Coronavirus

The Hon. F. PANGALLO (14:50): I seek leave to make a brief explanation before asking a question of the Minister for Health and Wellbeing about COVID-19 testing kits.

Leave granted.

The Hon. F. PANGALLO: I will seek a little indulgence from you, sir, as what I am about to reveal is of important public interest. Mining magnate Andrew (Twiggy) Forrest announced yesterday that his commendable charity, Minderoo Foundation, has secured 10 million COVID-19 test kits from China, Europe and the United States, along with 27 labs to be installed in each state and territory. These kits are of the polymerase chain reaction (PCR) type, and similar to those swab-like tests conducted here by South Australia Health and SA Pathology. They are reliable, and Mr Forrest is to be applauded.

However, in its rush to allow more tests to be carried out, the Australian Therapeutic Goods Administration has given approval to at least 29 point-of-care test kits, many by Chinese makers out to cash in on the pandemic. These kits supposedly allow doctors to rapidly screen patients for the virus within minutes via a blood test. There are also PCA tests (or nucleic acid tests) used by labs that are reliable. The federal health department said 'the expediated approval of the testing kits was based on evidence provided to the TGA at the time of application'. That must ring alarm bells, surely.

I have been made aware that these POCT (point-of-care test) kits can produce inaccurate results, in some cases ranging from between 5.4 per cent accuracy to 70 per cent accuracy, despite claims of 95 per cent accuracy. One Australian company suing them is already under investigation. I am further informed that several companies listed on the TGA's register did not even have approved manufacturing and export status, and were not listed on the official Chinese government register.

I am further informed today that India has just stopped the use of defective test kits from two companies that are on that register: Wondofo Biotech and Zhuhai Livzon Diagnostics. As you can imagine, like Australia the USA has been swamped with these kits. To quote Patrick Hsu, a PhD and assistant professor of bioengineering at the University of Berkeley and investigator at the Innovative Genomics Institute:

It's the Wild West right now. These tests are widely available and many people are buying and deploying them, but I realised that they had not been systematically validated and we need to figure out which ones would really work.

The WHO have suggested that, based on current evidence, they recommend that the use of these new point-of-care diagnostic tests only be used in research settings. They should not be used in any other setting, including for clinical decision-making, until evidence supporting use for specific indications is available. My questions to the minister are:

1. Is he aware of the poor efficacy of these POCT kits, and does he know if they are in use in South Australia?

2. What advice has he received about them from our health agencies?

3. What advice would he give to health care professionals about the use of these kits?

4. Does he think it is acceptable for the TGA to rush through approval of these point-of-care test kits without proper scientific analysis and proof that they are accurate or fit for purpose?

5. Will he write to the federal government asking them to urgently review the approval of these suspect kits on the register?

6. Will South Australia be taking up the generous offer of tests and labs offered by Mr Forrest, and at what cost?

The PRESIDENT: Just before you start, minister, the Hon. Mr Pangallo, you are right, that was lengthy, but there was a fair bit of commentary in it as well. It is a very important topic, but please be mindful of the fact that you are not supposed to add commentary to your question. Minister.

The Hon. F. PANGALLO: Point of order, Mr President: I think I only made one, which was 'ring alarm bells'. I think the rest I am actually—

The PRESIDENT: The Hon. Mr Pangallo, that is one too many, so please.

The Hon. F. Pangallo: Okay. Well, look, I don't want to waste the time of the health minister. He is a busy man.

The PRESIDENT: Let us hear the minister try to answer all of those questions. The Minister for Health and Wellbeing.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:55): I claim failure already. I must admit I will have trouble remembering them all. The first point I would make is that COVID-19 testing in South Australia up to this point has been completely managed by SA Pathology. That means that, I think, as at the end of yesterday there had been 57,389 COVID-19 samples taken. That represents 52,657 individual patients tested. At a rate per million, that is 32,672 tests per million people. That is over 3 per cent of the South Australian population tested. Thankfully, only 0.02 per cent—I will just make sure I get that right: 0.02 per cent—of the South Australian population has tested positive.

As of today, the South Australian tests as a percentage of the population is at 3.27 per cent of the population. We lead the nation dramatically. New South Wales is at 2.6 and Western Australia is at 1.39. The WHO, during this pandemic, has said the motto of this pandemic is to 'test, test, test'. In South Australia we have tested, tested and tested.

We have done that relying on the expertise and the technology of SA Pathology, and they have done an extraordinary job. I would just make it clear that PCR testing is a well-established technology and is certainly used by SA Pathology. We believe it is well founded. In terms of point-of-care testing, which I think the honourable member also reflected on, we make no apologies for point-of-care testing. Particularly for country South Australians, point-of-care testing is absolutely vital.

We have had point-of-care testing in country hospitals for some years. I can't quite recall—days run into weeks during a pandemic—but I think it was either last year or the year before that the government invested heavily in point-of-care testing for influenza in our metropolitan hospitals. So it is not a gimmicky technology. Point-of-care testing and PCR are both well-established technologies. Having said that I certainly do not discount the honourable member's point that there are plenty of people out there at the moment who are peddling technologies that are not reliable. I know that SA Pathology has very high clinical standards, particularly under the leadership of its clinical director, Dr Tom Dodd.

The reality is that we have, in SA Pathology, ramped up our testing capacity quite dramatically over the last couple of months, but it is becoming increasingly clear that we still need to ramp it up even more. If I remember rightly, it was perhaps not last Saturday but the Saturday before—forgive me for not being able to recall the date—that I think the Chief Medical Officer of Australia, Brendan Murphy, suggested that an ongoing response to the COVID-19 crisis might see us needing to ramp up our testing to 40,000 or 50,000.

I know that national cabinet is still considering the surveillance strategy going forward. But let us say that is what it was. My calculation is that 50,000 tests would mean that we would have to ramp up to about 3,700 or so, if you like, to have our population share of that spread. On a typical day—I shouldn't say 'on a typical day' because it does bounce around. The last daily figure I can remember was about 1,300 and now two or three record days of just over 2,000.

So really what the discussions at least are suggesting—these are Brendan Murphy's comments, if I correctly recall, to the media—is that the ongoing response to the coronavirus will mean that we would need to significantly ramp up our testing. Some of that testing is going to happen in the clinics. Some of it will happen in the community. Certainly, there will be a lot more testing in the community than proportionately there is at the moment. We will have to move away from clinic-based delivery.

If I could segue to the point the honourable member is making about the announcement, I think it was yesterday, by Mr Twiggy Forrest and the commonwealth, it is not the first time that the commonwealth has partnered with private pathology. My understanding is that the commonwealth has an arrangement with private pathology to provide inreach pathology services to residential aged-care facilities in the event that there is an outbreak. I presume that will be a service available to South Australians and I welcome that. I certainly would expect the commonwealth to be delivering a quality service and, as we have continued to partner with the commonwealth in so many different domains, we are happy to work with them on that project.

I don't know the details of what was announced yesterday but, in the context of the need to ramp up our testing, the Marshall Liberal government is more than willing to cooperate with the commonwealth government and with the private sector to ramp up the effort. I suppose a classic example of that cooperation was in relation to private hospitals. In a tripartite arrangement we have a very flexible, constructive partnership with the private sector when it comes to private hospitals. I am quite happy to look at similar partnerships with pathology services with the fundamental aim of making South Australia healthy so that we can come out of this crisis stronger than before.

The PRESIDENT: A supplementary question?