The onset of the COVID-19 pandemic in South Africa (SA), [1] as in Europe and North America, created numerous supply challenges, including testing for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR). Demand for diagnostic testing overwhelmed the capacity to deliver, leading to several innovative solutions. [2] Pooled testing was found to be an efficient and costeffective solution to the large numbers of requested tests, and the US Centers for Disease Control and Prevention released guidelines for laboratories. [3,4] Point-of-care (PoC) testing was suggested as another possible solution to help overcome the capacity issues faced by laboratories. [5] In our own experience at Chris Hani Baragwanath Academic Hospital, Johannesburg, obtaining COVID-19 results from the hospital laboratory meant a waiting period of 7 -14 days owing to a lack of onsite COVID-19 PCR testing. All emergency admissions were allocated to the COVID or non-COVID stream. Given the sheer size of our hospital (>2 800 beds), even a 24-hour turnaround time was not practically acceptable in terms of safety of both patients and staff. At that early phase of the first wave of the pandemic, rapid, accurate PoC PCR testing and antigen testing were not yet available. [6] Viral cultures are known to be time consuming, and the gold standard for the diagnosis of COVID-19 is RT-PCR, which detects SARS-CoV-2 RNA in clinical specimens. [7,8] The university Vaccine and Infectious Disease Analytics Research Unit based at the hospital had initiated a surveillance study using PCR to test symptomatic COVID-19 patients at the hospital. However, COVID-19 may have a variable clinical presentation, with a significant proportion of patients being asymptomatic. [9] To safely triage patients with non-COVID presentations, including trauma, acute surgical, obstetric, medical, paediatric and other emergencies, the intensive care unit (ICU) medical staff, with the assistance of a non-governmental organisation and the Perinatal HIV Research Unit (PHRU), established a mobile PCR laboratory and positioned it centrally in the hospital.We describe the utility and outcomes of this PCR laboratory established in a mobile trailer by non-laboratory healthcare workers.
ObjectivesTo describe the utility and outcomes of the PCR laboratory, estab lished in a mobile trailer and staffed by non-laboratory healthcare workers. The primary objective was to determine the clinical sensitivity, specificity, and positive and negative predictive values of the COVID-19 PCR assay used for patients requiring emergency hospital resources, and the secondary objective to determine the prevalence of COVID-19 infections among patients admitted to and medical staff working in the non-COVID ICU during the study period.
