Systems failures

No matter how good systems are, there’s always a risk of problems because of human failure.

When systems aren’t as good as they could and should be the risk of failure is far, far greater.

New Zealand has had 11 outbreaks of Covid-19 in the community in the last few months.

Multiple shortcomings in systems and protocols uncovered by the Simpson Roche report  point to systems failures in most if not all and it looks like this is the case with the latest one, and that isn’t a surprise:

Otago University epidemiologist Professor David Skegg says it’s no surprise Auckland is going back into lockdown.

“I don’t think we should see this as a surprise, I’ve been saying this all along. There will be more lockdowns in 2021 I’m afraid,” he told Nine to Noon. . . 

Sir David said border workers were doing a good job and they shouldn’t be criticised if there was fault or gaps, but rather the system.

“Recently, I have a sense that the Australians, we’re lagging behind them in some of the precautions. For example, in NSW now, there’s mandatory daily saliva testing of everyone who works at the border or hotels which are MIQ facilities.

“But we’re still doing weekly tests, or in the case of this woman who wasn’t herself been exposed to travellers, but she was working with people who were – she was having fortnightly testing and because she happened to be away the day they came around, it went [on for] four weeks.”

He said slowly piloting voluntary saliva testing once a week was not good enough.

“We need to stop dragging our feet and get on to that quickly.” . . 

The private sector is already going where the government is lagging:

Corporates are signing up for a privately-provided high-frequency saliva test for Covid-19, with government testing services unable to meet the capacity demands of more frequent testing.

On January 22, Covid Response Minister Chris Hipkins announced voluntary daily saliva tests for workers at quarantine facilities – first Auckland’s Jet Park, and then dual-use Managed Isolation and Quarantine facilities in Wellington and Christchurch.

But just as they got off the ground at Jet Park, they were stopped so the Ministry of Health could focus resources on an outbreak centred at the Pullman Hotel facility in Auckland. Stopping the saliva testing was “due to the need to concentrate efforts on testing at the Pullman managed isolation facility”, a Ministry of Health spokesperson said this morning.

The delayed testing finally got properly underway last week, the Ministry said – more than a fortnight late. As the Ministry testing programme has struggled to cope with higher demand, three organisations have already pushed ahead with privately-provided saliva tests, including Auckland Airport. . . 

If as the government tells us, keeping Covid-19 out of the community is a priority, the Ministry must have the resources to react to outbreaks without sacrificing routine testing.

In November last year, the Simpson-Roche report into New Zealand’s Covid response said the Government had taken too long. “Many other jurisdictions internationally are relying on saliva tests for the bulk of their surveillance,” the report found.

“While work is underway in New Zealand on verifying such testing, on current plans widespread introduction is still more than two months off, even though in other jurisdictions saliva testing, involving large numbers of test per day, has been well established for several months.

“The New Zealand time frame appears to be driven by a presumption that saliva test would replace the PCR test. This need not be so, as it could well be complementary.

“All efforts should be made to introduce saliva testing as soon as possible as part of the range of testing methods being conducted. If necessary outside assistance should be sought to accelerate development. While sensitivity of saliva testing may be slightly less than the current method, the ability to test more frequently and with greater acceptance, may far outweigh that.”

Two months later, Hipkins announced the deployment of saliva tests in the quarantine facilities, saying they would operate as an additional screening tool alongside nasal swabs, for the country’s highest risk border workers. . . 

But that hasn’t happened and meanwhile, Rako Science has quietly deployed its testing in three Auckland organisations. In an announcement scheduled before the latest south Auckland outbreak. the company tells Newsroom it already has capacity to run 10,000 tests a day. Rako has offered its services to the Ministry of Health, but officials chose to rely on the over-stretched ESR labs instead. . .

It’s hard to think of a good reason for turning down this offer from the private sector when public labs are overstretched.

Grice was coy about the pricing in New Zealand, saying it was about $40 to $50 but could be cheaper for bigger companies, because of economies of scale. He said it worked out about 80 percent cheaper than nasal swabs.

Whatever the cost, it would be a lot less than the multi millions of dollars locking the country down costs and it would be another much-needed systems improvement.

2 Responses to Systems failures

  1. adamsmith1922 says:

    Reblogged this on The Inquiring Mind and commented:
    I have a nasty suspicion that the MOH and Hipkins do not want Rako, a private company, to sow there are alternatives.Hipkins for ideological reasons, MOH for turf protection. Meanwhile, the country is at risk, the MOH keeps on having systems shortcomings, and NZ bears the burden and the cost. Never mind ‘Be Kind’

    Like

  2. Paul says:

    Yes, agree. However a greater issue is the number of kiwis being tested for Covid-19 when there is a few cases in the community. Day to day there is only a need to test quarantine workers, returnees etc. but in an outbreak the system is only testing around 10,000 people a day. Best practise has authorities testing 25 – 30,000 people a day. Of course the fewer you test the less that can be picked off. Worse still, what is MOH and the minister, even Arderns government doing for forward planning to increase testing capacity in NZ, and what are they doing to tighten their slack procedures for Quarantine.

    Like

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