The Lancet: High COVID-19 testing rate in Portugal
A sense of civic duty and mutual confidence between scientists and health authorities played a role in Portugal high testing rates. Marcia Triunfol reports.
What do a flight attendant, an algebra professor, a 21-year-old man dreaming to be a pilot, and a scientist working with malaria have in common? They have joined the volunteers task force created in Portugal at the beginning of the COVID-19 outbreak to increase the country's capacity to do RT-PCR tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On March 2, the country testing capacity was around 1500 tests per day. According to Maria Mota, a malaria researcher and the executive director of Instituto de Medicina Molecular (IMM), which is part of the Lisbon University, this scenario would soon change. “I saw Graça Freitas, the director of the Directorate-General of Health, on TV talking about the country limited capacity to test people and then I thought…wait a minute, it is just a PCR!”.
On the same night Maria Mota sent an email to the Ministry of Health stating that her institute had capacity to do the tests. A few minutes later she got a call back. “From this first contact to actually starting testing patients' samples for COVID-19 took only a couple of days”, recalls Mota.
On Mar 13, two researchers from IMM, Vanessa Zuzarte Luis and Miguel Prudêncio, plus Judite Costa, a lab manager, met with doctors at Santa Maria Hospital, the University Hospital of Lisbon University, who suddenly had an overwhelming demand for COVID-19 tests. “Initially we would help with RNA extraction only, but we soon realised that the help they needed was way beyond that”, says Zuzarte Luís. The group created the PCR protocol based on that of the US Centers for Disease Control and Prevention, designed primers and probes in-house using reagents available in Portugal, had the protocol validated by Instituto Ricardo Jorge, a reference state-owned laboratory in the country and the first to do the test, and set up a testing pipeline for COVID-19, all in a matter of days. Portugal has done more than 900 000 tests since March, the beginning of the outbreak, and according to the site Our World in Data, it is among the ten countries doing the highest number of daily tests per thousand individuals (85·7 tests per thousand people as of Jun 2). Of the 91 labs in the country currently testing for COVID-19, 25 are in universities and scientific centres.
“It was clear that this fight would require many people”, declared José Matos, president of Ordem dos Biólogos, a professional association for biologists and other related areas. Knowing that research labs were in lockdown, early on the association sent out a request to all its associates, hoping to recruit volunteers that could operate the many idle PCR machines and do other tasks as needed. In 24 hours, 2300 people had replied. “I was moved when I saw how many people were willing to collaborate!”, confessed Matos.
At the COVID Testing Centre (CTC) at Lisbon University, the group of volunteers included individuals like Ana Caetano, a flight attendant now in lay-off who previously had worked in a lab for more than 10 years. “I worked all my life and didn't want to stay home for months waiting for this to end. Having to leave home everyday to coordinate one of the stations in the PCR pipeline was what kept me going.” Tiago Rosa, a 21-year-old man studying to be a pilot, also heard the call. “I could have stayed home playing video-games, but I wanted to help instead.” Rosa has been responsible for creating bar codes for testing tubes and for implementing management programmes to improve CTC's capacity. For Maria João Gouveia, an algebra professor at Lisbon University, joining the group was a matter of civic duty. “They needed someone with mathematical thought to organise the information related to the materials used, orders, stocks, invoices and that has been my contribution.” According to Ricardo Dias, the CTC coordinator, the initiative recruited 300 volunteers, many through the call sent by Ordem dos Biólogos. Volunteers work 4 hours per day doing around 400 PCR tests daily. “We built a centre from scratch and our goal is to have a resilient structure that can rapidly provide answers to society in emergencies like this”. In the north of Portugal, at University of Porto's i3S scientific institute, more than 150 volunteers have been doing around 350 tests everyday.
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My university has been running a testing centre as well.
The UK could so, so easily have done something like this, and it would have fit perfectly with the all-mucking-in-together spirit-of-the-Blitz keep-calm-and-carry-on shtick Johnson has been trying to push (when he hasn't been gasping for breath in an ICU due to his own fecklessness).