'Controlled chaos': Inside the N.S. lab scrambling to process a record number of COVID-19 tests

The manager of the laboratory responsible for processing a huge spike in COVID-19 tests in the past week says staff are doing "an incredible job" of keeping pace with the demand.

"Of course I'm biased here because I'm in the middle of it," said Charles Heinstein, the manager of the primary microbiology lab for the central zone.

"It's been definitely some of the busiest times of my career here in Nova Scotia Health, but we're hanging in here."

Staff have been scrambling to process thousands of tests. Records have been broken three times this week, culminating in 6,875 tests processed on Tuesday.

Not bad for a lab whose testing capacity is about 5,000.

'It's hard to sustain'

"What we have the ability to do is stretch our capacity on a given day," Heinstein said. "For us to sustain almost 7,000 tests ... it's hard to sustain that for any period of time. So we can sustain it for two or three days, but then it has to draw down back to a more sustainable capacity."

Before COVID-19 hit, the microbiology lab would process about 600-800 tests per day, and in the particular section where the molecular COVID-19 polymerase chain reaction (PCR) tests are analyzed, "big weeks in there would be 150 to 200 samples in the whole week," Heinstein said.

"The scale of what's going on … is pretty impressive."

Heinstein said while the lab has the ability to analyze about 10,000 tests per day, it's the clerical work associated with processing tests — verifying names, health card numbers and dates of birth, as well as labelling the samples with a barcode that tracks that information — that slows the system down. But over the next month or two, some new technology may speed up that process, Heinstein said.

The lab has been drawing from every available resource within the system, as well as recruiting new workers and training them quickly to tackle the work.

"All hands on deck is really what we've been preaching."

As Nova Scotians continue to heed the calls from Dr. Robert Strang, the chief medical officer of health, to get tested, Heinstein's lab is always gearing up for the next big wave. He said after the lab saw a spike in testing last April and again in November, staff analyzed what worked and what didn't.

The time will come for that again, but for now, lab workers are just trying to get through the current influx.

"It's a bit of controlled chaos," Heinstein said. "So that's a little bit frazzled, but then on the opposite side of that is, staff are really proud, they're really happy, they're really invested in getting COVID tests out for Nova Scotians…. It's pretty neat to see the amount of teamwork."

Testing FAQ

Do daily stats of tests completed include rapid tests?

No. The rapid tests completed at pop-up sites across the province are not included in the daily or cumulative figures. To date, 27,760 rapid tests have been conducted.

Does the daily testing statistic reflect how many people were tested, or how many tests were processed in the lab?

The daily stat shows how many PCR tests (non-rapid tests) were finished being processed in the lab.

Does the number of new positives announced each day necessarily reflect swabs that were collected the day before?

No. The number of positive cases is not necessarily based on the tests collected the day before, but rather the tests that were finished being processed in the lab the day before. So, for example, if 6,551 tests were processed on Wednesday, and on Thursday three new cases were announced, it doesn't mean the three positive swabs were collected on Wednesday. They may have been collected before Wednesday, but the lab only got around to processing them on Wednesday.

Is the processing of tests prioritized in any way?

Yes. Staff prioritize tests for people who need results urgently — for example, people who are about to be admitted to hospital or undergo surgery or be transferred to a long-term care facility.

Why do test results sometimes come back at different times — even days apart — if two or more people got tested at the same time?

The lab uses different systems to process tests so they can use a variety of reagents and not be limited to one supplier. Since the systems function differently — for example how the samples are loaded and how many samples can be loaded at the same time — the results can come back at different times.

Why do some negative test results get delivered by email, while others get delivered with an automated phone call?

If there is an error in the email address, if an email hasn't been opened after 24 hours, or if someone doesn't have a Nova Scotia health card, an automated call will be used instead.

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