New Zealand / Covid 19

Covid-19: Expanded criteria for testing puts strain on assessment centres, doctor says

19:08 pm on 2 April 2020
Robin Martin, Reporter

The government's call earlier this week to "test, test, test" for the Covid-19 has put assessment centres under enormous stress, says a Hawke's Bay doctor.

Photo: Patrick Pleul / dpa-Zentralbild / ZB / AFP

The doctor, who did not want to be named, said the announcement was made ahead of the Ministry of Health updating its case definition and before more supplies of testing kits had arrived.

The doctor said the announcement caused confusion at the community-based assessment centre where they work, and it continued to turn away people who did not meet the official case definition.

They agreed with wider testing, but said many assessment centres did not have enough swabs to meet demand.

"It put us in the position of being caught between meeting public expectations set by the announcement and still following the guidance from our Ministry of Health, and it was also prior to a larger amount of swabs being made available to the Community Based Assessment Centres.

"Almost everyone seemed to run out of swabs because they were sort of swabbing until their doors closed."

Since the crisis began people who had been overseas, and those who had been in contact with them, were being tested in the vast majority of cases.

The government has now decided people with respiratory illnesses should also be tested but the original case definition remained up on the Ministry of Health website for at least another day.

The Hawke's Bay doctor said that led to uneven delivery.

"So different assessment centres were doing different things. Some were following the ministry guidelines - probably with the aim of preserving swabs - while others were following public expectations which was to test everyone with a symptom of Covid-19 so that meant coughs, sore throats, fever, shortness of breath, which applies to hundreds of thousands of New Zealanders at any one time."

Ngāti Ruanui Healthcare owns two medical centres in South Taranaki catering for 10,000 clients, of which 52 percent are Maori.

Te Rūnanga o Ngāti Ruanui chief executive Debbie Ngarewa-Packer has consistently championed wider testing, but said it was still not being applied.

Debbie Ngarewa-Packer. Photo: Supplied

"What we didn't account for was the Taranaki District Health Board taking a more enforcement mentality to testing and by the time central government clicked on and gave the messaging to the regions, they weren't ready. There's been quite a lot of fallout from those who have been sent away even after our GPs referred them."

Ngarewa-Packer believed the Hawera assessment centre did not have the capacity to meet demand for testing.

"We keep asking if they've got everything they need [to be able to do the testing]? If we bring the numbers through, are they able to receive us? And the answer is no.

"We could fill buses. We could get people who've got influenza signs, that have got all those critical things and if they've drop one thing off the criteria, which I believe they have, we could probably get even more who meet the testing criteria."

Royal New Zealand College of General Practitioners medical director Bryan Betty said he also supported wider testing, but warned the move had brought its own challenges.

"I think one of the problems that has arisen is the expectation that everyone can get access to testing when we still have problems with access to PPE [personal protective equipment], access to swabs, and the capacity of labs to actually carry out the testing," Dr Betty said.

"If that's the case then some people are going to be disappointed and not be tested."

The case definition might needed to be narrowed, Dr Betty said.

"I think we need to be clear about who should be tested in the present situation. The case definition seems to have gone very wide. There's obviously been a call to 'test, test, test' and test more," he said.

"I think there needs to be a streamlining of what the definitions are or [who] should be tested, so the public have the right expectations on this."

It was up to the Ministry of Health to do that refinement work, he said.

At the government media conference today, Director-General of Health Ashley Bloomfield said the ministry's case definition had been updated which should lead to a more consistent approach to testing.

Dr Bloomfield said more testing kits were also on the way.

"On the swab side of it, again, this is something we've grouped up and are taking a national approach to. We've got 100,000 swabs in the country and we're sort of moving as we are in other areas from what I would call a 'peace time distribution' system to a 'war time distribution system' to make sure the swabs are where they need to be."

The government was working towards a national distribution system for swabs and personal protective equipment, he said.

It planned to use the district health boards to funnel that equipment to the 49 community-based assessment centres and 50 medical practices directly involved in testing.

The biggest number of tests done in one day was yesterday, 2563. More than 26,000 tests in total have now been conducted.

  • If you have symptoms of the coronavirus, call the NZ Covid-19 Healthline on 0800 358 5453 (+64 9 358 5453 for international SIMs) or call your GP - don't show up at a medical centre

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