As the Government cautiously rolls out saliva testing at regional and international borders, the private sector has embraced the simple test as a way of keeping their businesses running and their staff safe. Jane Phare reports.
An increasing number of New Zealand companies are spending thousands of dollars to pay for private Covid-19 saliva testing as an extra check to make sure the virus has come nowhere near their workforce.
The private sector has been quick to adopt the Covid-19 test, less obtrusive than nasopharyngeal swabs, in the face of the Government's more cautious approach to the technology.
Saliva testing has been in place for border workers at airports and ports, and essential workers in MIQ for some time and this week has been extended to include permitted workers crossing Auckland's alert level 4 boundaries. But the Ministry of Health won't say when or if saliva testing will be available for the wider community.
Instead companies are contracting their own saliva testing providers, paying laboratories to test their workers' spit for traces of Covid-19.
Genesis Energy bosses nervously watched the borders open to Australia this year and figured a Delta leak was not a matter of if but when. They knew that if Covid-19 infected its Huntly Power Station team, New Zealand would face blackouts similar to those experienced shortly before the country's latest lockdown.
Genesis contracted Rako Science to train a dozen of its staff to do regular saliva testing on power station workers. Before last month's lockdown, 1300 samples had already been collected with a peak of 120 samples on the busiest day.
So imperative is it to keep Huntly running for the whole country that Genesis has set up rostered bubbles, workers are kept separate at shift changes, handover talks take place via video screens, and the control room has a dedicated cleaner.
Genesis Energy's chief operations officer Nigel Clark says Huntly is a critical part of New Zealand's energy network.
"It simply has to keep running, and the only people who can operate it are those who work there," he says. "Saliva testing gave us a level of assurance that our staff were healthy and the plant could remain operational."
As soon as lockdown happened, power station staff were able to swing into action, testing workers the morning before the next day's shift with results coming back from Rako's laboratory in Auckland the same afternoon. Workers were tested again once on site the next day. So far all results have been negative.
Rako co-founder and director Leon Grice says the company was first off the block with accredited private-sector testing in January, signing up Air New Zealand and Amazon Studios.
Other companies using Rako's saliva testing include Fisher & Paykel Healthcare, which produces medical equipment including much-needed respiratory machines, Mainfreight, Sisters of Mercy Hospice and aged-care facility Mercy Parklands, and a group of private hospitals and outpatient clinics, including radiology and oncology.
"We're testing patients the day before they present [at hospital] so they have a negative clearance result. And we're also testing staff inside the hospitals."
Grice won't be specific about the cost of saliva testing to the private sector but says the contract works on a sliding scale - very affordable when Covid-19 is not in the community but increasing when testing ramps up during an outbreak.
In recent months the Government has come under increasing pressure to acknowledge that saliva testing is as accurate as the more intrusive nasal testing and, compared with other countries, has been slow to embrace the method.
Employers and Manufacturers Association CEO Brett O'Riley says the Government should be encouraging businesses to do saliva testing on their staff.
"Why are we driving people to sit in a queue in a car for hours on end when they could actually be doing that testing at work, and that could just be a routine part of the health and safety regime for all businesses in New Zealand that have frontline interaction with people?"
Saliva testing unlikely to replace nasal swabs at testing stations
But it's unlikely that most of the workforce will be able to avoid the long queues and nasal swabs, which critics say deter some from getting a Covid-19 test, in the near future.
Darryl Carpenter, the ministry's group manager of Covid-19 immunisation, testing and supply, says nasopharyngeal swabs will continue to be used for diagnostic testing and is the preferred test in the event of a community outbreak.
"Diagnostic testing, rather than surveillance testing, is needed to confirm a positive Covid-19 test, and to enable genome sequencing of the positive case to be undertaken, which is a vital part of our response."
The ministry continues to review emerging testing methods, developments in science and in public health thinking, and changes in the virus, he says.
"Because we have had relatively low Covid-19 prevalence in New Zealand, the sensitivity of testing methods is important. By using testing with high sensitivity, we reduce the risk of missing a positive case."
Grice says Rako has offered "more than twice" to provide the ministry with the company's intellectual property and skills to public health laboratories.
"It [Rako's saliva test] is at least as accurate as nasalpharyngeal, and they haven't taken that up."
To date the Government has awarded the bulk of its saliva testing contracts to Asia Pacific Healthcare Group (APHG), sold by Australia's Healthscope last year to the NZ Super Fund and Ontario Teachers' Pension Plan Board for more than $550 million.
Last week NZ First leader and former deputy prime minister Winston Peters accused the Government of favouring APHG over Rako with a contract worth up to $60m because of the NZ Super Fund ownership. He further claimed APHG's testing accreditation did not match Rako's.
APHG added fuel to the fire by saying Rako did not have a laboratory - Rako contracts IANZ-accredited medical laboratory IGENZ for its saliva testing - and hitting back at Kiwi research scientist, Dr Anne Wyllie, currently at Yale School of Public Health, after she criticised APHG's diagnostic accreditation.
This week neither company wanted to talk about the spat. Grice says his company is concentrating on expanding its private-sector business, including the food industry and food exporters, and is "in discussions" with the ministry over becoming a saliva-testing provider.
Late last week APHG found itself scrambling to gear up quickly after the Government gave it just a few hours warning that its contract had been extended to include saliva testing for permitted workers crossing Auckland's borders.
Trevor English, APHG's head of strategic business development, says the company needed to quickly obtain large quantities of testing tubes for big companies like Mainfreight and Fonterra. The company has 150 collection points and a network of 200 couriers throughout the country to deliver samples to the labs. The first permitted-worker saliva samples arrived at APHG's labs on Monday.
As the Government increasingly rolls out saliva testing, critics are casting doubts on the efficacy of the do-it-yourself, drop-off system. Currently, permitted workers download a smartphone app and scan their saliva-tube barcodes. They drool into the tube under specific conditions, cap the tube, scan it again and drop it into a collection container.
Critics say that samples collected without trained staff overseeing the process will result in a percentage of failed tests. And they're concerned that a person's ID will not be checked at drop-off points.
English agrees a degree of honesty is needed to make the system work but points out that in most cases employers will be overseeing testing, and that in the case of Covid-19 most workers will have an incentive to look after themselves and their co-workers. The concept of the saliva test is relatively simple, he says.
"And we have quite good instructions and videos on the website (APHG)."
APHG recently processed a record 25,000 tests in one day through its network and is gearing up if it needs to increase its capacity across its network of more than 25 labs, he says. The company has recently invested around $2 million in four high-volume German analyser machines for Auckland, Wellington, Christchurch and Dunedin.
Grice would like to see saliva testing used as a rapid response if there is an isolated outbreak in a community because of the ability for very early detection. He points to saliva testing by the University of Illinois' laboratories, which have done 2.28 million tests on a 46,000-person campus population since July 2020. Out of 6600 positive cases, an estimated 85 per cent were identified through the saliva test before they became infectious.
"You need to be able to break the chains of transmission through early detection. And there's something that rapid antigen tests and slow testing operations don't do."