The fact that the coronavirus was detected in Poland was the first to be known by laboratory diagnosticians who have been working under enormous pressure for several weeks. Testing samples for the presence of coronavirus is a tedious and time-consuming procedure. – Particular stages of the test take time, and the result of one stage often determines subsequent determinations – explains Alina Niewiadomska, president of the National Council of Laboratory Diagnosticians (KRDL) in an interview with Medonet.
- For several weeks, the public has been wondering when the first case of the coronavirus will appear in Poland. Unfortunately, there were accusations that the services were hiding the truth and acting sluggishly
- Alina Niewiadomska explains that testing samples for the presence of coronavirus is a long process because these are the procedures
- Diagnosticians bear the same professional responsibility as other persons performing professions of public trust
Aleksandra Lipiec, MedTvoiLokony: What is the work of laboratory diagnosticians in the current situation?
Alina Niewiadomska: The pressure is enormous. The media and politicians have speculated for days why there is no confirmed case of the disease in Poland. How is this possible when they are sick in other countries? Speculating that the result has been hidden or falsified is absolutely out of the question. The diagnosis is subject to criminal liability, and let us remember that it is a profession of public trust – medical profession regulated by the Act on Laboratory Diagnostics.
The examination is ordered – usually by a doctor, everything is documented, including the result. The commissioner is waiting for the result. If he does not receive it, he simply asks for it in the world. All coronavirus tests are carried out in agreement with the State Sanitary Inspection and this is understandable in the current epidemiological situation. The laboratory diagnostician is obliged to immediately report the positive result to the doctor, for whom it is indispensable in the treatment of the patient, but also immediately notifies the Sanitary Inspector of such a result, who decides on further anti-epidemic procedures.
At the moment, the Ministry of Health has confirmed the first illness in Zielona Góra. But the expectations are still that the research should be done as soon as possible. However, you have to wait for the result.
Why is it taking so long?
These are the research procedures. Not always shorter is better. Particular steps of the test take time, and the result of one step often determines subsequent determinations. We must bear in mind the seriousness of the situation – it is essential to ensure the safety of all citizens. The patients are the most important here. Laboratory diagnosticians always perform their work with due diligence and in accordance with the principles of professional ethics. That is why I strongly emphasize: let’s not put any pressure on specialists. The safety and health of Poles now depend on the work of diagnosticians. We are positive at the moment, but the most important thing is to reassure the public not to panic.
Laboratories where such tests are currently performed have safety class 3. What does this mean in practice?
Biosafety Level (BSL) means which microbiological procedures, equipment and accessories are recommended for working with particular microorganisms. For work with a live coronavirus (isolation), level 3 is actually recommended, but the determination of inactivated material can be carried out in the laboratory of grade 2, which means that the laboratory premises and its equipment must meet the requirements specified in regulations, including it must be equipped with a class 2 laminar chamber.
Any diagnostician can work in a laboratory that tests samples for the presence of coronavirus?
Diagnostic technicians can choose which laboratories they will work in. If someone is interested in microbiology or virology, he chooses this laboratory profile. We have a choice of laboratories of various profiles: from general analytical, through microbiological, transfusion serology, genetic, cytomorphology, scientific or sanitary and epidemiological stations, in which laboratory diagnosticians also work.
Tests for SARS-CoV-2 are performed in specialized laboratories, laboratories using molecular biology techniquesthat require experience and skills that the diagnostician has acquired during his previous work and during his studies. Therefore, only experts, who are laboratory diagnosticians with appropriate qualifications and vast experience, deal with this type of dangers. And this applies not only to coronavirus research, but other very dangerous pathogens, bacteria, fungi and viruses.
Do the diagnostic methods used in Poland differ from the European ones?
If you ask about coronavirus diagnostics, then no, as is the case in other areas of laboratory diagnostics. As for the coronavirus, each country follows WHO and CDC guidelines. Nobody can imagine doing business on their own.
Why is the responsible work of a diagnostician underestimated at all?
Due to the lack of public knowledge about the knowledge and qualifications of laboratory diagnosticians. We end up difficult medical uniform five-year master’s studies at medical universities in the field of medical analyst. Then, as it is in the case of medical professions, we educate ourselves all the time, incl. we start specialization education. Our education lasts about 9 years, as much as a doctor’s. Due to the development of medicine, a laboratory diagnostician is obliged to improve his qualifications.
I also think that the workplace, i.e. laboratories, are the elements that constitute a barrier between the diagnostician and the patient. Patients do not have direct contact with the person who performs their tests, we are anonymous for them. Generally, for the patient, the laboratory testing process begins and ends at the point of collection. The samples are sent to the laboratory and the area is also closed for epidemiological reasons. The test results authorized by the diagnostician are sent back to the collection point or electronically transferred to the client. Direct contact influences social trust and the perception of the profession. Notice how it is with doctors, paramedics, nurses or pharmacists.
Another factor is the number of people. We are the least numerous local government.
It has long been said that there are too few laboratory diagnosticians in Poland. Can this translate into our safety now?
In Poland, we have over 16,7 thousand diagnosticians, of which about 14 thousand work in the profession. About 700 microbiology specialists. We definitely need more specialists. However, low salaries prevent young graduates from taking up employment in the profession. There is a problem of enrollment in the field of laboratory medicine precisely for financial reasons. Young people choose fields of study, after which they will be able to earn well. Meanwhile, the earnings of diagnosticians often only slightly exceed the national lowest, and I would like to remind you that they are graduates of difficult medical studies. Hence the staff shortages.
Currently, 11 medical universities train in the field of medical analyst / laboratory medicine. We currently have an employee market in Poland, you can work in various industries, not necessarily related to the completed field of study.
We are also an underestimated professional group when it comes to salaries and postgraduate education opportunities (paid specializations), which in the face of current events is of particular importance. I hope it will be a lesson for the future for all decision makers who will not make the mistakes they have made so far.
Trade unions associating diagnosticians, supported by the professional self-government, are attempting a dialogue with the Ministry of Health regarding remuneration. So far, the voice of the community has not been heard.
How do you assess the epidemiological threat related to the spread of the coronavirus?
The virus spreads very quickly, and this is the most dangerous virus in its case. It is important that most cases of infection are mild and it is worth emphasizing. People over 60 years of age and chronically ill patients are at risk of developing a severe course. I believe that at the moment the most important thing is to use common sense. Contrary to appearances, panic can cause more harm than a virus.
We must follow the recommendations of the State Sanitary Inspection – the key are: hand washing hygiene, avoiding gatherings, in the event of disease symptoms described in the GIS messages, the Sanitary Inspection must be notified. For epidemiological reasons, patients should not visit the HED, hospital emergency room or primary health care in the described cases.
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