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Questions and answers on virus testing

Kim Wilson, the Minister of Health (File photograph by Akil Simmons)

The Government has the capacity to carry out more than 200 Covid-19 tests a day at two up-and-running labs, it was announced at the weekend.David Burt, the Premier, said the Helix Laboratory, run by Desiree Spriggs, and the Bermuda Government Molecular Diagnostic Laboratory, led by Carika Weldon, could run more than 900 tests a day when fully staffed. A lack of swabs and other items had limited testing ability, but Mr Burt said on Sunday that the Government now had the “capacity to test as many persons as we will need to”.He added that the country also had enough swabs, needed to complete tests, for 10,000 people. He said 2,000 test kits had arrived on Monday and that 10,000 more bought from the Cayman Islands would arrive on an air-bridge flight from London tomorrow. Mr Burt said additional test-kit parts, sourced by Dr Weldon, arrived with her on the air-bridge flight from London on April 6. He added: “The balance of the shipment, which will give the island the ability to complete 40,000 additional tests, will begin arriving on the flight from London this coming Friday.” The Royal Gazette has asked the Government a series of questions about its Covid-19 testing and about other medical supplies since screening began last month.The latest responses, received on Tuesday were:The Royal Gazette asked on April 14: What does “testing capacity” mean? Is that the same as “test kits”? What limits the number of tests that can be carried out?Ministry of Health: “The testing process has multiple steps involving a range of manpower, personal protective equipment and testing supplies and equipment. The ‘testing capacity’ is determined by the extent to which we can meet 100 per cent of every step. “For example, we could have 5,000 kits for step 4, but if we only have 1,000 for step 1 the ‘testing capacity’ will be 1,000. Supplies vary on a daily basis as some are utilised and more are procured, so giving a solid number is unrealistic and it varies daily. “The testing process starts from referrals from GPs, the emergency room, epidemiology and port health, to having testing supplies like swabs and personnel and PPE to take samples. “Then the process requires collection kits and valid transport media, after which the samples are analysed and reported to epidemiology and to the physicians who ordered the tests. “The patient has to be informed also. And finally the results are compiled and reported to the public. It is a complex, involved process where no single number is static for long. With the developments over the weekend, the Government’s testing capacity has been expanded and we have progressed to more extensive testing.”RG asked on April 9: What portion of the 40,000 tests sourced by Dr Weldon, and paid for by a private donor, arrived in Bermuda on Monday, April 6 and were they complete tests, with all the needed elements? MoH: “None. What arrived were two machines and the initial items to do 40,000 tests.”RG asked the same day: When will the remaining portion of the 40,000 tests arrive? MoH: “Orders were confirmed last week and the first portion is to arrive on Friday’s British Airways flight.”RG also asked: “Is it correct that Bermuda is buying 35,000 test kits from the Cayman Islands, from its order from South Korea, and, if so, when are they expected to arrive? Are they complete test kits, with all necessary elements?MoH: “The kits are complete. We are finalising discussions with Cayman regarding how many we will take. They will be on the flight on Friday. On arrival, they will need to be validated with our equipment to ensure we can use them.” RG asked: The Premier said about two weeks ago that we were expecting a shipment of supplies directly from China on April 2. Health minister Kim Wilson said later that the shipment was delayed. Did this shipment arrive? If so, when and what did it include? If not, when is it expected? RG asked a few days later: Has this been delayed by the embargo imposed by the Chinese Government, in terms of quality control on its exports, as discussed by the Minister of Health on April 13?MoH: “Part of the shipment from China arrived last week, bringing 49 cartons of face shields. The remainder of the China consignment arrived yesterday (Monday, April 20), which included surgical masks and infrared thermometers. The order for 500,000 N95 masks was delayed by the quality-control embargo by the Chinese Government and they are now en route via courier.RG asked on April 16: Is the ministry confident that every patient in Bermuda who needs a ventilator will get one? MoH: “Please direct this question to Bermuda Hospitals Board. Our job is to ensure that a combination of measures to reduce transmission means that our healthcare system will not be overwhelmed.”RG asked the same day: Is the ministry confident that the hospital will be able to cope with the projected demand?MoH: “With continued compliance by the public regarding all the necessary public health advice and by putting in place mitigation measures to reduce transmission, our healthcare system should not be overwhelmed. “The hospital has done an excellent job preparing for the worst-case scenario, by creating more bed space as well as providing additional capacity for ventilators and more negative-pressure rooms.”RG asked on April 9: The Ministry of Health has said that local modelling indicates that the Government’s strategies for tackling Covid-19 can reduce healthcare demand by up to two-thirds and deaths by half. If healthcare demand can be reduced by two-thirds, why do the predicted deaths only halve?MoH: “We can discuss this once we have presented the modelling to the public.”RG also asked that day: “When will the full local modelling be released to the public?”MoH: “This week.”RG asked on April 16: Is the ministry investigating the 3D printing of swabs or other components needed to make a complete test kit? MoH: “This was something that may have been considered, but it is not needed as we do not have a limitation on swabs. Also, in collaboration with Johns Hopkins, this was actually advised against.” RG: also asked: Regarding the 2,000 tests a week due to come from Public Health England, have those weekly shipments begin to arrive?MoH: “Yes.”RG asked the same day: Will those tests be complete tests, with all needed components, or will they need additional components? MoH: “Complete.”RG asked: Is it correct to say that though the Government’s policy and wish is to have an aggressive testing regime, it does not yet have one because of a lack of complete tests? MoH: “Not correct, the only limit was swabs, which was rectified last week.”RG also asked on April 16: Where is the ministry trying to get component parts for tests from? MoH: “We are confident we have all the items we need to test.”RG also asked that day: What per cent of the population would the ministry ideally like to test? MoH: “We want the capacity to test who needs it.”