Ontario’s COVID testing slowed by shortage of key chemical
OTTAWA • World-wide shortages of a Swiss pharmaceutical company’s crucial chemical for COVID-19 testing, along with staff shortages, are hampering Ontario’s laboratory system as the province deals with record numbers of tests.
On Thursday, Ontario reported 797 cases of COVID-19 across the province after performing 48,500 tests, a new record number for tests in a single day. Still, there are nearly 60,000 tests waiting to be completed, down from nearly 90,000 tests last week.
The province’s testing system relies heavily on instruments from the Swiss pharmaceutical giant Roche. Their machines use a proprietary reagent chemical that only Roche manufacturers and the company has struggled to keep up with demand.
Reagents are chemicals used in lab tests that are added to samples taken from patients and then analyzed.
Premier Doug Ford has said several times this week the shortages are a major problem for the province and he has been calling the company’s Canadian CEO regularly to try and ensure the province is supplied.
“There’s a worldwide shortage of reagents,” Ford said at a press conference this week.
Ford announced more funding to improve testing Wednesday and Ontario has switched to an appointment- based system in an effort to eliminate long lines and help labs catch up.
The federal government has handled much of Canada’s health procurement during the crisis and has signed several contracts for reagent.
A New Brunswick company signed a deal with the government in April to provide up to 500,000 tests per week and one federal source speaking on background said the government has plenty of reagent to give, but Roche has a unique blend for its machines and are the only makers of it.
Ford said Deputy Prime Minister Chrystia Freeland has spoken with Roche’s global CEO in Germany to help make Ontario’s case.
Matthew Anderson, president and CEO of Ontario Health, said they procured the Roche instruments because the company is an industry leader, but Ontario wasn’t alone.
“Everybody knows they are world- class machines, which is why we are now in a global shortage for the entire kit, not just the reagents.”
Anderson said Ontario is looking to becoming less reliant on any one type of testing equipment, but that’s not a simple transition.
“We have been looking to diversify the equipment that is on our network. We have a little over 120 different analyzers and machines on our network.”
He said the challenge in bringing new equipment online is that it has to be fitted into an existing system of machines and labs and that’s not easy while the labs are dealing with such high demand.
“All of our team members in the labs are working 24-7 to increase capacity; to keep the flow, it’s difficult at that time to start to swap out pieces of equipment.”
Roche said the demand for their large, fully automated testing machines and the reagent chemicals they use has risen considerably during the pandemic and they’re doing everything they can to make more.
“Due to the quality, reliability, performance, and high throughput of this particular testing solution, demand of this testing solution surpasses the demand, globally and locally,” a spokesperson said in a statement. “Roche is making substantial investments in building additional manufacturing capacity to increase production of tests and the instruments on which they are performed.”
The company said it is working with the provincial and federal governments to get supplies where they need to be. “We are diligently providing our solutions for COVID-19 testing to laboratories and we are taking the necessary measures to help reduce the level of pandemic impact.”
Roche said their testing equipment is complex and if laboratories use generic reagents instead of the ones Roche supplies, there could be issues and the machines would not be covered by warranties.
Michelle Hoad, CEO of the Medical Laboratory Professionals’ Association of Ontario, said the reagent issue has been a major concern and it can have ripple effects as labs without supplies have to shut and their work is shuttled elsewhere.
She said the system is running full speed right now and that stresses delicate scientific instruments.
“They ’ re rea l ly not equipped to run 24-7. We’re running them 24-7 now. So what happens is you run this machine for a couple of weeks, and then it has to go down because it needs some maintenance.”
Hoad said the technologists analyzing results are also not equipped to run 247, but they have been. She said many are stressed from the workload and decades of decisions to close training schools and reduce staffing levels had already left the industry with shortages before the pandemic hit.
“Unfortunately, the lab has been an afterthought in health care for many, many years, just as long- term care was and then look what happened with long-term care.”
Health Canada has approved two rapid tests in the past few weeks that ease the pressure, because they don’t need a laboratory for results. Ford’s Health Minister Christine Elliott urged the federal government to get those tests out to provinces soon.
Hoad said while they can help the government has to be aware they are less sensitive and may miss some cases.
She said everyone wants to see faster, home- based tests, but regulators are taking prudent steps
Unfortunately, the lab has been an afterthought in health care for many years.