Andrew Dickens: Coronavirus will expose the under-investment in health system

Author
Andrew Dickens,
Publish Date
Sun, 22 Mar 2020, 9:29AM
(Photo / via CNN)

Andrew Dickens: Coronavirus will expose the under-investment in health system

Author
Andrew Dickens,
Publish Date
Sun, 22 Mar 2020, 9:29AM

I want to talk about testing for Covid 19.

On Friday the Health Minister was asked how many testing kits New Zealand had.  He couldn’t give an answer.

A while later the Prime Minister was asked the same question.  She said that we have 30,000 swabs and the capacity to process 1500 tests a day.  She was then pressed about the number of kits in the country. She repeated the number of swabs and the testing capacity.

A number of commentators took from that answer that our government is useless.  How can you have confidence in a Health Minister or Prime Minister who have no idea of how many kits we have.  One commentator went as far as to call the Prime Minister a liar.

Let me tell you about Covid testing.

First you take a swab.  These swabs are bought from overseas.  We have 30,000.

The sample is sent to a lab where it goes through a copyrighted process perfected in Germany.

The sample is pipetted into a number of reagents or chemicals, again sourced from overseas.  The process extracts RNA out of the virus.  Then using a piece of machinery that switched temperature rapidly the RNA is converted into DNA.  Then through more processes the lab technician can determine if the DNA belongs to Covid or the flu or something else.

My point is that there is no kit as such.  It’s not like a pregnancy testing kit where you pee on a stick, though Boris Johnson claims UK scientists are developing a one stop testing kit that searches for specific antibodies.  The so called kit is a chain of processes, chemicals, equipment and humans that finds a result. That kit also does multiple tests.

So the Prime Ministers answer is completely correct.  It’s all about capacity and not the number of so called “kit”

To call a government incompetent, useless and lying, because of a question that is unanswerable because it’s been framed badly is, in my opinion, irresponsible and is frankly panic mongering.

We need to hold the government to account with rigour, but also with accuracy.

So to capacity for testing.

Firstly we have imported 30,000 swabs.  We have been testing at 1500 a day, that was confirmed yesterday by Ashley Bloomfield. That means we have 20 days testing capacity.  Do we have more swabs on order? When will the first tranche run out?

What are our supplies of reagents like?  How long will they last? The interesting thing about the Covid reagents is that many of them are also used in flu testing, so will we end out robbing Peter to pay Paul.  When rationing of tests comes in will we be reducing flu tests or Covid tests first.  What has priority?

What about all the other tests these technicians do?

There are many questions about testing but how many kits are there is not one of them.

Finally, the most important thing about testing are the humans that are doing it.

Has everyone forgotten the threatened lab technician strike from two weeks ago.  Lab technicians claim they’re paid $15,000  less than similarly qualified occupations.  Negotiations on their collective contract have been plodding on for six months and their complaints go back years to previous governments.  As a result many have left the profession. That’s left our labs understaffed.

On Friday a technician who had left the profession for greener pastures told me that the remaining technicians are currently working double shifts.  They are already exhausted and they’re still being paid less than they’re worth. What are health authorities doing to ensure we have the staff to keep the testing going.

To these technicians, I say thank you very much.

So here we are in the middle of a health crisis.

Our healthcare professions including GPs, lab technicians, emergency medical specialists and anaesthetists have remained on Immigrations NZ’s skills shortage list for years.

Our public health service has just been through a stocktake which found 11,000 facilities are judged to be poor or very poor.  In Palmerston North they’re still operating in 50 year old theatres.

You could argue that this government hasn’t prepared sufficiently for this crisis.  But it’s more truthful to say that we’ve been underinvesting in the health service for decades through multiple governments and this crisis is going to highlight our mistakes and folly.