Covid-19 testing: Only a fraction of Mkhize’s 60 mobile units are ready

New mobile testing units on display at the NHLS in Sandringham on Wednesday, 1 April 2020. (Kyle Cowan, News24)
New mobile testing units on display at the NHLS in Sandringham on Wednesday, 1 April 2020. (Kyle Cowan, News24)

Only five of 60 new mobile testing units launched by Health Minister Zweli Mkhize on Wednesday are operational, with a further five to be rolled out on Monday.

And the mobile laboratory unit that was on display at the launch is the only one that currently exists. That one can also not be deployed yet because the tests the GeneXpert machines on board can conduct have yet to be validated by authorities, with the tenders for the rapid tests also yet to be issued.

Plus, it will take several weeks before these 60 mobile units will be able to increase testing capacity to the envisaged 30 000 tests a day, despite Mkhize’s comments on Wednesday.

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The CEO of the National Health Laboratory Service (NHLS), Dr Kamy Chetty, told News24 on Thursday morning they hoped to have, in the coming weeks, 10 vans fully outfitted with the GeneXpert machines, and in total planned on 20 such vans.

The majority of the vans, however, will only be outfitted with the machines at a later stage.

The NHLS already has some GeneXpert machines ready to be installed in other vans as soon as the tests are validated, but envisaged some problems getting more machines imported from the US.

The 10 mobile units to be rolled out today and Monday will also not be able to conduct on-the-spot testing, but will be used to transport nurses to priority areas where they will screen patients and collect samples to be tested at a laboratory.

The sampling and screening units are equipped with a fridge that can store samples at temperatures up to minus 26 degrees Celsius. It also has some plastic folding tables and chairs, and will be fitted with a computer that can feed information on testing and screening back to the National Health Laboratory Service (NHLS) central database.

The samples collected will still need to be transported to one of 10 NHLS laboratories for testing, which have new machines that will significantly increase the capacity to test the higher number of samples collected.

“Today we came to unveil a number of mobile laboratory vans. The NHLS has procured 60 mobile vans in addition to the seven that were currently being used. It, therefore, brings us now to 67 mobile testing units - vehicles that are equipped as laboratories,” Mkhize said.


The view of the interior of one of the mobile testing units that will be used to conduct screening of patients, and collecting samples that will be tested at NHLS laboratories.  (Kyle Cowan, News24)

Only one unit has actually been outfitted as a mobile laboratory. It carries four GeneXpert machines, capable of testing four samples at a time in under 45 minutes.

But the tests kits – a small plastic cartridge containing a mix of ‘reagents’ that are mixed with a sample – have yet to be validated locally by the NHLS. The kits have been approved by the Federal Drug Agency in the US and are made by the same company that manufactures the GeneXpert machines, Cepheid, which is also based in the US.  

Mkhize did not clarify that the majority of the mobile units would, for now, not be able to conduct these PCR tests on site using the GeneXpert machines – they would still have to transport the samples after collecting them on site.

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PCR refers to “polymerase chain reaction” - a method of testing that ‘amplifies’ tiny amounts of DNA from, for example, a swab, to enable laboratory tests on the sample and it is the type of test the GeneXpert machines and existing machines in the labs conduct.

Chetty clarified that five mobile units, being outfitted with a computer, fridge for storing samples and other necessities, would be rolled out on Thursday, and five more on Monday. But these units would screen people and collect samples only.

It will be delivered as soon as the two companies branding the vehicles finish, Chetty said.  

Rapid testing

The mobile units would also at a later stage be used to deploy rapid testing as part of the screening process.

But the rapid testing would not be a magic solution, and full testing would still be needed to confirm whether a person has or had Covid-19, Chetty said.

The rapid tests are, however, subject to validation done by the South African Health Products Regulatory Authority, Chetty explained.

Only once this had been done would they be able to draw up the specifications and go out to tender for a large number of the rapid test kits.

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