Businesses desperate to increase rapid antigen testing are upset about Government rationing of test kits for critical workers
Friday, 18 February 2022
Businesses desperate to ramp up rapid testing of workers to prevent spread of Omicron are upset at the Government’s rationing of test kits.
Several companies with their own supplies of rapid antigen tests (RATs) for regular surveillance testing have reported a significant increase in positive cases over recent weeks, and they credit the test kits for picking up asymptomatic employees before they enter the workplace and infect others.
Free rapid antigen tests (RATs) are only available to critical businesses when an asymptomatic worker is exposed to a positive Covid-19 case, then allowing them to skip self-isolation and continue working if they return a negative RAT.
But businesses ranging from construction and transport companies to medical equipment suppliers claim that approach is too restrictive, and say more regular testing of employees is needed now.
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The Government stockpile of RATs is expected to reach 22.5 million by the end of the month and Covid-19 Response Minster Chris Hipkins has cited the global shortage of RATs as the reason for introducing the close contact exemption scheme targeting more than 14,000 critical businesses and their 667,000-plus employees.
“When supply constraints ease, we’re looking to make RATs more widely available.”
In addition, Hipkins says that during phase three of the Government’s Covid-19 plan, when cases are in the thousands, only the highest risk contacts – defined as household or household-like contacts – will need to isolate.
Right now that is cold comfort to workplaces facing the very real prospect of big disruptions if Omicron gets past their defences.
Medical Technology Association chief executive Cushla Currie says her 450 members represent companies that manufacture, import, supply and maintain medical equipment, and they are worried sick.
The limited supply of free tests kits is a start, but they want to be able to test staff daily before they get to work, so essential hospital supplies of things like lures, intravenous drip lines and surgical implants are not disrupted.
“Everything will grind to a halt in the health sector if our warehouses are overrun with Omicron.
“Hospitals don't function without medical suppliers, all they want to do is keep their staff safe, and in this case, when you are keeping staff safe, you’re keeping patients safe.”
The construction sector – not classed as critical – is also concerned about access to RATs which are available to anyone with a registered New Zealand business number at a cost of anywhere from about $8 to $14 per test.
Construction Industry Council executive director Graham Burke says the average building company has five employees, so if they were to lose a third of them to Covid-19 or isolation requirements, that would be a significant hit, as would supply chain shortages if cement handling or steel mill workforces were greatly reduced.
Some larger operators are already using RATs, and Fletcher Building has sufficient supplies to run surveillance testing three times a week on some of its sites, increasing to daily if required according to a company spokeswoman.
“In the past week we’ve seen a significant increase in the number of positive RATs during surveillance. In all cases, individuals were asymptomatic and were tested and isolated before they entered the worksites.”
Leighs Construction chief executive Gary Walker says its workers, already working in bubbles, would be a lot safer if it could use rapid testing, but it’s not clear whether health-related projects, such as the new Taranaki hospital, qualify as a critical business.
Mainfreight has helped coordinate delivery of 1.5 million test kits for a couple of dozen large companies that strongly lobbied the Government last year for the right to import their own supplies, and chief executive Don Braid says surveillance testing of 3400 workers since January had returned 11 positive results, all of them in the last week.
Testing varies over Mainfreight’s 80 sites. “When we have the possibility of a close contact or a positive case, then we’re testing every day on that site, it gives comfort that other people around you are negative.
“That’s why we’ve gone out and bought our own [RATs] to cover us, we’re not going to rely on the government supply.”
Braid says he had recommend surveillance testing for every business, not just the big ones.
“The gym I go to is busy testing their trainers because they can’t afford to lose anyone and nor can the trainers afford to be at home.”
The call for more regular surveillance testing has some support from medical experts.
Victoria University biological sciences associate professor Janet Pitman says rapid antigen tests are less sensitive than the nasopharyngeal PCR tests we have relied on until now, and only pick up people with higher viral loads.
Now PCR testing is being prioritised to relieve pressure on laboratories, businesses will have to rely more on RATs, and they were “pretty much useless” if used weekly.
“If the only thing available is RATs, then there should be a large number of them available for people to use.
“If you do [RAT testing] on a daily basis, you’re far more likely to pick up someone who is positive.”
Respond Global specialises in health crisis emergency management and Australian founder Dr Ian Norton has been advising New Zealand government agencies, and companies in the construction and maritime sectors.
He also says evidence suggests weekly RAT testing is not enough, and with Omicron’s shorter incubation period, some higher risk industries were increasing testing to three times weekly.
“It depends on local case rates. Daily may be too much, we’re not necessarily recommending that for every worker on every site right now, but if there are critical points in an industry which supply multiple sites, then that’s when we’d look at daily or three times a week.”
All rapid tests need Ministry of Health approval and the slowness of its assessment process has come in for criticism.
Since April last year the ministry has received 168 applications for approval to import and sell RATs, (in some cases multiple applications were received for the same device), and it has so far approved 11.
Customs has detained more than 20,000 kits at the border since last June, the vast majority part of a single shipment that had not received the ministry tick before entering the country in mid-January.
Of the 37 devices subjected to a “full technical review,” 18 devices were not been recommended for import or use, and a further 11 are still going through the review process.
The ministry did not respond when asked to elaborate on its reasons for withholding approval.
It said the first stage of the assessment and evaluation process for considering applications was updated in January, which allowed for more devices to progress to a second stage full technical review, and the time that process took depended on the level of information provided.
Norton says that with well over 70 different RATs of variable quality available globally, the ministry is right to be cautious
Some countries had approved test kits out of desperation, whereas Australia and New Zealand had taken a stronger evidence-based approach.
“[RATs] are not all the same. We did tests in NSW, West Australia and Victoria in independent public health laboratories, and we found a huge range of sensitivity different to what was advertised on the product literature.”