DILI, 9 May 2020 (TATOLI) – Dili’s National Health Laboratory has begun reporting test results for coronavirus independently for this first time, without the need for “verification” at a secondary site.
The NHL has partnered with Australian’s Menzies School of Health Research since the beginning of the outbreak to run the “complex” tests locally, but then sending samples to the Royal Darwin Hospital to be checked.
But Josh Francis, Menzies’ Timor-Leste project lead, said since the beginning of this week, the laboratory has become self-sufficient.
“It’s a massive feat,” he told TATOLI by phone. “I think it’s a real credit to the guys working at the lab.”
“It’s not a straightforward test to be able to put into a laboratory, it’s quite complex… And it’s so crucial to get it right, too, there’s obviously a lot at stake. I feel very proud of the national laboratory for what they’ve achieved with that,” he said.
Dr Francis said similar developing countries “with limited diagnostic capabilities” are facing an enormous challenge with COVID-19. Many Pacific countries without in-country testing capacity have also had to send specimens to Australia for results.
The laboratory is now processing 40 to 50 samples per day, compared with just 10 to 12 during the beginning of the outbreak. Dr Francis said a “small number” of samples would continue being flown to Darwin for “ongoing validation”.
“But we’re very comfortable with the results that the laboratory is producing here. It’s great to have the process happening locally here, it speeds up the turn-around time. And I think it’s a really crucial part of the country’s response to coronavirus,” he said.
Related news: Timor to Close Borders to All Arrivals from Monday
Dr Francis, a paediatric infectious diseases expert, said Timor-Leste’s “extraordinary” early response to COVID-19 means the country is well placed to cope with the outbreak.
“Some of the work that’s happened in terms of restricting entry into the country, using quarantine effectively, testing widely and being able to do good contact tracing… has, I think, put Timor in a really strong position at this stage,” Dr Francis said.
“The response has been extraordinary, initially.”
Australian government support
Following the World Health Organisation’s donation of primers and probes to initiate testing, and support to ship the swab samples to Darwin, Australia’s Department of Foreign Affairs and Trade (DFAT) has also played a key role in Timor-Leste’s fight against the highly-infectious virus.
Related news: Work Begins on Extension to National Laboratory in Dili
A spokeswoman from the Australian Embassy in Dili told TATOLI funding for Menzies to develop in-country testing came from the country’s existing development assistance program, worth around AUD$100 million (US$62 million) in 2019-20.
However she added that DFAT has allocated a further AUD$10 million to help Timor-Leste respond to COVID-19.
“We are discussing implementation with the Timor-Leste Government. A large component of that additional amount will go towards supporting community resilience and economic recovery,” she said.
For a rundown of international support for Timor-Leste to deal with COVID-19, read here: Covid-19: The World Sends Support to Timor to Tackle Virus
Other areas of assistance will include food security, further support for the health sector, and humanitarian response, the spokeswoman said. Some AUD$500,000 has already been allocated to NGO Maluk Timor, which has provided critical COVID-19 training to more than 1,000 local health workers.
Australian funding for an extension of the NHL, where a concrete slab was poured yesterday, amounts to around A$380,000 (USD $234,000), on top of existing support from the UK’s Fleming Fund.
Expatriates step up to support laboratory
Dr Josh Francis said has been travelling back and forth from Darwin to Dili for the last seven years with Menzies. But this year has been unlike any other.
Under Timor-Leste’s state of emergency, which began on March 29, the borders have been sealed off to arrivals from all countries, including Timorese citizens.
“The travel restrictions are significant. A number of our Australian staff have had to travel back to Australia and are working from home… supporting the work here, which has been really crucial,” he said.
There are more than 20 Timorese staff working at the laboratory, he said, and they have been boosted by an intensive care nurse who arrived from Australia yesterday.
Dr Francis said other staff have travelled across the globe, leaving their regular jobs and lives to help Timor tackle the crisis.
Former NHL executive director Ismael Barreto had been studying a masters at the London School of Economics, Dr Francis said. But he’s re-joined the team during the COVID-19 crisis.
Nevio Sarmento, a student of Josh’s in Darwin studying childhood pneumonia and malnutrition, has also returned to Dili.
“He’s come back across, paused his Phd, and returned to be integrally involved in the lab as well,” Dr Francis said.
The Australian government also reportedly repatriated nine Timorese doctors from Fiji to bolster local health services.
Scaling up with “sentinel surveillance”
The World Health Organisation provided Timor-Leste with an initial supply of in-demand PCR COVID-19 testing kits. The Ministry of Health said as of Friday, 830 of those kits have been used, with 692 returning negative results, 24 positive and 117 pending.
Now, Menzies has donated 2,500 kits as the Ministry steps up testing for the virus.
Dr Francis said the “sentinel surveillance” is a logical progression from testing people in quarantine who’ve returned from overseas.
“The next step really is to try and expand the testing strategy to say: ‘Can we go looking for and finding cases that are already within the community?’ Obviously, that’s a really important question,” he said.
That will involve testing people with symptoms consistent with COVID-19, but no history of contact with a known case, or overseas travel. (There have been no cases of such “community transmission” registered so far.)
Dr Francis said the next stage – including efforts to further localise testing in the municipalities – is critical, especially as some countries have experienced a spike in cases after initially having the outbreak under control.
“I’m very convinced that [Timor] needs more testing, but that’s part of the strategy that’s ongoing at the moment: to scale up the testing,” he said.
“Timor, for its size, for its health system capacity, I think it’s a really good start,” he said.
Reporter: Robert Baird