Thursday 18 November 2021

MoH and Testing

I wasn't particularly kind about the Ministry of Health's approach to Covid testing in this week's Dom Post. 

A snippet.

The Ministry of Health’s approach to Covid testing is going to kill people.

For the past year, the ministry has been horribly wrong about Covid testing systems. It has ignored substantial reviews of testing policy.

And it has allowed petty resentment against the only appropriately validated provider of rapid saliva-based PCR testing to drive its procurement policies.

A new Covid case popped up in Christchurch yesterday. 

Christchurch has about 400k people on over 1400 square kilometers. People can get a Covid test through their GP, but that's a substantial barrier for a lot of people. 

The city has two testing sites running limited hours taking swabs.

One is out near the airport, which will be impossible for anyone without a car to get to. It is open 9 am to 4pm, seven days a week, and can run later "if demand requires". I take that to mean that they'll stay open if they still have a queue to serve. 

The other one is on Pages Road in Wainoni, I believe at the National Marae. Unless you live nearby, you're not going to be walking there. It's about an hour's walk from downtown. It runs 9am to 3.30pm, 7 days a week, with the same "or later if demand requires" note. 

If the kid comes home from school with a sniffle, you'll be waiting until 9am the next day to get a test. And you're forbidden against using a rapid antigen test in the meantime. 

The University of Illinois's Urbana campus serves about 50,000 people and sits on some 2500 hectares. Presumably students there could also choose to go to their GP for a Covid test. But the University runs four different testing sites on that campus. You can be tested from 6 am to 6 pm, Monday to Friday, 8-3 on Saturday, and 10-3 on Sunday - but not all sites run the longer hours. 

So if it is between 3 and 3.30 on a weekend, and you live really close to a testing site in Wainoni, you may have an easier time being tested in Christchurch than at the University of Illinois. 

If it is between 6 am and 9am, or 4 pm and 6 pm, on a weekday, or between 8 am and 9am on a weekend, or if you do not have access to a car, it is far far easier to be tested as a university student at Illinois. 

Why can the University of Illinois run testing like this? Because they have a testing system built around simple saliva collection. Saliva collection isn't nearly as complicated as the swabs. It's easier to train people up to do it. That makes it easier and cheaper to have stations running all the time. 

That also then makes it easy for Illinois to have fairly comprehensive testing requirements. Vaccinated students only need to be tested if they've been in contact with a case (or have symptoms, or in case of outbreak). Unvaccinated students need to be tested every other day. You can do that when testing is cheap and easy. 

We could have it here too. It's the testing system that Rako Science here runs under licence. But the Ministry of Health isn't interested. 

FWIW, I have zero conflicts of interest here. Rako isn't a member of the Initiative, and neither is APHG.  It wouldn't affect how I've read this stuff in any case. 

The Ministry of Health's procurement panel sure cannot say the same thing.

Multiple poorly managed conflicts of interest, no formal procurement plan, and a failure to properly appoint a probity auditor are among the failings in the health ministry’s procurement of saliva testing in a report published today by the Office of the Auditor General (OAG). 

The watchdog makes a number of damning findings and expresses “serious concerns” about the way the ministry conducted the highly controversial $60 million contract to provide saliva testing that was awarded to Asia Pacific Healthcare Group (APHG) in May. 

Among key findings was that four of the five people on the panel selecting the saliva testing provider had declared possible conflicts of interest, including “past and current employment relationships with staff from potential respondents or associated laboratories”. 

The OAG also caned the ministry over its approach to the appointment of a probity auditor to oversee the process, as is required by public sector procurement rules.

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