Some doctors are warning a promised influx of almost 100,000 COVID-19 test kits in the coming week, won't be enough as stocks are already being rationed and the infection rate is yet to peak.

Key points: Immunologist John Dwyer says Australia needs to dramatically increase testing

Immunologist John Dwyer says Australia needs to dramatically increase testing He says 100,000 more test kits would not go far enough

He says 100,000 more test kits would not go far enough Queensland will increase the number of labs able to test samples

The ABC can reveal the promised influx comes just days after Australia's largest hospital service raised the threshold for COVID-19 testing twice in one day, in what a prominent immunologist said was a "regrettable" sign that health departments were "rationing" the tests.

Some doctors have voiced concerns the move by Metro North Hospital and Health Service, which caters for almost 1 million people in Brisbane's north, makes it harder to detect the early spread of the virus in the community.

They are worried frontline healthcare workers are also being placed at risk amid a shortage in the supply of protective equipment.

Immunologist John Dwyer of University of NSW said another 100,000 test kits would not go far enough and authorities were still not casting their net wide enough.

"Because we're looking for people who have either been traveling, and or have a fever, as well as cold symptoms, we're missing out on a lot of people who are infected and importantly, are infectious," he said.

"Hopefully they can sell us some more [testing kits] because it's not going to be enough."

More labs to test samples



Queensland Health Minister Steven Miles said the state, which now has 94 confirmed cases — less than a fifth of Australia's COVID-19 case total — had done more than its fair share of testing.

According to Queensland Health, 22,524 COVID-19 tests have been completed with another 2,102 results pending.

A spokeswoman said the addition of three new testing labs in Toowoomba, Rockhampton and the Sunshine Coast would "dramatically improve turnaround time".

Mr Miles told Parliament on Tuesday that Queensland Health had been performing more than 1,200 tests a day and more than 3,400 people were in quarantine across the state.

Mr Miles said the government had spent almost $900,000 to buy Hologic Panther Fusion Instruments to test samples in each lab.

About 81,000 tests have been done nationally, according to Federal Health Minister Greg Hunt.

"From day one, we decided we would test a lot," Mr Miles said.

"International experience says we should test a lot. And we will not stop testing a lot.

"It will give us the best chance of containing this virus."

'What we're talking about is rationing'

But Metro North, which runs five hospitals including the Royal Brisbane and Women's Hospital, has adopted even stricter testing criteria than that spelled out by Australia's chief medical officer.

"Unfortunately, the extreme pressure on our personal protective equipment stocks continues, and the situation regarding pathology test kits, reagents and swabs [which] is deteriorating rapidly, with kits no longer being available in some regions of the country," Dr Brendan Murphy wrote in a letter to GPs last Friday.

Until then, Metro North staff were under instructions to "consider testing any person, including healthcare workers, with symptoms suggestive of COVID-19".

This meant testing people with close and casual (less than 15 minutes) contact with confirmed COVID-19 cases who had fever or other symptoms, healthcare workers with fever and symptoms irrespective of travelling and contact history, overseas travellers with fever and symptoms, and people with severe pneumonia.

But just one day after Dr Murphy's letter, Metro North changed its criteria to stop testing people who had been in casual contact with those infected, and to only test healthcare workers with a history of direct contact with COVID-19 patients.

Hours later that same day, it changed the criteria again — to remove direct reference to healthcare workers.

Instead, it specified testing for overseas travellers with fever and symptoms, those in close contact with COVID-19 cases, and those with severe pneumonia.

"What you're talking about is rationing," Dr Dwyer said.

"That's perfectly logical. But it's regrettable because the point is that we are handicapped in our fight against this virus by not being able to do more tests.

"I don't think we're doing anything like enough testing."

Dr Dwyer says the virus is spreading fast and more people need to be tested. ( Reuters: Francois Lenoir )

'Look below the top of the iceberg'

Dr Dwyer, a onetime head of immunology at Yale University and a leader of Australia's original response to the AIDS crisis, said the shortage of testing kits, reagents and swabs had led doctors to focus on fever as a key threshold for testing.

"But we know perfectly well that there are a lot of people who have this virus and who are infected and infectious who don't have a fever," he said.

"We need to be able to broaden the testing capacity and we should be doing epidemiological studies in the community … to try and look below the top of the iceberg.

"Testing, testing, testing — in other words, get objective data rather than having some magic thing [like 14-day quarantines]."

One senior clinician at Metro North, speaking on condition of anonymity, said raising the threshold for testing was "a pragmatic response" to a shortage in testing kits, swabs and reagents.

"But the worst thing is you're not testing unless you've been in contact with a positive person who travelled overseas [and] you're going to miss most of the community spread," the doctor said.

"So we get a false sense of security that numbers aren't rising, but the numbers are rising.

"Certainly, if you want to protect staff and maintain hospital services, we're going to have to know who is potentially COVID-positive. If we don't test them, we won't know and so we've got one hand tied behind our back to provide protective environments and to reduce spreads of both patients and staff.

"Being able to reassure staff to turn up to work to look after these patients is going to be critical, that their perception of the risks of infection is minimised.

"That, to me, is the importance of testing — but you can't get over the fact there's a shortage."

'Quarantine no guarantee people are clear of infection'

Dr Dwyer said testing of overseas arrivals, which would take three days, rather than the blanket 14-day quarantine, was no guarantee people would emerge clear of infection.

"The lack of productivity with so many people coming home being locked up for two weeks is an inconvenience which is only necessary because we don't have objective data about their status, and of course the vast majority of those people are going to be negative," he said.

Dr Dwyer said even more tests were needed to clear people to leave quarantine to ensure they didn't remain infectious after 14 days.

"We know there's been all sorts of reports of people who had no symptoms, who were shedding the virus in South Korea, they know there was an awful lot of children who had no symptoms whatsoever who were spreading the virus to their grandparents, etcetera," Dr Dwyer said.

A spokesman for Metro North referred questions to Queensland Health.

A spokeswoman for Queensland Health did not say if hospital services would broaden their testing criteria with improved supply.

However, the spokeswoman said the state's facilities had been "testing in line with the current criteria (including healthcare workers) that has been set out by the Federal Government".

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