Huge delays in Covid-19 test results

Doctors express concern that results are so late they are not clinically useful

Two Cape Town doctors have independently told GroundUp that Covid-19 results from the National Health Laboratory Service (NHLS) are taking at least a week to reach patients. Private sector tests are now taking up to 72 hours.

One of the doctors, who works in a public sector hospital, told GroundUp that there is a backlog of about 10,000 Covid-19 tests at the Green Point NHLS facility in Cape Town.

The doctors said that the delay in test results makes the contact tracing process a lot more difficult.

“The utility of the community screening and testing is close to zero now but continues to be pushed by the Department of Health. It’s causing huge delays in test results for hospitalised patients. So this strategy is actually impairing service delivery,” said one of the doctors.

“Completely insane,” he said.

Western Cape Premier Alan Winde has also written to President Cyril Ramaphosa expressing concern over the delayed tests. “Policy decisions, such as the decision by the Department of Labour that a person must test negative before being allowed to return to work and other government departments requesting testing for their staff members, place additional strain on the system and further compound the problem,” he wrote on Twitter.

Western Cape Health Department spokesperson Mark Van der Heever said that the backlog is national.

“As the Western Cape, and other provinces, ramp up testing, they are finding it challenging to keep up and process these tests, resulting in a nationwide backlog in the results,” said Van der Heever.

Once a person tests positive, the Health Department immediately identifies their contacts and screens and tests them, after which they have to be quarantined or self-isolated.

“The delay in results delays this process and puts pressure on these systems when results are released in larger batches as they process the backlogs,” Van der Heever explained.

Van der Heever told GroundUp that there has been an average of about 1,600 people tested per day over the past 14 days in the Western Cape.

Nationally there have been about 10,000 Covid-19 tests per day over the past week, according to updates by the National Health Laboratory Service (NHLS). The number of tests conducted has also been steadily rising. But a test is presumably only counted once the final result is processed, which could have been a week or more ago.

Testing targets missed by a long way

On 25 March, the NHLS said it had the capacity to process 5,000 tests a day. “This number will increase to 15,000 in 24 hours in April. At the end of April, the NHLS will be able to process approximately 36,000 tests in 24 hours.”

It is now 8 May and not even the 15,000 target, let alone the 36,000 target, is close to being met. One of the likely reasons is that worldwide demand for cartridges for Gene Xperts – small machines that give results in 45 minutes and can be transported on the vehicles driving around communities to test people – far exceeds the supply by Cepheid, the American manufacturer of the machine and cartridges (see this New York Times report).

Despite this, South Africa is testing proportionately more people than countries at comparable levels of development. Wikipedia is maintaining a table of tests per country. South Africa as of 7 May had tested 4,753 people for every million citizens. By comparison, it’s 1,594 and 3,499 per million for Argentina and Brazil respectively. No other African country even comes close (Egypt is at 899 per million). On the other hand Uruguay at 6,322 and Chile at 10,456 per million are well ahead of South Africa.

Delayed test results means delayed statistics

It takes about five days to show symptoms of Covid-19 after being infected. If it’s taking a week for test results to be processed, it likely means that the daily Covid-19 statistics released by the Minister of Health estimate the epidemiological situation nearly two weeks ago.

In the meanwhile Covid-19 cases in the Western Cape are accumulating from Groote Schuur Hospital in Cape Town, to relatively remote areas like the Witzenberg municipality.

NHLS’s slow response to media queries

We have for days been attempting to get a response to our questions from the NHLS. We have delayed publishing because of promises for a response by Friday. As of Friday afternoon, we’ve now been promised a response by 5pm. This article will be updated with the NHLS response, if we receive it, but we can no longer delay publication.

Additional reporting by Kirsten Pearson

This article first appeared on GroundUp.