Reduction in the level of service for certain microbiology tests
12 March 2020
You will be aware of the current UK and global Covid-19 epidemic. The impact on healthcare systems is expected to be significant and diagnostic testing plays a pivotal role in the management of patients and the safety of staff.
Public Health England (PHE) has instructed South West London Pathology (SWLP) Microbiology to act as the sole south west London hub laboratory for Covid-19 testing, serving four acute hospital trusts and population of approximately 1.5 million. We have been asked by PHE to provide a minimum capacity of 500 tests a day, seven days a week by the end of March – which is 10 times the volume of testing we do for seasonal flu during the peak of flu season.
This will require a considerable staff resource to deliver and maintain throughout the epidemic. As a result we have no choice but to reduce our level of service for certain tests. We also anticipate disruption and extended turnaround times for some tests. Specifically:
- chlamydia and gonorrhoea NAT testing will be done three times a week instead of Monday to Saturday
- HIV and hepatitis virus loads will be done twice a week instead of Monday to Friday
- viral skin PCR (vesicular rash PCR) will be done once a week
- viral eye PCR (for keratoconjunctivitis investigation) will be done once a week.
For all microbial serology (including virology and syphilis) – normal testing will continue however we will be unable to add on tests to samples already tested (note – testing of stored antenatal booking samples is excluded).
We anticipate extended turnaround times for the tests above and further impact on the rest of our service, including longer turnaround times, reduced storage of previously tested samples, and a restriction in add on testing. We are asking all our users for understanding that this is an unprecedented situation and a national emergency to which the laboratory’s staff and service must respond.
- Please consider whether sending samples for microbiology testing is absolutely necessary. Some tests are of low clinical value – eg taking a swab for culture from a chronic leg ulcer) and may not need to be sent. Other tests may be able to be done less frequently – eg urine samples for culture from those with mild symptoms and no prior history of urinary problems before course of empirical treatment.
- Please communicate this message to your colleagues and patients to help them understand why some tests are not being done and others are taking longer than usual.
Please understand that during this time the laboratory’s services are severely stretched and our staff are working under extreme pressure, often putting in extended hours and dealing with very large volumes of critical samples. They may not readily be able to answer routine queries as this will divert them from their work.