Exclusive: Medical body points to ‘very variable stocking’ of the critical reagent across different states and territories

This article is more than 6 months old

This article is more than 6 months old

The department of health says it is acting to preserve domestic supplies of a critical component in coronavirus testing, which have come under “considerable strain” during the current pandemic.

The Australian Medical Association told the Guardian on Monday that some jurisdictions had failed to properly stockpile a common reagent critical in the testing of coronavirus, creating supply issues because of the huge demand on Australian laboratories due to Covid-19.

Chemical reagents are used to extract nucleic acids from swabs taken from potential coronavirus patients. The extraction of ribonucleic acid (RNA) is only one part of the coronavirus testing, but it is crucial in confirming the presence of the virus.

The reagent used to extract the RNA is not specific to coronavirus and is used in testing for a range of illnesses, including other types of influenza, the AMA said.

The department of health said there was currently significant pressure on stocks of all consumables used by laboratories.

But it voiced particular concern about RNA extraction.

“Due to global demand exceeding supply, stocks of all laboratory related testing consumables are under considerable strain,” a spokeswoman said.

“At the moment there are particular concerns around supplies of swabs and DNA extraction kits.”

The department said there was also pressure on the stocks of swabs.

Urgent steps were being taken to prevent any danger of shortages, the department said, including to “conserve the supply of consumables” already in Australia.

Doctors were also being urged to only perform tests for those who met the definition of a “suspect case”. The department was analysing the supply chains of multinational manufacturers, and assessing emerging technology and innovative testing methods.

“Some laboratories are also beginning to screen test request forms for relevant clinical and travel history and where a test is not justified, the testing request is being rejected,” the spokeswoman said.

Quick guide Coronavirus advice for Australia Show Hide What are the common symptoms of Covid-19? Fever

Dry cough

Fatigue

Muscle aches and pains When should I get tested? The current national advice is to get tested if you:

are experiencing the symptoms above, and

have travelled overseas recently (within the past 14 days); or

have been in close contact with a confirmed case of Covid-19 Help lines The national coronavirus health information hotline is 1800 020 080.

The federal health department has a coronavirus health alert website. The state health department websites and contact numbers are:

NSW – 1300 066 055

Victoria – 1800 675 398

Queensland – 13 HEALTH or 13 432 584

South Australia – 1300 232 272

Western Australia – 1300 62 32 92

Tasmania – 1800 671 738

ACT – Business hours: 02 5124 9213, after hours: 02 9962 4155

Northern Territory – 08 8922 8044

Chris Moy, the AMA’s president in South Australia, said Australia currently has “very variable stocking” of the RNA extraction reagent across different states and territories.

Australian stocks of coronavirus testing kits 'rapidly deteriorating', says chief medical officer Read more

That’s left some jurisdictions facing supply issues but others well-prepared, he said.

South Australia was singled out for praise. It has spent the past decade “carefully” stockpiling a supply of the reagent, something Moy said was a complex and difficult task.

“You need this reagent to do the test,” Moy told the Guardian, speaking from a clinic where he is testing potential coronavirus patients. “There’s probably two issues at the moment. Firstly, there has been very variable stocking by the state pathology services of this.”

“The other reason why there is a bit of a burn-through ... there is still a proportion of the ‘worried well’ getting tested. The problem with that is the criteria for testing keeps changing.”

Moy said the problem again showed the need for the establishment of a nationally-coordinated disease control authority, similar to the Centre for Disease Control and Prevention in the United States.

Australian state governments declare public health emergencies to contain coronavirus Read more

“It just shows again that dealing with a pandemic which is a state thing can’t rely on jurisdictional inconsistencies, and also that dealing with a pandemic is a practical not a theoretical issue. That’s why the AMA has been calling for a centre for disease control to coordinate responses.”

Australia is hardly alone in facing strain on its supply of reagent.

Last week, the head of the US Food and Drug Administration, Stephen Hahn, said he was “aware of pressure in the supply system on the reagents” needed in coronavirus testing. The agency was working 24/7 to address the problem, he said, and was seeking to supply laboratories with reagent alternatives.

Grattan Institute health program director Stephen Duckett, a former secretary of the health department, said Australian officials had know for weeks that testing supply issues would arise. He said more should have been done to forecast the demand for testing.

“Were there estimates of demand?” he asked.

Q&A How can I protect myself and others from the coronavirus outbreak? Show Hide The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the coronavirus, for which there is no specific cure or vaccine. The UN agency advises people to: Frequently wash their hands with an alcohol-based hand rub or warm water and soap

Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing

Avoid close contact with anyone who has a fever or cough

Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers

Advice about face masks varies. Wearing them while out and about may offer some protection against both spreading and catching the virus via coughs and sneezes, but it is not a cast-iron guarantee of protection Many countries are now enforcing or recommending curfews or lockdowns. Check with your local authorities for up-to-date information about the situation in your area. In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

“At the moment they are still basically saying we can’t meet demand. We can only test those who have very clear symptoms.”

Paul Kelly, the deputy chief medical officer, said supply issues with “consumables” were rapidly emerging, but not surprising.

“There are some issues in relation to some of the consumables around the tests. That’s a global issue,” he said. “As you can imagine, there’s a lot of testing going on. All of those 160,000 people that we have definite diagnoses on have had at least one test.”

Moy said the government’s decision to bring private laboratories into the testing regime would help alleviate the pressure, as would stricter and more consistent criteria for who can be tested.

The New South Wales health minister, Brad Hazzard, said on Monday his state had a significant capacity for testing, compared with other jurisdictions. He urged only those who met certain criteria went for testing.

“The reason why I’m telling people that is that obviously pathology laboratories have a limited amount of capacity,” he said. “We have a very big capacity here in New South Wales compared to other states and territories, but it’s still limited. It’s finite .

“We need to make sure those likely to have the test, can have the test.”

• This article was amended on 17 March 2020. A previous version, which was based on advice from the department of health, referred to DNA extraction in the test for coronavirus. Covid-19 is an RNA virus and DNA is not extracted in the process of testing.