Lab technologist crisis results in faulty sample collection, inaccurate results

A bank official in Dhaka was tested three times for Covid-19.

After two tests yielded negative results, his third test, finally, confirmed he was positive for the virus – but he had already passed away.

Like that bank official, many people are also getting wrong reports every day.

Accurate sample collection is crucial for novel coronavirus testing. However, a crisis in the number of medical technologists is leading countrywide labs to collect patients' samples inaccurately as well as perform below their capacity, say experts.

Furthermore, many samples are also losing their quality due to this.

The health directorate is providing one-hour online trainings for its healthcare providers and sending them to collect samples. However, the quality of samples has been called into question as the healthcare providers do not have enough skills to draw samples.

Dr Jahidur Rahman, an assistant professor of the virology department at Shaheed Suhrawardy Hospital, said samples should be collected efficiently and taken to the lab – maintaining a cold chain through a specific medium.

"However, in most cases, samples are not properly being collected and transported. This is because technologists, who are supposed to test the samples, have not been recruited for 11 years," he said.

More technologists must be recruited quickly, he said, adding that just providing online training, for an hour or so, a day, without recruiting technologists, will not end the crisis.

Dr Rahman further said the quality loss in samples wastes the government's money, on the one hand, and fails the job, on the other – causing the patients to suffer.

In addition, the infected patient would no longer be staying in isolation after receiving a negative result, posing risks of spreading the virus, the expert added.

Since its inception, the novel coronavirus testing PCR lab in Rajshahi Medical College Hospital has binned eight to 10 samples every day.

A doctor at the novel coronavirus lab of the hospital, preferring not to be named, said the lab found a few samples every day whose reports were invalid.

"This is mainly because technologists do not collect samples properly. What healthcare providers learn in one-hour online trainings is inadequate."

"These field-level workers are bringing in saliva from patients' mouths instead of nasopharyngeal and oropharyngeal swabs," he said, adding that this practice is wasting kits and the healthcare workers are spreading the virus by mixing with others before collecting new samples.

Former secretary general of Bangladesh Medical Technologist Association Selim Molla said the health directorate's move to collect samples through community healthcare providers was a suicidal decision.

"This is because collecting samples is a complex process. Anyone who does this should know about anatomy and physiology. Healthcare providers do not know which part of the nose or throat to collect samples from," he said.

According to the directorate's latest bulletin, the country has about 26,000 posts for doctors.

As per the World Health Organisation standards, there should be five medical technologists for every doctor. As such, the country needs more than one lakh medical technologists.

However, at present, there are only 5,184 medical technologists. Again, only 1,488 of them are at laboratories.

It has been learned that around 30,000 medical technologists are currently unemployed. Of those 15,000 are lab technologists.

Selim Molla has urged the government to hire the 15,000 jobless medical technologists in this moment of crisis.

The National Technical Advisory Committee on Coronavirus has also recommended the required number of technologists be recruited.

A member of the committee, a virology expert and former vice chancellor of Bangabandhu Sheikh Mujib Medical University, told The Business Standard that many more technologists would have to be recruited, and trained, in order to collect and test samples properly.