Supply Shortages Curtail Israel's Coronavirus Testing

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A drive-through coronavirus testing site in Jerusalem on July 2, 2020.
A drive-through coronavirus testing site in Jerusalem on July 2, 2020.Credit: Emil Salman

As the number of people infected with the coronavirus in the country rises, creating a need for increased testing, the Health Ministry has reported a shortage of the laboratory supplies that are needed to carry out the tests.

To overcome this shortage, the ministry is now employing a no-bid process to expedite the purchase of test kits from three suppliers. The total cost of the combined purchase will come to 58 million shekels ($17 million).

Initially, the ministry will purchase seven types of test kits that are in particularly short supply. But purchases of other items may also soon become necessary

Esther Admon, the chairwoman of the Israel Association of Microbiologists, Biochemists and Lab Technicians, said that the shortage will reduce the number of daily coronavirus tests that can be performed.

Currently, she said, there’s a shortage of reagents for a particular type of machine that is used in Israel’s major testing laboratories. Each of these machines can process up to around 3,000 tests per day for the coronavirus.

“Their shutdown means that we have to obtain coronavirus test results from less efficient machines, which reduces our daily output,” Admon explained.

Currently, 37 laboratories across the country are performing coronavirus tests. These laboratories are located in hospitals, the facilities of health maintenance organizations, the Israel Defense Forces, the Weizmann Institute of Science and other institutions.

But they rely on roughly 20 different types of testing equipment, imported via eight different suppliers. The variety is a result of the speed with which the Health Ministry had to expand the state’s testing capacity, which required it to take whatever was available for purchase when the coronavirus pandemic broke out in Israel, in February.

The result is that different laboratories use different equipment and supplies, including reagents. For example, machines that extract the virus’ RNA can only use the kits that are produced by that machine’s manufacturer.

Machines that use the standard swab test, known as PCR (for polymerase chain reaction), can in theory work with several different types of kits. But according to professionals in the Health Ministry, doing so is complicated and carries certain risks.

A third type of machinery can extract RNA and also perform PCR tests. But it, too, can only use kits that are supplied by the manufacturer.

“Even in machines for which this is possible, converting the machine to work with a kit that isn’t its own requires a very complicated procedure that also entails significant risks,” wrote Dr. Dina Nof, of the Health Ministry unit that has been tasked with breaking the chain of infection, in her request for an exemption from the requirement to issue a request for proposals, a more prolonged procurement method.

People wearing masks in Jaffa on July 9, 2020.Credit: Moti Milrod

Of the seven types of kits that the ministry seeks to purchase, four are for machines that won’t work with any other type of kit. Regarding the other three, Nof wrote, “Because the process of switching is complicated and risky, and because the kits are urgently needed, the ministry thinks that it’s better to maintain the status quo and order the kits needed for them today.”

Coronavirus testing is one of two critical elements for blocking the spread of the virus, with the other being contact tracing. And not only would curtailing testing impair efforts to break the chain of infection, but it would also delay people’s release from quarantine.

Currently, the number of daily tests is approaching 20,000. Yet doing such a large number of tests doesn’t just put a heavy burden on all the bodies involved – HMOs, hospitals and labs – it also requires an appropriate inventory of equipment for taking samples and test kits suitable for each lab’s machines.

Admon said that the Health Ministry still hasn’t told the laboratories when the new batches of testing kits will arrive. “This is another example of the lack of communication and disregard we have experienced from the Health Ministry ever since the crisis began,” she added.

This isn’t the first time during the coronavirus crisis that a shortage of equipment and reagents has created a bottleneck. In early April, the height of the first wave, shortly after the first drive-through testing stations were opened, a shortage of reagents developed. Consequently, the labs were told to prioritize samples taken from hospitalized patients over those from people with mild symptoms.

Over the weekend, the ministry announced that it would trace confirmed coronavirus patients’ contacts only for 10 days prior to the diagnosis, rather than 14 days, as had been the norm previously. That is expected to reduce both the number of people in who are quarantine and the number of coronavirus tests that are performed on people in quarantine.

However, quarantine will still last for two weeks from the date of contact with a confirmed coronavirus patient.

Two weeks ago, the Health Ministry had promised that people who are under quarantine would be tested for the virus within 48 hours after being exposed to a verified carrier of the virus, instead of within four to seven days. The new protocol followed criticism regarding the delays in setting up a system for breaking chains of infection.

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