Ministry of Health gave saliva testing provider 'the metaphorical finger' during outbreak
Thursday, 14 October 2021
Saliva testing provider Rako Science offered to help the Ministry of Health with Covid-19 testing as it struggled to test people during the Delta outbreak, but never received a response.
Rako Science executive director Leon Grice said New Zealand’s Covid-19 testing systems had failed to keep up with demand, but he strongly opposed the ministry’s proposed solution: a new law giving the Ministry of Health the power to take over all private labs and resources, at a price set by the Government.
“The minister himself has said he doesn’t anticipate using these powers to seize reagents or compulsorily requisition services … why put this risky statute on the books?
“There’s nothing stopping the ministry contracting right now for the capacity it needs to prepare for the emergency.”
**READ MORE:
* Covid-19: U-turn on saliva testing as fears grow around nasal swab hesitancy
* Covid-19: The issues with saliva tests, and why NZ's rollout has been so slow
* Slow saliva testing roll-out hurting New Zealand's ability to get on top of outbreak: Scientist
**
On Thursday, Grice told a select committee considering the law, part of the Covid-19 Public Health Response Amendment Bill (No 2), that the real problem lay with testing infrastructure.
Current testing strategies relied on inadequate data collection systems, required people to stand in line for nasal swabs, and leaned on large centralised sample collection stations.
“New Zealand’s sample collection infrastructure has failed every time we’ve needed it, and it will continue to fail,” Grice said.
The law is being passed in the context of a saliva testing roll-out which has caused public embarrassment for the Ministry of Health.
An immediate move to saliva testing was recommended in September last year, but only rolled out to border workers a year later,
A leaked Government study raised questions about the validation data used by its chosen saliva testing provider Asia Pacific Healthcare Group (APHG).
Ageing computer systems have come under strain from having to run more than one test per border worker per week, and APHG’s chief executive has also verbally attacked a respected Yale public school of health research scientist while defending his company’s saliva test.
National Party Covid-19 response spokesman Chris Bishop expressed shock that the ministry had not asked Rako Science to reserve any of its testing capacity for the public health response, and also had not taken up an offer for publicly-owned laboratories to use Rako Science’s saliva test for a “peppercorn” fee.
“While the public was facing 10 to 12 hour waits in testing queues at the start of this outbreak, the Ministry of Health was giving the metaphorical finger to New Zealand’s only diagnostically validated Covid-19 saliva testing provider,” Bishop said.
“Testing capacity is still an issue, even today. We should be utilising Rako’s saliva testing services right now.”
Grice argued a law expropriate private testing labs would discourage new players from entering the testing market, it would also take so long to implement that valuable time would be wasted getting extra testing capacity online.
If the Ministry of Health wanted more testing capacity, it could simply purchase it, he said.
Gripes between Rako Science and the Ministry of Health stretch back to a $60 million border worker testing contract where Rako’s diagnostically validated test was passed over for another test by APHG that wasn’t similarly validated at the time.
Since then Bishop has called for an independent inquiry into saliva testing, NZ First leader Winston Peters has asked the auditor-general to look into it, and a senior government official has slammed the way the whole procurement process was handled.
“They’ve got themselves into a situation with Rako [Science] and I don’t think they know how to manage their way out of it,” the official told Stuff.
“It’s unconscious incompetence. It’s the people at the Ministry of Health in charge of a large procurement programme.
“Yes, some of them had procurement backgrounds. Were they backgrounds where they had procured this sort of very specific professional service? No.”
The new law would also give the Ministry of Health the power to set standards for Covid-19 testing. Grice said the ministry’s clinical advisory teams had already changed international accreditation standards.
“International Accreditation New Zealand, which Parliament has empowered to oversee international standards, is now accrediting tests at the ministry’s instruction … and those tests have no known accuracy,” Grice said.
“The Ministry of Health has shown it does not have the capability or experience to regulate quality standards for COVID-19 testing.
“Formally giving it those powers will fatally undermine public confidence in those tests, and put the public at increased risk of Covid-19 infection,” he said.
Rako Science uses a method of PCR testing saliva from the University of Illinois, which skips the “extraction” step usually used for nasal swab PCR testing.
A similar method has been pioneered by Yale public health research scientist Anne Wyllie. Both Wyllie and Grice have said it is faster, cheaper, and uses fewer resources than the method used by the Government’s chosen saliva testing provider APHG, with accuracy that is similar if not better.
An request uner the oOfficial Information Act revealed nasal swabs cost taxpayers $138 a test. Costs for saliva tests through Wyllie’s SalivaDirect method usually run to less than $10 a test.
Both Grice and Wyllie have argued saliva testing is superior to nasal swab testing when it comes to preventing outbreaks, because you are better able to detect cases early, thanks to how frequently you can run these tests.
The University of Illinois had been the subject of a scientific study reviewing its experience with saliva testing. Every student on the 48,000 strong campus was subject to frequent testing, sometimes several times a week, and positive cases were isolated early. The campus has had no Covid-19 deaths, and low transmission rates.
Wyllie has argued the Ministry of Health was taking a risk with public health by using the same nasal swab PCR testing processes on saliva without putting it through an open and transparent validation process.
APHG, the ministry’s chosen testing provider, has always defended its test and the validation used for it, although in a recent Stuff story it wouldn’t comment on whether it drew on data from a leaked Institute of Environmental Research Science for its validation.
Rako Science’s test was widely used in the private sector. It was the pre-departure test of choice for the NZ Olympic Team, and it is used by te Whānau o Waipareira trust, along with private hospitals, Air New Zealand, Auckland International Airport, Genesis Energy, Fisher & Paykel healthcare, and Mainfreight.
“This is the most accurate saliva PCR test on the market, without question the evidence is moving that way, and so we’ve always wanted to be part of the public health response,” Grice said.