An inside look at how Nova Scotia tests for COVID-19

As coronavirus cases continue to climb in Nova Scotia, front-line workers across the province are gearing up and are well prepared.

That includes staff at the province’s main testing laboratory.

The microbiology lab on the third floor of the QEII Health Centre’s Mackenzie Building may be small, but its job is massive and seemingly never-ending.

“It’s busy, it’s constant,” chuckles the lab’s manager Charles Heinstein.

“I think I’ve said this before; it never stops.”

The team at the lab process all of the COVID-19 tests from mainland Nova Scotia, as a lab at the Cape Breton Regional Hospital, handles samples from that part of the province.

Right now, the QEII lab is receiving and processing between 1,000 and 1,500 samples per day, but with current infrastructure, it can handle up to 2,500 a day.

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“So we’re in an enviable position compared to a lot of jurisdictions in Canada,” Heinstein tells Global News.

“As I mentioned, we’re about 1,500 tests per day coming in, so we have a bit of room to grow in terms of capacity. That being said, we’re still not just taking that for granted, and we’re actively looking at ways to improve and increase capacity.”

Streamlined process

When a sample first arrives at the lab, a medical lab assistant will process it, checking for overall quality and data integrity. Once that’s complete, it’s entered into the lab’s information system, labelled and then “poured off” to be sent upstairs for testing.

A sample being tested for COVID-19 at Nova Scotia’s microbiology lab at the QEII hospital

A sample being tested for COVID-19 at Nova Scotia’s microbiology lab at the QEII hospital

Ashley Field/Global News

“Once the samples are on the fourth floor, the technologists create runs. The runs are then placed on extractors. The extractors process the samples and remove the nucleic materials that are required to identify the COVID-19 virus,” says Heinstein.

The final step includes putting it through a Thermocycler machine, which raises and lowers the temperature of the sample, replicating the virus to determine whether the sample is positive or negative for COVID-19.

“A typical sample will probably go through at least three to four people before it’s resulted,” Heinstein says.

“We’ve got a number of different systems we test on, so our more automated analyzers, would be fewer people, so maybe only two people in that process, but generally speaking I would say most samples are three to four people.”




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Staffing

Tests are being processed 24 hours a day, seven days a week, and Heinstein applauds his staff for rising to the occasion.

“They’ve worked through overtime shifts, extra shifts, a lot of different staffing scenarios, so certainly they’ve been great — starting to be a bit fatigued now as we hit that second wave and the demands are increasing again,” he says.

“Everyone has a home life. We try to balance that off, but obviously it’s very difficult in these times.”

Making matters worse, there’s a shortage of medical lab technologists, according to Heinstein, which has made recruiting difficult.

“So we’ve really focused our efforts on other areas where we can help support, which is in clerical staff, registration clerks, and medical lab assistants. If we can kind of balance out with their classifications then it helps everyone overall to have a larger pool of staff to help in different areas,” he says.

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And as the number of COVID-19 cases climb in Nova Scotia, Heinstein says he and his team are prepared.

“We haven’t stopped since early in the pandemic, and we won’t stop until the levels go down and there’s a vaccination.”

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