Rapid COVID-19 results a 'valuable resource' in next phase of recovery, says Horizon exec
As hospitals tackle surgery backlogs, GeneXpert reduces test wait times to 45 minutes
As New Brunswick recovers from COVID-19 and hospital services restart, last month's lab upgrades to provide faster test results continue to play an important role, according to the Horizon Health Network's chief of staff.
"Now that we've moved into Level Orange [of the province's recovery plan], we are more dependent on positive or negative tests to do surgeries, for example," said Dr. John Dornan.
"And in the surgical world, sometimes the people need surgery very quickly."
The GeneXpert instruments, which reduce wait times to 45 minutes from as long as two days for some patients, are "an extremely valuable resource," he said.
The Saint John Regional Hospital Foundation's COVID-19 emergency fund paid for the upgrades at the Horizon and Vitalité hospital labs in Edmundston, Campbellton, Bathurst, Miramichi, Moncton, Fredericton and Saint John.
Previously, all of New Brunswick COVID-19 test swabs had to be driven in batches to the lab at the Dr. Georges-L.-Dumont University Hospital Centre in Moncton. Those results, including travel time, take between 24 and 48 hours.
The GeneXpert upgrades came at "just the right time," as the province was ramping up its testing, said Dornan.
The combined capacity of the seven labs is about 200 tests a day, he said. "Thus far, the people that have needed to have a rapid turnaround, we've been able to meet that."
And now the GeneXpert will contribute to this next phase, during which the two regional health authorities are able to restart non-emergency surgeries, diagnostic procedures and health services.
Earlier this week, Horizon announced it will only be restarting elective surgeries that are "urgent and critical."
It has a 15,000-patient backlog of surgery patients.
"There's a long wait list in New Brunswick," acknowledged Dornan. "We're working our way gradually through increasing our ORs. We're quite excited about that," he said.
"We want to help people get better through surgery."
GeneXpert will only be used for certain pre-op patients, but if they test negative, the faster results will save time and money because fewer precautions will be required, said Dornan. Not everyone in the operating room will have to fully gear-up in personal protective equipment, he said.
The faster GeneXpert test results cost more than the Dumont lab, said Dornan. "As you've heard, you can't be quick, reliable and cheap at the same time."
But he couldn't say how much either analysis costs. Horizon spokesperson Kris McDavid was also unable to provide any estimates.
"Cost is not the factor," said Dornan. "It's the issue of getting a test back quick enough to have an impact on the care that people get."
GeneXpert has been used for prioritized groups, including: patients being admitted to intensive care, women in labour, people in level three nursing homes or adult residential facilities who are suspected of having COVID-19, people in correctional facilities and people who are homeless.
But others can be added on a case-by-case basis by contacting the microbiologists, said Dornan.
Crisis calls for quick decisions
Although some rapid testing efforts in other jurisdictions have run into problems, Dornan is undaunted.
"One of the things that I've learned in the COVID crisis is that you have to make rapid decisions," he said. "You cannot keep decisions in abeyance for weeks and months on end.
"We're not cavalier."
For example, when the GeneXpert upgrades were completed, their initial results were considered preliminary until they could be validated against the "gold standard" Dumont lab.
"So it doesn't trouble me that there's some hiccups along the way because … people's health are not put in jeopardy," said Dornan.
With any new equipment, appropriate precautions are always taken, he added.
There are no longer any active cases of COVID-19 in New Brunswick, Public Health reported on Saturday.
The final of all 120 patients has now recovered, officials said in a news release.
A total of 20,032 tests have been conducted to date.