The Ministry of Health's failure to accurately project its Covid testing capacity raises questions about whether other elements of our pandemic response are being sufficiently stress-tested, Sam Sachdeva writes
It was a solemn-looking Dr Ashley Bloomfield who faced the media on Tuesday – and the reason for his demeanour quickly became evident.
The director-general of health opened the relaunch of 1pm press conferences in the Omicron era with a startling admission: it was now clear the Ministry of Health had overestimated the number of Covid-19 PCR tests the country’s laboratories could process as the virus took off in the community.
Bloomfield’s mea culpa was merely confirmation of what many already suspected, with widespread reports of long waits for results (some stretching past seven days) and health experts expressing concern about laboratories being pushed to breaking point.
The swift increase in the proportion of tests coming back positive was a factor, he said, as were supply chain problems affecting access to test components, and lab workers testing positive for Covid or needing to be rested due to their punishing workload.
In all, a backlog of 32,000 test samples is still waiting to be processed – down from a peak of around 50,000 – with just over 9000 of those sent to Australia to ease the burden on labs here.
Bloomfield offered an apology and a promise health officials were working to fix the issue, but that candour has not been entirely swift in coming.
Newsroom’s quest for clarity on the matter began a week ago, in the wake of an initial story on the gap between the number of PCR tests the ministry had said it could process each day, and the reality of a system buckling well short of that.
In that instance, a ministry response came relatively swiftly. Bloomfield said there was a current baseline capacity of 31,000 tests per day compared with the 58,000 figure offered up at the start of the year – a difference attributed to the inability to ‘pool’ samples for testing in batches.
There was just one problem: the new baseline was still 20 percent short of the 39,000 tests the director-general had said in January could be processed each day if pooling was not possible. What was the reason for that discrepancy?
“It should not take an intrepid journalist from Newsroom chasing and chasing and chasing for more than a week to actually find out from the Ministry of Health that our testing capability is not what they said it was.”
– National MP Chris Bishop
That follow-up question, asked last Tuesday, received an initial acknowledgement and was followed two days later by a promise to provide the information “absolutely ASAP”.
On Friday, Newsroom was told a response was undergoing “a final review”; it did not arrive (although the result of a PCR test this reporter had undergone in Wellington on Wednesday did sneak through by the end of the day).
On Monday, another apology was offered, with a commitment to provide a response by the end of that day; suffice to say, that did not occur.
Finally, an intervention from Associate Health Minister Ayesha Verrall’s office on Tuesday led to a promise of an answer from Bloomfield at that day’s 1pm press conference.
It transpired that the higher figure of 39,000 had been “inadvertently” used by Bloomfield, and referred to the eventual unpooled capacity by the end of March; but as we now know, problems with the ministry’s testing projections went well beyond that slip of the tongue.
National Covid-19 response spokesman Chris Bishop said of the director-general’s admission: “It should not take an intrepid journalist from Newsroom chasing and chasing and chasing for more than a week to actually find out from the Ministry of Health that our testing capability is not what they said it was.”
But while it would be fair to describe the communication process as suboptimal, more important than how the information was shared is what it has revealed.
Unanswered questions
Namely, testing projections shared with the public little more than a month ago were rendered unfit within weeks of Omicron taking hold in the community.
Throughout the pandemic, the Government has hammered home the importance of contact tracing and testing to keep Covid in check – but with tracing now next to impossible due to the variant’s spread, testing assumes more importance than ever.
While Prime Minister Jacinda Ardern has previously expressed steadfast confidence in PCR tests as the gold standard of testing, it is hard not to wonder whether the pivot to rapid antigen tests (RATs) would have occurred more swiftly had there been a fuller picture of the system’s fragility.
There are a number of other questions which remain unanswered, some easier to address than others.
How did the ministry produce its testing projections, given New Zealand Institute of Medical Laboratory Science president Terry Taylor says his organisation was not consulted? What independent assessment, if any, did they receive, and why?
How many Kiwis may have opted not to seek out a PCR test when necessary, due to the knowledge of lengthy wait times and associated self-isolation (irresponsible though that may be)?
Could some Covid cases have been avoided if a positive RAT result had been received more swiftly and the patient in question able to better protect others around them; and will any positives be missed due to the degradation of backlogged PCR samples?
As epidemiologist Sir David Skegg noted on Monday, it is highly likely a new variant will be dominating the public conversation by the end of the year – and as the virus adapts, so too must our approach.
Ardern appeared keen to brush off the issue, acknowledging errors had been made but focusing on the “freely available” RATs across the country.
Yet standing alongside Bloomfield in January, the Prime Minister had offered the public this assurance: “We’ve got plenty of testing capacity – it’s there and available for people.”
It may not be fair to use the PCR problems to cast a shadow over the rest of the Covid response, but equally it isn't unreasonable to question whether ministers and the ministry should be more rigorously testing some of their current assumptions.
There is sometimes a sense that the Government mindset and machinery is still stuck in the afterglow of the initial pandemic response in 2020: a world-leading response, yes, but one in need of adjustment to the differing threats posed by different variants.
A simple look across the ditch to Australia would have offered some insight into the speed at which the highly transmissible Omicron can overwhelm testing systems and laboratory staff already suffering from burnout.
As epidemiologist Sir David Skegg noted on Monday, it is highly likely a new variant will be dominating the public conversation by the end of the year – and as the virus adapts, so too must our approach.
