Dr Glover: The Nitty-Gritty Of Testing

This coverage of the PAC hearing is not intended to be a verbatim transcript of the full sitting and should not be treated as such, you can listen to the full sitting here.

Our final instalment from yesterday’s PAC evidence session with Dr Rachel Glover. Here, we learn all the nitty gritty details on testing and the friendly competition between the crown dependencies to test test test.

PAC line up;

Juan Watterson MHK – Speaker – Chair (JW)

Lawrie Hooper MHK – Vice Chair (LH)

Jane Poole-Wilson MLC (JPW)

Chris Robertshaw MHK (CR)

Julie Edge MHK (JE)

FEAT: Dr Glover (Dr G)

CR: This has been fascinating, I just want to point out you have submitted a detailed timeline which will be part of our report. What motivated you to step in at the start of the pandemic?

Dr G: End of February, start of March I could see what was happening around the world, Italy was very dire, I started thinking what would happen if it came here and I thought about it and thought I have expertise which Noble’s didn’t have. So I ummed and arred, as I didn’t want to step on toes,  but by February 13 I decided to send an email thinking – if they say no then they say no but I’ll have a clear conscience. So I emailed the path lab and they seemed glad to accept the help.

CR: How was the decision made around your working relationship with DHSC?

DR G: The DHSC sent down one of their senior microbiologists and the following day they rang me up and said they’d found a PCR machine and they asked me to go up and show them how to use it so I was there for like nine hours outlining what we needed to order and what I could order on their behalf and it was an organic relationship of what was needed to be done. The boss of the pathology lab asked about how I was going to be paid so I went back on as bank staff, covered a number of things including liability insurance etc. I had to work 100 hour weeks and we had to move the hours around to make sure I got paid. The gov system couldn’t cope with that many hours. 

CR: Method of payment was via pay slip?

Dr G: Yes I was classed as a bank worker as a medical scientist. And then we realised that the hospital didn’t have supplier relationships to buy the equipment we needed.

I asked for an agreement to say that they had to pay me back for anything that I paid for via my company. I didn’t want to get stung for £50K from my business without being reimbursed. 

*Speaker accuses Robertshaw of being Darth Vader* 

CR: Relationship with the UK, know people well, shared respect etc?

DR G: Being a scientist is like living on the island, it is a small community, so I’ve either worked with or know a lot of the UK guys doing this. I emailed the team there as I was concerned the Isle of Man wouldn’t be involved in this because funding etc doesn’t extend here. Ultimately we ended up in touch with Al Derby who was running sequencing in North West England. So I asked how the island gets to be part of the genomic side of this and they all said we could sequence on island or send the RNA to them. We had the option to sequence on the island since March last year.

CR: Turning to PCR testing. Is that sort of testing available as normal in all hospitals?

Dr G: In a hospital the size of Nobles, those types of laboratories tend to use a point of care device. Simple to use and easy to train people on. 

For Covid, because it was a brand new virus the test had to be designed from scratch in a lab. The kind of machine used in bigger labs with clinical scientist teams. They use the PCR machine we found in Nobles. They are more technical, you need to set up the reaction yourself. That’s why the UK centralised their testing in lighthouse labs run by academics. 

There are two or three specialist centres in the entire UK that do their own genome sequencing. On the Isle of man, my philosophy was let’s bring a lighthouse lab to the Isle of Man as fast as possible. 

CR: Had we not been able to do this on island, what was the capacity and speed that we could’ve achieved if we hadn’t done it here?

DR G: Initially it was a three day turn around in Manchester and was limited to 30 a day. A machine was on order but it wouldn’t have been here until the end of April. However, cartridges for machines used were being rationed and we were limited to 16 a day. Without my high level input that I brought in, we would’ve had up to 16 a day possibly until the end of May.

CR: Accelerating the number of tests, is it correct that you transferred BOB the robot from your lab to increase tests?

Dr G: We’ve got one called Hal too. The pipetting robot moves liquid from one place to the next. Pipetting all day is bad for health and safety and robots are better at doing it than humans. Our Isle of Man scientists had never done anything in the process before and I couldn’t give them five years training in five days. 

Two reasons for loaning Bob to the Hospital – 1. More accurate testing 2. Massive increase in throughput. 

It was a big commitment from our business because we needed Bob at the time and he is the only robot of his kind on the island. I had to make a choice between my company and covid testing – and chose the covid testing. I lent Bob for free.

CR: Achieved all of this in 21 days?

Dr G: Yes. The only delay was getting hold of things from suppliers. Everyone around the world wanted the resources. At one point I was sourcing stuff from Estonia as UK suppliers didn’t have stock. I was pulling out multiple plans in parallel. 

It was fairly stressful, at one point I was putting pleads out on Twitter for medical supply sales reps to speak to me on a Sunday. 

CR: Jersey spent about £5 million on external contractors to run the testing. Trying to compare this with you helping us out…

Dr G: There was friendly competition between Jersey, Guernsey and Isle of Man on who could test the most.

Jersey went down the route of getting loads of rapid test cartridges. They were meant to give 10% to Guernsey. They blew through them without giving any, then Guernsey and the supplier cut them off. 

They had to send tests to the UK in the end. Then, as they had their borders open they engaged with a third party for a mobile testing lab. They could do 2-3,000 a day. I remember reading this and thinking this may not go as they think.

In September their company CEO got in touch to ask for a hand so they could do things faster. I was the one giving the tips to Jersey. 

Guernsey has its own Dr G – Dr Andrew Bell. He set up their PCR and he has been doing all of their modeling of red, green and amber system on which countries Islanders could travel to. We met to share expertise so we shared protocols but they had it in hand. 

Recently they got in touch for some advice on genomic sequencing. Andrew wanted a refresh as he hadn’t sequenced in a while. 

With regards to Isle of Man costs. We were buying a commercial test which cost £18 per sample, alongside that I was ordering in a human RNA check as well and that was £5.15 per sample. Just over £23 per test. 

I introduced multiplexing to run tests at the same time to reduce the cost. We doubled throughput and reduced cost to £7 per test. 

My job is how to do something faster, cheaper and quicker so it was nice to show the gov that they didn’t have to pay as much as they thought. 

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