‘Medical fighter pilots’ - An inside look at lab testing for COVID-19
They fly into bacterial and viral turbulence to provide accurate analysis of disease outbreaks and study the form and behaviour of organisms that lead to pandemics like the highly contagious novel coronavirus that has put the medical world on the back foot.
They are currently at the forefront of the COVID-19 fight at The University Hospital of the West Indies (UHWI), which houses the National Influenza Centre, the only lab currently testing samples for the virus in Jamaica.
Medical chief of staff at The UHWI, Dr Carl Bruce, calls the lab staff “medical fighter pilots” who are providing armoury to physicians on the front lines of the disease outbreak in Jamaica.
Jamaica currently has 58 positive cases of the novel coronavirus. Three COVID-19 patients have died.
Dr Alison Nicholson heads the Department of Microbiology, which has as its mandate the training of world-class healthcare workers with a commitment to scholarship and research. The department provides oversight for the infection prevention and control, and antibiotic stewardship programmes.
Nicholson, during an interview with The Gleaner last week, heaped praise on Professor Monica Smikle, who she describes as the hands-on person and face of COVID-19 testing.
She explained how positive or negative results are garnered.
“We have what is known as a biosafety lab (BSL-2+), almost BSL-3 level lab, which is like a very high-tech lab. ... Doctors on the ward will send the samples over there via porters, or they bring them themselves,” Nicholson said.
“That will be like your throat swabs and nasopharyngeal swab to extract the genetic material.”
A nasopharyngeal swab, or culture, is a sample of nasal secretions taken from the back of the nose and throat and analysed for the presence of organisms or other clinical markers for disease. The swab is tested to identify germs that may cause infection in the throat.
“What you put on the machine is the genetic material, which is what is converted from ribonucleic acid (RNA) to deoxyribonucleic acid (DNA), and that is processed, running for three to four hours,” she said.
DNA is a complex blueprint of genetic information while RNA influences gene expression.
Preliminary positive results prompt a second test in three to four hours for confirmation. The hospital has a Roche LightCycler machine that reads the genetic material. Three other machines are expected shortly and so is another team of technicians.
With healthcare workers in a race against time to curb COVID-19, those results are passed on seamlessly to the relevant authorities. As Jamaica braces for the prospect of community spread, time, as a commodity, is in short supply.
That reality is top of mind for Nicholson.
“When we get the results, we call the wards as quickly as possible because decisions are being made, especially at Accident and Emergency. Results are critical to keeping the flow of patients in the hospital,” Nicholson said.