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Novel collaborative approach among public and private sectors

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For streamlined SARS-CoV-2 testing towards optimised patient outcomes.

The SARS-CoV-2 pandemic is a global challenge and threat to the healthcare system and economy of all countries. Early in the pandemic, the limited supply chain of PCR reagents and extraction kits was a global challenge. However, the Pathology department at the DHA has taken the lead to engage the private laboratories for increasing testing capacity, and boost access to COVID-19 testing to public as well and facilitate mass screening programmes. The competition between private and public laboratories had disappeared and the testing price became lower. It had allowed increased access to COVID-19 testing via mass screening.

The objective of the partnership with private laboratories is to provide the Dubai community with accurate COVID-19 testing with high capacity and timely reporting within 24-48 hours of the PCR test. Timely reporting was crucial in quick tracing and isolation of infected patients and consequently, reducing transmission of the virus and reducing mortality. In addition, providing rapid PCR within two hours at all Emergency departments of all hospitals had a great impact on early triage of patients. Both routine PCR and rapid PCR had reduced the transmission of the virus, hospitalisation rate and mortality rate. The pathology department at DHA also had a crucial role in improving quality of testing, regulating private laboratories with DHA rigorous testing guidelines, mandating 24 hours turnaround time, inspection visits and mandating monthly interlaboratory comparison programmes among all private laboratories. Integrating PCR machines with Lab Information System (LIS) and interfacing LIS with Dubai’s Public Health software was very robust in making tracing and isolation of infected people and their contacts an efficient platform to fight the pandemic.

The strategy adopted by the Pathology department in increasing testing capacity by the engaging private sector, governance, timely reporting to public health had a drastic impact in reducing the infection rate, hospital admission rate, and mortality rate in the community.

Engaging private laboratories with public laboratories removed the barriers and competitive edge. It facilitated the collaboration, resource utilisation, and operational efficiency to boost DHA’s management in fighting the pandemic.

It also helped DHA in increasing testing capacity with fast turnaround time (TAT) and improving the quality of testing of private laboratories.

In addition, it allowed mass screening and national screening programme, consequently; rate of infection, rate of transmission, admission rate and fatality rate were reduced drastically. Providing testing for patients and other people in mass screening or screening hot spots requires fast TAT to isolate infected people promptly away from clusters in labour camps and work groups. This is a very important tactic used among testing, tracing and isolation strategy in fighting pandemics. It allows the government to relax public health measures and take decisions in re-opening the economy.

Unnecessary hospital admissions create a burden to the healthcare system. COVID-19 testing in a timely manner at the Emergency Departments of four DHA hospitals helped greatly in triaging positive COVID-19 patients promptly and reduced admission cost.

Following international statistics of COVID-19 cases in UAE compared with other countries, high-capacity testing within 24 hours by engaging private laboratories had enabled DHA and the Dubai community to trace and isolate infected people promptly. This strategy had reduced infection rate, admission rate and mortality rate. Patients in Dubai felt safe to access hospitals for elective procedures earlier than other countries as many hospitals declared that they are COVID-19 free hospitals.

Patients with other diseases were not hesitant or fearful to access hospitals early for clinical care, and this reduced complications of avoiding healthcare services. Hospitals had resumed provision of ordinary healthcare services and had sustainable financial income from providing the services.

The pathology department at the DHA established PCR guidelines of SARS-CoV2 testing along with Health Regulation sector. Consequently, COVID-19 testing was standardised among private laboratories to have consistency and reduced variations. DHA laboratory monitors private laboratories for TAT, capacity and percentage of presumptive positive.

Engagement of private laboratories with DHA had optimised shared resources regarding skills to set up PCR laboratories, logistics, LIS integration, sample transport and shared big data of all COVID-19 test results in Dubai.

Declaration of COVID-19 free hospitals had encouraged patients to access COVID-19 free hospitals for other treatment and clinical care. This had resumed the hospital financial income from outpatient visits, operations, and in patient services. The continuous financial income to hospitals and medical centres-maintained cash flow and sustainability.

Also, jobs are secured for healthcare workers, healthcare providers, as well as insurance (people resumed purchasing insurance policies and access hospitals.

Key performance indicators:

  • 94.6 per cent of clinicians at DHA are confident that reporting of SARS-CoV2 Test results by RT-PCR was in less than 24 hrs.
  • 90.3 per cent of private laboratories in Dubai were satisfied about the governance of DHA on SARS-CoV2 testing by rigorous guidelines for SARS-CoV2 testing, continuous inspections and interlaboratory comparison programmes conducted by Pathology department in order to improve quality of SARS-CoV2 Testing
  • 91.3 per cent of clinicians strongly supported the fact that the DHA role in COVID-19 testing had a big impact on the safe return and restarting of elective and routine procedures.

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Dr Rana Nabulsi

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

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