ECONOMYNEXT – Sri Lankan authorities have “given up” on continuing PCR tests and numerous issues that have cropped up in supply chain management have caused a worrying drop in daily testing, a spokesman for a government lab technologists’ collective said.
President of the Association of Government Medical Laboratory Technologists Ravi Kumudesh blamed the Ministry of Health (MoH) on the drop in tests.
“For about two months now, reagents needed for PCR testing have not been supplied to the Mulleriyawa lab. As a result, that lab is no longer operating,” Kumudesh told EconomyNext yesterday.
“An extraction machine at the Bandaranaike International Airport (BIA) is also not being used, which is a big blow for PCR testing there,” he added.
Health Services Deputy Director General Dr Hemantha Herath yesterday confirmed to EconomyNext that health officials staffed at the BIA have stopped collecting samples for on-site PCR testing.
According to Kumudesh, issues in the supply chain have contributed to the drop in testing.
“The Medicines Supply Division (MSD) of the Health Ministry has monopolised the supply chain according to various consultants they are working with. Maybe the MSD only imports one type or one brand which cannot be used in some of the labs we have,” he said.
An MSD spokesman was unavailable for comment.
Kumudesh claimed overtime payments for the medical technicians that work in government laboratories that come under provincial Medical Officers of Health have been delayed and outright refused in some instances.
“It seems like they have given up on PCR testing the way they did earlier. They are focused on other things. The interest to conduct PCR tests is gone,” he said.
Despite delays in overtime payments, laboratory staff are willing to work and continue to test all samples received, he added.
Kumudesh further said that along with the number of PCR tests conducted, the number of samples sent over to the labs for testing has also seen a drop. Some laboratory equipment are also still under repair, further contributing to the drop in tests.
Acccording to Kumudesh, over 7,000 backlogged PCR tests have yet to be completed at the Medical Research Institute (MRI) and other government laboratories: some 5,000 at the MRI, 1,500 at the Anuradhapura hospital lab and over 1,000 at the BIA.
“This is not an issue with the capacity of these labs but a question of mismanagement by the Ministry of Health (MoH). If it is a question of funds, we can use the money from testing new arrivals to Sri Lanka at the BIA (about USD 50 per test),” he said, adding that the funds can be used by the MoH to repair test machines and to purchase reagents.
Kumudesh claimed that concerns raised and suggestions made by the association he represents have fallen on deaf ears, with the MoH allegedly neglecting processes that need financial support. The ministry is only interested in continuing PCR testing where there is opportunity to earn revenue or receive donations, as opposed to conducting free-of-charge tests in the community, he said.
Speaking to EconomyNext, Deputy DG Health Services Dr Herath said all government labs are in operation and continue to conduct PCR tests throughout the country. He denied allegations that the drop in tests was due to issues in the supply chain.
Health authorities stopped collecting samples from new arrivals at the BIA a few days ago but, according to Herath, testing continues at the Molecular Diagnostic Laboratory. The BIA samples are now being collected at quarantine centers which new arrivals are directed to.
Though the number has decreased, Health Services continue to conduct more than 12,000 PCR tests per day, he said, adding that no party involved is neglecting it.
“Yes, there is a drop. There are various reasons for that. The most common reason is that when they’re run for an extended period of time, these machines occasionally need to be repaired, at which event the number of tests can go down,” he said.
With a single breakdown, he said, the numbers can go down drastically depending on the capacity of the laboratory.
“When something like that happens 40 percent of the tests carried out in the lab comes to a halt. We have labs that do 200 to 300 PCR tests per day, with some doing over 1,000 a day. If something happens to the machines these labs use, the number can go down drastically,” he said.
“That is why the numbers are down,” he added.
However, Herath said, the ministry is still able to maintain a daily average of 12,000 to 13,000 tests a day. If a situation arose that demanded more testing, he said, health workers will increase capacity by working overtime.
“That’s how we were able to do 15,000 to 18,000 tests on some days,” he said.
“We try to keep it at this level because we don’t want to put unnecessary pressure on the staff either,” he added.
Commenting on delayed overtime payments, Herath admitted it has been a problem at the provincial level for 20 years. With the issue being highlighted with the advent of the pandemic, he said, authorities have begun to pay attention to it.
“It is an issue in the system,” he said.
Deputy Director General, Laboratory Services, Dr Sudath Dharmarathne told EconomyNext that, despite all the allegations against them, the laboratories dedicated for PCR testing are continuing to operate with supplies being adequately received.
“All the labs are working,” said Dharmaratne, adding that a new lab was opened recently in Kegalle as well to increase the number of tests.
“Currently we have 31 labs working under both government and private sectors. The lab at the BIA is also in operation. We have only stopped taking samples from new arrivals. Apart from that, we continue to receive supplies from the MSD as usual,” he said.
Meanwhile, Executive Director and fellow of the Institute for Health Policy (IHP) Dr Ravindra Rannan-Eliya tweeted that though he would not endorse all the allegations leveled at the authorities regarding the drop in tests, a lack of effective top level leadership or management since April 2020 has held back daily testing capacity. There has been a systematic failure to optimise, improve and innovate, among other things, coordination, logistics and lab processes, he said.
I won’t endorse all the allegations, but true that a lack of effective top level leadership/management since April 2020 has held back daily testing capacity.
Systematic failure to optimize/improve/innovate coordination, logistics, lab processes, etchttps://t.co/x8s26zp34f
— Ravi Rannan-Eliya (@ravirannaneliya) February 10, 2021
Reported by Chanka Jayasinghe. Edited by Himal Koelawala. (Colombo/ Feb 10/2021)