Covid-19 and the medical laboratory sector: Effects, Challenges and prospects

By Johnson D. Delia

Everyone seems to be aware of the deadly coronavirus disease also known as COVID-19 which has spread throughout the world resulting in an increasing number of fatalities and an ongoing pandemic.

What is the place of the medical laboratory scientist in combatting this deadly disease?

Of what effect, challenge and prospect of the Coronavirus could be associated with the medical laboratory sector?

Corona Virus is an infectious disease caused by severe acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, the capital of China’s Hubei province and has since spread globally resulting in a pandemic.

A Medical Laboratory or a Clinical Laboratory is a laboratory where clinical-pathological tests are carried out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment and prevention of diseases. It comprises of various Diagnostic departments such as Histopathology, Clinical Microbiology, Hematology, Virology, serology, chemical pathology, Toxicology etc.

A Medical Laboratory Scientist is a trained healthcare professional who performs chemical, haematological, virological, histopathological, Microscopic and bacteriological diagnostic analysis on biological specimens, such as blood, urine, sputum, stool, cerebrospinal fluid, peritoneal fluid, pericardial fluid, semen, aspirates, ascitic fluids, etc, to aid diagnosis and treatments.

It is safe to say, therefore, that a Medical Laboratory Scientist is trained to work in a viral laboratory, isolate viruses, develop vaccines and play a major role in the diagnosis, treatment and prevention of viral diseases. However, this function is greatly impaired due to the cumbersome challenges faced by the medical laboratory sector which has affected its effectiveness and role which it should play in the eradication of this deadly viral disease - Coronavirus.

Challenges of the Medical Laboratory Sector

The medical laboratory sector faces a number of significant challenges being a direct consequence of the global pandemic.

The challenges include inadequate training of Medical Lab Scientist.

In Nigeria, virology ( which is the study of viruses and its pathology in plain terms) is not studied in depth (compared to the other branches of the medical lab unit) in most tertiary institutions across Nigeria.

This has made the medical laboratory sector handicapped, as well trained and licensed scientist after undergoing a 5-year Bmls (Bachelor in medical laboratory science) program and an additional year of internship are equipped and knowledgeable in the other aspects of laboratory medicine but less proficient or in worst cases, completely ignorant of Virology due to this major challenge faced.

The few who are knowledgeable in Virology are those who had to specialize in the study of Virology and viral related course at MSc(master of science) level, and even at that, their knowledge of the course is quite insufficient to compete with their counterparts (fellow medical lab scientist around the world).
They are also not sufficiently trained in 21st-century lab diagnostic method such as molecular biology /biotechnology of which the knowledge of these methods is greatly applied in viral diagnosis.

This is largely attributed to factors such as:

Limited numbers of tertiary institutions in Nigeria offering this course.
The cost of procurements of equipment for a laboratory test and students practicals are expensive.
Only a few numbers of lecturers/professors who could lecture this course due to the aforementioned reasons, and
The presence of non-functioning equipment, or in some cases, its complete absence in the few Virology labs available.

Furthermore, another major challenge faced by the medical laboratory sector is:

Failure of the government and hospital administrators in recognizing the role of medical laboratory scientist in the health sector, which accounts for unequipped viral laboratories, and insufficient funding and support from Laboratory councils and Health ministries.
Due to the increasing Use of Rapid diagnostic test kits (RDTs) in the diagnosis of most viral disease, the Virology unit of the medical laboratory sector has been abandoned and left unattended to.

Although this method has proven to be 60-75% effective in viral diagnosis, it has equally proven to be greatly disadvantaged and limited as it cannot be employed in cell culturing, advanced viral laboratory procedures such as the production of testing kits and subsequent vaccines to the deadly coronavirus disease.

The provision and use of personal protective by medical laboratory scientist, and bankruptcy of the knowledge on how to observe biosafety measures also poses a major challenge, as adequate attention is not given to this aspect.
Sadly many scientists are faced with the challenge of attending to potentially exposed and/or infected individuals and highly infected specimens or samples without the use of personal protective equipment. This poses a risk for the scientist and scares many away from the field of Virology being a delicate area in laboratory Medicine.

Effects of the Corona virus on the Medical Laboratory Sector

The effect of the coronavirus pandemic and the lockdown it triggered is clearly visible in the medical laboratory sector. The health care sector is at the epicentre of the unprecedented global pandemic challenge especially the medical labs.

These effects includes:

dwindling economy: this has affected every sector of the world including the medical labs leading to unpaid or under-paid staffs, ineffective running of the laboratories etc,
there are more reduced numbers of test samples being sent or received in the laboratories as many individuals due to fear of going to hospitals or health care centres resort to self medications and homemade treatments depending on when the lockdown would be lifted or rather when the pandemic would be over.
The medical laboratory sectors have also sadly been relegated to the background which limits their ability to operate in their full capacity and provide an effective solution against the virus.

There are a good number of promising prospects in the medical laboratory sector with regards to its role to be played in the eradication of the Viral Disease. This includes the roles of the administrative arm of the health sector in the formulation and implementation of policies to ensure proper runnings of the laboratories. Seminars, Training and expository workshops should be organized for scientists to impart adequate knowledge and skills needed in the field of viral laboratory diagnosis, vaccine productions and treatments.

A scientist should also be trained in complex diagnostic fields such as immunology, immunochemistry, molecular biology and biotechnology, therefore, paving the pathway for positive prospects in the laboratory sector in relation to the pandemic and otherwise hence increasing the chances of recognition of the medical laboratory scientist playing a major role in diagnosis and in the society.

Whereas the proper equipping and training of scientist to allow for maximum performance in the field of Virology cannot be overemphasized, it is equally imperative for the Government and private health organizations to build more infrastructures across the country and equip them with “functioning” instruments and machines which would serve as standard Virology labs and also incorporate them into the curriculum for routine clinical laboratory postings at undergraduate levels.

Cardinal measures should be put in place to safeguard the environment and humans, secure viruses cultured and grown in the laboratory from biotheft, provide adequate personal protective and implement safety rules and regulations.

Prospects

These prospects would be made feasible by the roles played by the administrative arm of every health care (federal, state n private institutions) in the formulation and implementation of policies to ensure proper equipping and management of clinical laboratories.

Training, seminars, conferences, and expository workshops, if timely and properly organized for scientists, would impact adequate knowledge and the needed skills in viral disease diagnosis, vaccine production, and alternative treatment measures. However, the emergence and continuous progress of molecular diagnostic techniques, biotechnology and bioinformatics, in Nigeria is a pathway for good prospects in the Medical lab sector, in relation to tackling the ongoing global health pandemic. This will increase the recognition of the role played by Medical lab scientists in diagnosis and management in the health sector in particular and society at large.

Johnson D. Delia is a 500 level student of Medical laboratory science, University of Calabar