I work at a COVID test lab. Think twice before joining the PCR traffic jam

The queue for a PCR COVID test this morning in my suburb meandered for over 1.5 kilometers, down an arterial road, around three street corners and through a roundabout. The cars pulling out of the queue in frustration seemed to be more of an immediate danger than the Omicron.

A few hours later, police arrived to close the queue, leaving many stranded and presumably angry. It is a sad accusation against public services if the only information about queuing times is through a community-oriented Insta site (@bondi_lines). It is best not to go between kl. 7 and 9.

The queue for PCR tests at Roselands Shopping Center's open-air parking this week.

The queue for PCR tests at Roselands Shopping Center’s open-air parking this week. Credit:Flavio Brancaleone

I am a pathologist at a large Australian laboratory where these tests for COVID are performed, so I am at kulface. You might ask what it’s like to work in a busy lab? Or you may ask, what is a PCR, anyway?

A PCR is a molecular test that detects SARS-CoV-2, the COVID-19 virus. It can be done on high-capacity machines in about five hours. But getting the sample into the machine is the difficult part and requires manual handling. It must be collected properly, driven to the laboratory (fine if you live in Sydney, slowly if you are in rural NSW or on the border with Queensland), and the details are entered into computer systems.

The fast part is the machine that performs the test and automatically sends an SMS to the person being tested. A positive result also goes to the National Board of Health, which in principle quickly contacts the case for advice.

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Laboratories are busy places at the best of times, unpacking boxes and crates of samples, checking paperwork, performing tests and verifying results, answering phones, and managing logistics. As with any pathological test, staff are well aware of the consequences of positive outcomes and that people are anxious and want speed.

PCR capacity has increased dramatically during the pandemic, but the limits have been reached. Labs can combine or “pool” samples to increase the number of tests – if the combined sample is negative, all samples in the pool are called negative. That approach works when the number of cases is low, but Australia is well above that stage now. The figures released Thursday morning showed that there were more than 17,000 positives in NSW and Victoria alone in the previous 24 hours.

Mistakes can creep in, as we’ve seen this week with a private lab releasing the wrong results, the Ruby Princess debacle early in the pandemic, and the occasional lost sample. The staff need a break as they have been in full fur for almost two years. They are committed, but constantly ask them to make extra shifts, work longer hours and walk faster: It’s starting to feel like we’re mixing the deckchairs on the Titanic. And it is becoming increasingly difficult to access the reagents needed for the tests from abroad.

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