'held together by Sellotape', IT system struggles with frequent testing

Thursday, 7 October 2021

Early research into Omicron shows it can be detected earlier in saliva.

The Government is struggling to meet its existing border worker testing obligations, allegedly thanks to IT systems “held together by sellotape”.

There have been growing calls for border workers to be tested more frequently than once a week in response to the more infectious Delta strain of Covid-19. Yet a recent move to saliva testing has highlighted a significant IT issue standing in the way of more frequent testing.

A much-anticipated plan to ramp up Covid-19 testing is likely to be announced on Thursday, part of a review led by David Murdoch, chairman of the Ministry of Health’s Covid-19 Testing Technical Advisory Group.

Yale school of public health researcher Anne Wyllie said all PCR tests, whether they be nasal swabs or saliva tests, need to be taken at least twice a week by border workers to catch cases early, before they turn infectious.

Covid-19 Response Minister Chris Hipkins explained that saliva testing will be offered as part of routine testing at the border from June.

* Covid-19: Saliva testing at the Level 4 Auckland boundary

* Covid-19: The issues with saliva tests, and why NZ's rollout has been so slow

* Covid-19: Ministry of Health 'now confident' saliva testing could identify cases early

The advantage of saliva PCR testing over rapid antigen testing, is that it can detect Covid-19 before people become infectious, allowing health authorities to isolate an infected border worker before they spread the virus to someone else. You lose this advantage if your test is not run frequently enough.

However, it is understood the infrastructure underpinning border worker testing systems is already unable to handle an increased frequency of testing.

The problem was exposed during the saliva testing roll-out, because workers were required to be tested twice a week.

Researcher Anne Wyllie says border workers should be tested twice a week, whether by swab or saliva.

The mish-mash of IT systems, and other delays within the testing regime, meant the deadline for a border worker’s next saliva test could pass before they were asked to take their next one.

One source close to the problem said the whole system was “held together by Sellotape, and it should have been replaced 15 years ago”.

At the core of these problems is an ageing database system called EpiSurv. The current version of this was created in 2007 within the Institute of Environmental Science and Research, but governments of both stripes have not invested much into updating it.

The whole testing regime requires test results be put into EpiSurv, delaying the time before a new “event” is generated requiring border workers to be tested again.

There is a call for more frequent testing on the back of the infectiousness of the Delta strain.

These delays have not been an issue for border worker testing in the past, because nasal swab tests were conducted once a week.

However, saliva testing was approved for “surveillance” testing, which meant it needed to be run twice a week.

A controversial saliva testing border contract signed by the Ministry of Health has compounded some of these IT issues, because it required the provider to get samples to the lab 24 hours after they were dropped off for collection, then gave them 24 hours to turn around a test result.

This meant a testing firm could deliver results up to 48 hours after a worker dropped off their test, and not be in breach of contract.

All of these issues can cause a delay of several days between when a border worker takes their first saliva test, and is asked to take their next. This is not an issue if their next test is only meant to be taken seven days after their last, but is if they need to be tested two days after they take their first test.

Border workers are saliva tested twice a week, a frequency which effectively means once every two or three working days.

Wyllie said workers should be tested more than once every seven days, even if they were tested by nasal swab.

A spokeswoman for Asia Pacific Healthcare Group, which holds the Ministry of Health’s border worker saliva testing contract, said it was not aware of any issues with IT systems at the ministry’s end.

The spokeswoman said the delays described were not “our interpretation” of how the current system worked.

“From our point of view we receive the information from the Ministry of Health systems, and then the worker does the saliva sample and then we send messages with the collection, drop off details and then the results.”

She said the contract times of 24 hours collection, followed by 24 hours to get samples to the lab, were a maximum, and APHG was currently well within these.

The Ministry of Health was approached for comment on these issues on Monday, and acknowledged the request, but did not provide a statement or explanation before publication.

Last month Wyllie was backed up by IGENZ clinical microbiologist Arthur Morris who called for testing to better reflect the infectious nature of the virus. IGENZ are contracted by saliva testing provider Rako Science.

In a blog post published last week, Morris argued that New Zealand should test high risk groups multiple times a week, but we don’t do this because we do not think we can get people to agree to frequent nasal swab testing.

Morris argued a better testing regime should include wider use of saliva, a test which could be run more frequently without causing the same level of discomfort as a nasal swab.

“The biology of [Covid-19] means those needing frequent workplace testing should undergo testing every two days,

“Saliva is the specimen that allows this testing frequency to be acceptable to these important work groups.”