Patchy information is beginning to emerge about the impact Covid19 is having in the laboratory. With A&E attendance down a whopping 30% in March 2020 compared to the same month last year (and the lock-down only kicking-in on March 23), as well as the cancellation of all non-emergency operations, it is unsurprising that many pathology labs are seeing a massive cut in their workloads.
Estimates are difficult to quantify, but experts have recently suggested that although an average month would see 30,000 cancer cases identified across the NHS, the last month has registered just 5,000. There is anecdotal evidence that histology labs which might process 130 samples a day are now being sent an average of 18. That’s a cut of 86% and suggests a worrying downturn in the levels of necessary diagnoses. Where the private sector has stepped in to perform some vital health services, it has tended to conduct the necessary laboratory work too, which has been welcome, but it is often undertaken without the same capacity or expert resources.
Inevitably, the new paradigm has meant sacrifices amongst some lab professionals. In private labs, it is understood that up to 80% of staff have been furloughed, leaving one or two left in the lab to manage the limited workload. The only exception to this is for the labs working with food, beverage and specialist Covid19 products, such as hand sanitiser.
In contrast, public sector lab employees are not furloughed, but are expected to continue to provide essential public services or in some way contribute to the response to the outbreak. As a result, many have been transferred across to other laboratory disciplines or even, in some cases, mortuary services (where those services fall under the same auspices as pathology). Ironically, despite the overall dramatic decrease in workload for labs, there continue to be some areas where there is a personnel shortage as a result of those needing to self-isolate (we should not forget that most NHS laboratories are based in hospitals, where the virus is easily transmitted). This is something that will have an even greater impact once the NHS starts to resume cancer services, as the Government has recently sanctioned (27 April).
Against this backdrop of dramatic change, there is one area of frantic activity in the busiest of the pathology areas: microbiology, where testing for Covid19 is undertaken. Despite some speculation concerning the Government’s testing targets and whether they are being met, there is no doubt that microbiology labs are rising to the enormous challenge facing them. As an example, we know of one lab in Scotland working through 300-500 testing kits a day. As well as needing testing kits, PPE and consumables, some are also looking to expand their capacity by investing in certain key pieces of equipment, including PCR machines, vortex mixers and microcentrifuges.
Looking to the longer term, many commentators are predicting that the current climate could spark a root and branch change to the NHS procurement policy, which has been criticised as cumbersome and bureaucratic, particularly in its response to the PPE crisis. Others argue that this is unfair in these extraordinary times of global need. However, questions are being asked about a return to autonomous departmental purchasing with bulk-buying no longer seen as a silver bullet in all circumstances, but rather an albatross which has prevented the best products reaching the right hands at the right time at the right price.
As we wait for the dust to settle, we will continue to develop our understanding of what’s happening generally in the laboratory setting, not least as it allows us to react as quickly as possible to your changing needs and so continue to help you run the most efficient laboratory.
In the meantime, we wish you and your families the very best during these difficult times.