Calls for Ministry of Health to apologise for saliva testing roll-out, thousands fewer tests than hoped for

Sunday, 17 October 2021

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

The Government put a $60 million saliva testing contract out to tender envisaging 6000 to 20,000 tests a week, but Ministry of Health data reveals the current level of testing is falling well short of this.

Ministry of Health Covid-19 immunisation, testing and supply group manager Darryl Carpenter said $2.2.m had been paid out for saliva testing so far, and that amount was for testing only, no up-front costs had been requested or paid.

The ministry has not yet released how many saliva tests have been conducted.

But Ministry of Health data reveals 3423 Covid-19 tests were taken by border workers last week, both nasopharyngeal and saliva, well short of the figures projected for saliva testing alone.

* 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

ACT leader David Seymour says the Government just needs to admit it made a huge mistake with its saliva testing roll-out.

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

ACT MP David Seymour has slammed the low level of saliva testing, and said the Government urgently needed to apologise and move on.

Seymour alleged the Government’s chosen saliva testing provider, Asia Pacific Healthcare Group (APHG), had no incentive to really push for wider use of saliva testing.

Meanwhile, private hospitals were using a saliva test from Rako Science, and public hospitals urgently needed to do the same.

Director-General of Health Dr Ashley Bloomfield has denied claims the Ministry of Health is not working with Rako Science on the public health response.

“If you go to Mercy Ascot, if you go to Southern Cross, they’re saliva testing everywhere.

“You go and work at Auckland City Hospital, they’ve never heard of it. And the doctors are personally fearful that they’re going to pick up Covid-19 and take it home to their kids, who can’t be vaccinated.

“The Government just needs to level and say we made a huge mistake, we’re now going to open a new contract and that way they would actually head-off the various inquiries and, more importantly, get some security in our response right now.”

Saliva tests are run twice a week, as opposed to the once a week testing you get with nasal swabs, although Stuff reported Ministry of Health systems have struggled to handle the frequent inputting of saliva test results.

Saliva testing is seen as crucial to tackling outbreaks because it can be conducted more frequently with the same level of accuracy as nasopharyngeal swabs.

A saliva testing roll-out to border workers has been plagued with delays.

Proponents of this form testing say saliva PCR tests are good for early detection of the disease, cheaper than nasal swabs, and allow the isolation of contacts before they become infectious.

Saliva PCR tests are often confused with rapid antigen tests, but saliva testing is more accurate, and rapid antigen can generally only detect Covid-19 after people have become infectious.

Seymour also questioned why a new law, the Covid-19 Public Health Response Amendment Bill (No 2), was needed if the ministry wasn’t using the saliva testing capacity it had already contracted for.

The new law will allow the Ministry of Health to requisition private testing laboratories and their supplies at a market rate set by the ministry itself.

“This is the one time ACT is less worried about the cost because the cost of lockdowns and other measures is so great that good testing is worth it at almost any price right now.”

Seymour said the Ministry of Health made a mistake choosing saliva testing provider, APHG, because it was also a key provider of expensive nasal swab testing.

National MP Chris Bishop wants an independent roll-out into our saliva testing roll-out.

“They [APHG] haven’t actually got any incentive to push it [saliva testing], all they’re doing is transferring people from one sample collection method to another,

“I suspect there’ll be a whole lot of people out there who could be doing saliva, but continue to do nasopharyngeal because it’s not in anyone’s interest to tell them of a possible change.”

An Official Information Act request revealed nasal swab testing costs the taxpayer $138 per week. Promoters of polymerase chain reaction (PCR) saliva tests have said it could achieve better early detection, and was just as accurate as a nasal swab, but could cost less than $10.

APHG would not comment on how much it was being paid for delivering the saliva testing contract.

“We are not at liberty to reveal the details of any contracts we have with any of our clients.”

The saliva testing roll-out has been the source of much public embarrassment for the Ministry of Health after its roll-out fell behind schedule. An immediate roll-out of saliva testing was recommended by the Simpson Roche report in September last year.

David Seymour says the Government’s chosen saliva testing provider has no incentive to push saliva testing.

A saliva testing contract for border workers was tendered in March, enacted in May, but only rolled out to border workers days before the Delta outbreak in August.

Much of the public tension has revolved around a dispute with saliva testing provider Rako Science, whose diagnostically validated test was passed over for another test which was not similarly validated at the time.

Since then, a leaked Government study raised questions about the validation data used by APHG.

APHG chief executive Anoop Singh has also verbally attacked respected Yale public school of health research scientist Anne Wyllie while defending his company’s saliva test.

National MP Chris Bishop accused the ministry of giving Rako “the metaphorical finger” when Rako’s test could have helped the country get through its Delta outbreak, after a select committee appearance by Rako Science executive director Leon Grice, where he outlined attempts the company had made to provide its saliva testing service to publicly-owned laboratories.

Director-General of Health Ashley Bloomfield told NZME on Friday

that “Rako Science have been in active discussion with us for well over a month”.

Bloomfield said Rako was helping with the public health response and providing testing, but it was a small part of the overall volume.

But, Seymour said this was not his understanding of the situation, and questioned why the new law allowing the requisitioning of private laboratories, like Rako, was needed if the relationship was really that good.

“That’s a little bit like a kid standing in the schoolyard saying ‘give me your lunch or I’ll smash you’.

“If Ashley Bloomfield thinks that’s a good relationship then I suspect he’s a bit dysfunctional in his relationships.”

NZ First leader Winston Peters has written to the auditor-general asking for him to investigate this contract.

Bishop wanted a full independent inquiry into the issue.

Seymour said the timeline was too urgent for those things and he just wanted the ministry to apologise and sign a contract with Rako Science.

APHG has claimed its test had been through a thorough diagnostic validation, but it had not yet provided details on whether samples for validation were taken during a controversial institute of Environmental Science and Research testing process.

Data on specificity and sensitivity, which allowed people to judge a test’s accuracy, had also not been provided.

An APHG spokesman admitted its testing process was likely to be slower than the Rako Science’s because it included an RNA extraction step. But he claimed the time difference was slight and real time savings depended on how quickly saliva samples could be collected and transported.