Public Health Laboratories Response to SARS-COV-2 Diagnostic Testing during COVID Pandemic in Pakistan

Challenges in Laboratory Diagnosis of COVID-19 in Pakistan

Authors

  • Hasnain Javed Primary and Secondary Health Care Department, Government of the Punjab, Lahore
  • Rimsha Khan Primary and Secondary Health Care Department, Government of the Punjab, Lahore
  • Warda Fatima Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore

DOI:

https://doi.org/10.53560/PPASB(60-sp1)773

Keywords:

COVID-19, Pakistan, Healthcare system strengthening, Challenges of outbreak, Pandemic, Lesson Learned

Abstract

During COVID-19 Pandemic, diagnostic laboratories played a vital role in outbreak investigation, surveillance, patient monitoring, and therapeutic effectiveness, and hampered the transmission cycle globally. In Pakistan, the health department took an initiative to build BSL-III labs at divisional levels. A qualitative study was conducted among healthcare professionals from 13 major public health national-level laboratories through in-depth interviews with key informants to note down the challenges they faced during the COVID-19 pandemic during diagnostic testing. In this study, 77 % of public health laboratories faced sampling, administrative, and leadership issues. 53 % of laboratories have faced the unavailability of well-trained staff and human resources while both the biosafety and biosecurity protocols, and the lack of resources were compromised in 69 % of labs. Some lab staff (54 %) felt the wastage of resources in terms of excessive testing and fake sampling, while others (54 %) discussed a lack of training and work experience issues. As the majority of the technical lab staff was hired in temporary consultancy mode so 61 % of issues were related to late salaries. 38 % of issues were about fake reporting pressure from higher authorities. 69 % had issues with the continuous supply chain of kits, reagents, PPEs, etc. The work environment was not up to the mark of 69 %. High workload and mental health issues were faced by 92 %, while waste management was 23 %, shortage of lab space for massive testing by 38 %, and stigma and discrimination among healthcare workers and the general public due to involvement in COVID-19 testing were felt by 46 %.

References

R. Joshi, R. Lodhe, S. Agrawal, and A. Jain. Hospital based infectious disease related proportional mortality study. Journal of Global Infectious Diseases 6: 10 (2014).

Info W: Coronavirus Update (2020) https://www.worldometers.info/coronavirus/ (accessed on 28 August 2020).

Z. Song, Y. Xu, L. Bao, L. Zhang, P. Yu, Y. Qu, H. Zhu, W. Zhao, Y. Han, and C. Qin. From SARS to MERS, thrusting coronaviruses into the spotlight.

Viruses 11: 59 (2019).

R. Parreira. Laboratory methods in molecular epidemiology: viral infections. Microbiology Spectrum 6: 6-6 (2018).

P.L. Delamater, E.J. Street, T.F. Leslie, Y.T. Yang, and K.H. Jacobsen. Complexity of the basic reproduction number (R0). Emerging Infectious Diseases 25: 1 (2019).

K.D. Zhuang, A. Patel, B.S. Tan, F.G. Irani, A. Gogna, S.X. Chan, S.K. Sanamandra, T.T. Chong, S.P. Chng, and K.H. Tay. Outcome and distal access patency in subintimal arterial flossing with antegrade-retrograde intervention for chronic total occlusions in lower extremity critical limb ischemia. Journal of Vascular and Interventional Radiology 31: 601-606 ( 2020).

J.Y. Song, J.G. Yun, J.Y. Noh, H.J. Cheong, and W.J. Kim. Covid-19 in South Korea—challenges of subclinical manifestations. New England Journal of Medicine 382: 1858-1859 (2020).

Z. Li, Y. Yi, X. Luo, N. Xiong, Y. Liu, S. Li, R. Sun, Y. Wang, B. Hu, and W. Chen. Development and clinical application of a rapid IgM‐IgG combined

antibody test for SARS‐CoV‐2 infection diagnosis. Journal of Medical Virology 92: 1518-1524 (2020).

G. Webb, M.J. Blaser, H. Zhu, S. Ardal, and J. Wu. Critical role of nosocomial transmission in the Toronto SARS outbreak. Mathematical Biosciences & Engineering 1: 1 (2004).

T. Wong, T. Wallington, L.C. McDonald, Z. Abbas, and M. D.E. Christian, Low, D. Gravel, M. Ofner, B. Mederski, L. Berger. Late recognition of SARS in nosocomial outbreak, Toronto. Emerging Infectious Diseases 11: 322 (2005).

G. Lippi, and M. Plebani. A Six-Sigma approach for comparing diagnostic errors in healthcare—where does laboratory medicine stand? Annals of Translational Medicine 6: (2018).

C. Sheridan. Coronavirus and the race to distribute reliable diagnostics. Nature Biotechnology 382-384 (2020).

G. Lippi, M. Plebani, and M.L. Graber. Building a bridge to safe diagnosis in health care. The role of the clinical laboratory. Clinical Chemistry and Laboratory Medicine 54: 1-3 (2016).

G. Lippi, and M. Plebani. Laboratory abnormalities in patients with COVID-2019 infection. Clinical Chemistry and Laboratory Medicine 58: 1131-1134 (2020).

Organization WH: COVID-19 strategic preparedness and response plan: operational planning guidelines to support country preparedness and response. (2020).

M. Plebani. Errors in clinical laboratories or errors in laboratory medicine? Clinical Chemistry and Laboratory Medicine 44: 750-759 (2006).

M. Plebani, and P. Carraro. Mistakes in a stat laboratory: types and frequency. Clinical Chemistry 43: 1348-1351 (1997).

M. Espy, J. Uhl, L. Sloan, S. Buckwalter, M. Jones, E. Vetter, J. Yao, N. Wengenack, J. Rosenblatt, and F. Cockerill III. Real-time PCR in clinical microbiology: applications for routine laboratory testing. Clinical Microbiology Reviews 19: 165-256 (2006).

T.R. Matos, M.A. de Rie, and M.B. Teunissen. Research techniques made simple: high-throughput sequencing of the T-cell receptor. Journal of Investigative Dermatology 137: e131-e138 (2017).

G.V. Zyl, J. Maritz, H. Newman, and W. Preiser. Lessons in diagnostic virology: expected and unexpected sources of error. Reviews in Medical

Virology 29: e2052 (2019).

L.O. Gostin, C.C. Mundaca-Shah, and P.W. Kelley. Neglected dimensions of global security: the global health risk framework commission. Journal of the American Medical Association 315: 1451-1452 (2016).

J. Hanefeld, S. Mayhew, H. Legido-Quigley, F. Martineau, M. Karanikolos, K. Blanchet, M. Liverani, E.Y. Mokuwa, G. McKay, and D. Balabanova Towards an understanding of resilience: responding to health systems shocks. Health Policy and Planning 33: 355-367 (2018).

J.V. Olmen, B. Marchal, W.V. Damme, G. Kegels, and P.S. Hill. Health systems frameworks in their political context: framing divergent agendas. BMC Public Health 12: 1-13 (2012).

G. Lippi, G. Lima-Oliveira, G. Brocco, A. Bassi, and G.L. Salvagno. Estimating the intra-and inter-individual imprecision of manual pipetting. Clinical Chemistry and Laboratory Medicine 55: 962-966 (2017).

H. Feng, Y. Liu, M. Lv, and Zhong J: A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT. Japanese Journal of Radiology 38: 409-410 (2020).

S.M. Jung, A.R. Akhmetzhanov, K. Hayashi, N.M. Linton, Y. Yang, Yuan B, Kobayashi T, Kinoshita R, and H. Nishiura. Real-time estimation of the risk of death from novel coronavirus (COVID-19) infection: inference using exported cases. Journal of clinical Medicine 9: 523 (2020).

Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nature Medicine 26: 861-868 (2020).

Mizumoto K, Kagaya K, Zarebski A, and Chowell G: Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance 25: 2000180 (2020).

K.K.W. To, O.T.Y. Tsang, C.C.Y. Yip, K.H. Chan, T.C. Wu, J.M.C. Chan, W.S. Leung, T.S.H. Chik, C.Y.C. Choi, and D.H. Kandamby. Consistent detection of 2019 novel coronavirus in saliva. Clinical Infectious Diseases 71: 841-843 (2020).

Downloads

Published

2023-01-20

How to Cite

Hasnain Javed, Rimsha Khan, & Warda Fatima. (2023). Public Health Laboratories Response to SARS-COV-2 Diagnostic Testing during COVID Pandemic in Pakistan: Challenges in Laboratory Diagnosis of COVID-19 in Pakistan. Proceedings of the Pakistan Academy of Sciences: B. Life and Environmental Sciences, 60(S), 35–43. https://doi.org/10.53560/PPASB(60-sp1)773