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Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report

Early in the course of the coronavirus infection disease 2019 (COVID-19) pandemic in South Africa, the Department of Health implemented a policy of community screening and testing (CST). This was based on a community-orientated primary care approach and was a key strategy in limiting the spread of t...

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Autores principales: Porter, James D., Mash, Robert, Preiser, Wolfgang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564763/
https://www.ncbi.nlm.nih.gov/pubmed/33054266
http://dx.doi.org/10.4102/phcfm.v12i1.2624
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author Porter, James D.
Mash, Robert
Preiser, Wolfgang
author_facet Porter, James D.
Mash, Robert
Preiser, Wolfgang
author_sort Porter, James D.
collection PubMed
description Early in the course of the coronavirus infection disease 2019 (COVID-19) pandemic in South Africa, the Department of Health implemented a policy of community screening and testing (CST). This was based on a community-orientated primary care approach and was a key strategy in limiting the spread of the pandemic, but it struggled with long turnaround times (TATs) for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction test. The local experience at Symphony Way Community Day Centre (Delft, Cape Town), highlighted these challenges. The first positive tests had a median TAT of 4.5 days, peaking at 29 days in mid-May 2020. Issues that contributed to long TATs were unavailability of viral transport medium, sample delivery and storage difficulties, staffing problems, scarcity of testing supplies and other samples prioritised over CST samples. At Symphony Way, many patients who tested COVID-19 positive had abandoned their self-isolation because of the delay in results. Employers were unhappy with prolonged sick leave whilst waiting for results and patients were concerned about not getting paid or job loss. The CST policy relies on a rapid TAT to be successful. Once the TAT is delayed, the process of contacting patients, and tracing and quarantining contacts becomes ineffective. With hindsight, other countries’ difficulties in upscaling testing should have served as warning. Community screening and testing was scaled back from 18 May 2020, and testing policy was changed to only include high-risk patients from 29 May 2020. The delayed TATs meant that the CST policy had no beneficial impact at local level.
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spelling pubmed-75647632020-10-22 Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report Porter, James D. Mash, Robert Preiser, Wolfgang Afr J Prim Health Care Fam Med Short Report Early in the course of the coronavirus infection disease 2019 (COVID-19) pandemic in South Africa, the Department of Health implemented a policy of community screening and testing (CST). This was based on a community-orientated primary care approach and was a key strategy in limiting the spread of the pandemic, but it struggled with long turnaround times (TATs) for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction test. The local experience at Symphony Way Community Day Centre (Delft, Cape Town), highlighted these challenges. The first positive tests had a median TAT of 4.5 days, peaking at 29 days in mid-May 2020. Issues that contributed to long TATs were unavailability of viral transport medium, sample delivery and storage difficulties, staffing problems, scarcity of testing supplies and other samples prioritised over CST samples. At Symphony Way, many patients who tested COVID-19 positive had abandoned their self-isolation because of the delay in results. Employers were unhappy with prolonged sick leave whilst waiting for results and patients were concerned about not getting paid or job loss. The CST policy relies on a rapid TAT to be successful. Once the TAT is delayed, the process of contacting patients, and tracing and quarantining contacts becomes ineffective. With hindsight, other countries’ difficulties in upscaling testing should have served as warning. Community screening and testing was scaled back from 18 May 2020, and testing policy was changed to only include high-risk patients from 29 May 2020. The delayed TATs meant that the CST policy had no beneficial impact at local level. AOSIS 2020-10-02 /pmc/articles/PMC7564763/ /pubmed/33054266 http://dx.doi.org/10.4102/phcfm.v12i1.2624 Text en © 2020. The Authors https://creativecommons.org/licenses/by/4.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Short Report
Porter, James D.
Mash, Robert
Preiser, Wolfgang
Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title_full Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title_fullStr Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title_full_unstemmed Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title_short Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
title_sort turnaround times – the achilles’ heel of community screening and testing in cape town, south africa: a short report
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564763/
https://www.ncbi.nlm.nih.gov/pubmed/33054266
http://dx.doi.org/10.4102/phcfm.v12i1.2624
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