When 60-year-old Nafisa Begum was brought to Lyari General Hospital, Karachi, on June 3 after her oxygen saturation dropped below 90 percent, she was admitted to a Covid-19 treatment ward as a suspected virus patient, exhibiting all classical symptoms of the viral disease. Even after her death five days later, she was still a suspected Covid-19 patient as the public lab where her sample had been sent for testing was unable to test it and issue a report due to a backlog of thousands of samples.

“My mother had all the symptoms of Covid-19; she had fever, cough and developed shortness of breath but most of the public and private hospitals refused to admit her arguing that they were packed to capacity with Covid-19 patients. When we managed to find a hospital with a vacant bed, they asked us to get her tested for Covid-19 first. But when she was admitted to a Covid-19 treatment ward as a suspected patient, they did not treat her as her Covid status was not known,” says Ahmed Ali, Nafisa Begum’s son. Ali blames the health authorities for lack of adequate testing facilities in Karachi, the largest city of Pakistan and a hub of coronavirus infections in the country.

Ali says he had managed to arrange a plasma donor for transfusion to her mother but the treating physician said without knowing the patient’s Covid status she could not be given the plasma. “The delay in testing deprived my mother of treatment, and she lost her life,” laments Ahmed.

22-year-old Laiba, is an expecting mother from Saddar, Karachi. After developing symptoms, Laiba got herself tested from Dr Ruth KM Pfau Civil Hospital, Karachi (CHK) on June 5. But when she inquired about her test result five days later, on June 10, she was told that the lab had lost her sample and they would be unable to give her a test report. “When I told them that I could give another sample, they said they were not accepting more samples as they had a backlog of thousands of samples which were yet to be tested.”

This scribe approached several public and private labs in Karachi to get himself tested for Covid-19. Many labs were not accepting samples as they were overwhelmed with piled up samples that have yet to be tested. Meanwhile, hundreds of fresh samples were being sent to these labs.

“All public labs in Karachi have refused to take samples from the district health administration offices of Karachi. Indus Hospital Karachi, CHK, Sindh Institute of Urology and Transplantation (SIUT), Jinnah Postgraduate Medical Centre (JPMC), Ojha Hospital of Dow University of Health Sciences (DUHS) and the Karachi University’s lab are not accepting samples any longer. The situation at private labs is similar. They are asking people to take appointments before coming to labs for giving their samples,” says Dr Qamar Abbass, the district health officer on District South.

“You can buy PCR machines and virus extraction kits but the availability of trained and qualified manpower has emerged as the biggest impediment in running these labs,” says Dr Zeeshan Ansari, a senior pathologist in Karachi.

Dr Abbass says that Karachi seriously lacks testing facilities.

“Karachi neither has enough beds for its Covid-19 patients nor do the labs here have the capacity to test the large number of samples being sent for testing. This is a complete collapse of healthcare system in the most populous city of Pakistan,” Dr Abbass says.

Confirming that they are facing a huge backlog in testing samples, medical superintendent of the Civil Hospital, Karachi, Dr Khadim Hussain, says that at the moment they have hundreds of samples, which they have yet to test as Indus, the SIUT and other labs in Karachi have refused to accept samples. He says one of their automated PCR machines has broken down and they are waiting for its repair.

“There is an urgent need to enhance testing facilities in Karachi. We are overburdened with the samples from health facilities which are treating patients without having testing facilities. Samples from hospitals like Lyari, the isolation centre at Expo Centre and even from the airport are being sent to us while we only have a capacity to test 150 samples a day,” says Dr Khadim Hussain.

Conceding that Covid-19 testing public labs in Karachi were overwhelmed with the workload, a spokesperson for the Health Department said due to a sharp increase in the number of cases after Eid, labs had received a very large number of samples. When the Sindh government announced starting a home sampling service, the entire system choked as thousands of samples piled up at each testing lab in the city.

“Together, all public and private labs have a capacity of 8,000 tests a day. Thousands of samples are being received at these labs daily. Both the technicians and staff of these labs are getting exhausted, machines are developing problems and systems are under tremendous pressure due to the huge workload,” says the official, requesting anonymity owing to the nature of information being shared. He adds that efforts are under way to enhance the testing capacity and set up new labs in the city.

Experts fear, however, that it would not be easy for the authorities to establish more testing labs and enhance the testing facilities, as the city lacks trained and qualified technicians, virologists, pathologists and molecular scientists for the work.

“At the moment, many private and welfare organisations are planning to establish Covid-19 testing labs in Karachi but finding trained and qualified workforce is a big challenge. You can buy PCR machines, probes and primers for testing, virus extraction kits and viral transport media but the availability of trained and qualified manpower has emerged as the biggest impediment in running these labs,” says Dr Zeeshan Ansari, a senior pathologist associated with a leading health facility in Karachi.

The writer is a Karachi-based investigative reporter covering health for The News