CCL offers 500 Covid-19 tests a day for care homes in Cambridge region
A Milton-based laboratory is now offering Covid-19 testing for care homes in the Cambridge region.
Cambridge Clinical Laboratories (CCL) is part of a network of independent labs that has negotiated a deal with the Department of Health and Social Care to provide much-needed coronavirus tests.
CCL has the capacity to carry out 500 tests a day – and CEO Dr Tony Cooke hopes to expand that to 5,000 daily within a couple of months by taking on more staff.
The lab’s team have begun contacting care homes, which represent one of the key front lines in the battle against the virus, to offer their services.
It is something Dr Cooke would like to have done two months ago – but he was left frustrated by what he describes as a centralised approach adopted by public health bodies in the UK, which left many private labs under-utilised.
Having acted as the catalyst for the formation of the Covid-19 Volunteer Network of labs, CCL is now joining the fray.
“The network has negotiated a single contract for the supply of services to the NHS. It’s up to 30 labs,” Dr Cooke explains to the Cambridge Independent.
“We’ve got a service level agreement with the network to provide testing to fulfil the NHS contract. We’ve been approved by NHS Innovation to provide that service. We get paid per test by the Department of Health and Social Care.
“We are primarily going to focus on care homes over the next few months to give them a more sophisticated solution than the odd test for anyone who is symptomatic.
“We want to test everybody – the staff and the residents – on a regular basis to make sure they are safe places.
“We have one signed up already, with 82 residents and 85 staff, and we hope to start testing them this week.
“The homes we test, we want to do well. We hope to test every week. The results will be back within 24 hours of receipt of the sample in the lab, or 48 at the worst – not 10 days.”
But he stresses: “We are not providing private tests at this time – we will only work with healthcare professionals: GPs, nurses and occupational health nurses.”
The service will work with the logistical help of PH Cars, run by Phil Hacker and based at Hacker’s Farm in Dry Drayton.
“They will be our courier network, dropping off and picking up samples. We will focus to begin with on a 30-mile radius,” explains Dr Cooke.
The test offered is the antigen test that uses the PCR (polymerase chain reaction) technique to test for the presence of active infection.
Using the NHS protocol, the test kits require a healthcare professional to take a swab from the back of the throat and inside of the nose.
“Most big care homes have their own nurses, who will do this,” explains Dr Cooke. “For those care homes who do not have in-house nursing staff, we will have to make different arrangements through an occupational health company, like Cambridge-based Corazon Health, who we are talking to.
“The swab goes into a viral transport media, which is a tube with some liquid in the bottom that has a viral inactivator, so when you put the swab in, it kills the virus off but preserves its RNA so we can sample for it.”
This inactivation means it is safer to transport the samples and testing can be carried out in CCL’s category 2 facilities in Winship Road, rather than in category 3 labs that handle live viruses.
“What we want to try and do is ensure that nobody has got the virus and the care home staff aren’t bringing it in. We will test all residents and staff to begin with to get a baseline.
“If anybody does get ill, they can phone and say they need the test straight away, but hopefully we’ll be testing everybody on a weekly or two-weekly basis anyway.
“I think demand will outstrip what we can do, but our focus is quality of service.
“In the future we are looking at having more sophisticated systems – software that allows the person sampling to enter information so it is on our computer system by the time it arrives at the lab, so we can process them even quicker.”
In the meantime, CCL – formerly Lab 21 – will look to expand its team by employing more molecular and biomedical scientists.
“We are doing this through our own means, because the banks have given us minimal help,” adds Dr Cooke. “We have a £50,000 innovation loan from the government that we will use to buy the materials, as to start this off is expensive. We have some financial backing through our investors and the network is helping us to set up, so in spite of poor backing from the banks, we’ll achieve this.”
Covid-19 is, of course, a notifiable disease, so any positive tests are reported back to the health authorities.
The lab will use the Gensig test, from Prima Design in Southampton, which is approved by the World Health Organization, FDA and others, and is fully accurate providing samples are taken properly.
“We can measure down to two copies of the virus, so it’s very sensitive,” says Dr Cooke, who believes testing at care homes has varied considerably according to geography.
“Some care homes have been able to access tests if someone is symptomatic. But it’s extremely dependent on the locality in the country.
“It depends a lot on Public Health England and the resilience network locally to supply it to care homes, and I think it’s been patchy at best.
“What we can do is demonstrate best practice and hopefully other labs and suppliers can match that.”
Speed is a key consideration.
“There’s not much point if the test comes back in 10 days,” Dr Cooke points out. “Research is showing 30-40 per cent of people are asymptomatic. You could be walking into a care home and spreading it, with no idea you’ve got it.
“What the World Health Organization said at the start – test, test, test – is absolutely true. It’s the only way we get through this.
“The more people we test, the more we know where the virus is in the population and we can deal with this quicker.”
And if Dr Cooke had his way, his lab would have been offering these tests before the virus had reached its peak.
“We could have been offering this for two months,” he said. “They’ve brought into private labs and smaller labs right at the end.
“Germany went straight to a decentralised system, using as many labs as they could.
“My argument has always been that they should have looked on the UKAS register for the number of virology-accredited 15189 labs. There were 109 labs listed on there, and all of those could have been doing Covid-19 testing within 48 hours.
“I’m convinced that [health secretary] Matt Hancock’s challenges of 100,000 and 200,000 tests were to get people in gear. He was saying, ‘This is not good enough’. Eventually, they’ve realised they need to pull in more labs.
“Over the last month there has been a significant shift from the NHS, Public Health England and the Department of Health and Social Care – they have been far more accommodating than they have before.
“My belief is that it was not a government problem, it was a bureaucratic problem.”
But having finally been given the green light, the CCL team are now just pleased to be playing their part – and there’s more to come from the lab.