Laboratory medicine has pit crews and no cowboys

May 9, 2020 0 By FM

The success of laboratories rests on the shoulders of its trained manpower. The ongoing lockdown has affected teams at a humanitarian level. Young technologists braved the fear of contagion to volunteer to be on COVID-19 testing teams. We required teams to work in shifts so that if anyone in one shift was affected by the virus, the backup shifts continued to do testing. 

Some of the laboratories are testing over 400 samples a day, working in multiple shifts. On certain occasions, some personnel have to turn up for two shifts in a day. 

Containment zones declared at the end of lockdown 1 played havoc with our team composition, because any personnel residing in these zones were not allowed to move out. 

New teams had to be trained. Requests to release essential services personnel from these areas have not been addressed. Some data entry teams are working from remote locations. 

All I can say is that I have come across awe-inspiring, dedicated professionals who have kept laboratories running day and night through the pandemic response. People who have worked with RT-PCR will tell you that this technology was never meant to function on this scale and speed. But it is functioning! An average run can take anywhere from 5 to 6 hours (2.5 hours for sample extraction and another 2 -3 hours of PCR run). 

As samples keep increasing, the turnaround times for tests keep increasing. Angry ICU teams and the pressure from civil/health administrations put our testing teams under extreme stress and anxiety.

Laboratory medicine has a complex team involved in COVID testing. Clinical virologists are rare in our country. Clinical microbiologists are holding the fort in most laboratories. Molecular biologists are assets you will have by your side in this battle if you were wise enough to invest in them during the non-pandemic period. 

The laboratory technologists who are quietly running the tests are the ones I am thankful for every single day. Atul Gawande’s famous words that healthcare needs pit crews and not cowboys hold good in laboratories too. Laboratory medicine has pit crews and hardly any cowboys. Perhaps that is why you hear less about these pit crews, because they are busy helping frontline clinical workers make vital decisions based on their reports. 

Sample collection and processing does expose the laboratory teams to the virus. But laboratories function in a controlled environment where meticulous attention to donning and doffing of PPE is given.

Since the virus is invisible, the laboratory is your eyes and ears in this pandemic. That is an extremely inspiring idea that has kept laboratory personnel in the COVID labs motivated. We are responsible for the safety of our teams. Our housekeeping staff is trained in biomedical waste management and PPE is mandatory for them too. However, we realize the anxiety that they go through too. For everybody who is helping the laboratories function in this pandemic, I have nothing but deep gratitude!   

The author is Consultant Microbiologist at Core Diagnostics, Gurgaon.
Her views are personal