COVID-19 Technical Training Support to the Rarotonga Hospital Laboratory Services
In preparation to open Quarantine-free travel between New Zealand and the Cook Islands, the New Zealand Ministry of Foreign Affairs and Trade (NZ-MFAT), on behalf of the Cook Islands, Te Marae Ora, requested face-to-face technical training support from the Pacific Pathology Training Centre to setup COVID-19 RT-PCR testing in Rarotonga.
The PPTC accepted this request and in association with the Doherty Institute (Melbourne), delivered face-to-face training in-country which complemented online training that had already been planned for the Cook Islands. Navin Karan, the PPTC’s Project Manager, and Molecular specialist carried out this training for 4 staff in the country which was two weeks in duration, and it is planned that two consolidation one-week visits will follow a month apart.
Through recent modifications, the laboratory services established a clean room, extraction room, and amplification room for its real-time RT-PCR setup. During the initial two weeks visit, the laboratory was set up with all equipment supplied through Pacific Community (SPC), the workflow was established, and staff were practically trained on all aspects of performing molecular testing for SARS-CoV-2 in the country, which included performing manual extractions from nasopharyngeal swabs. At the completion of practical training, the laboratory successfully performed testing on its validation panel and went live with clinical sample testing in the second week of May, just before the travel bubble opened on 17 May 2021.
Above: Ms Iva Vakalalabure, Laboratory Scientist performing extractions at the PCR laboratory in Rarotonga. Below: Laboratory Scientists, Ms Iva Vakalalabure and Ms Theresa Tatuava performing result analysis on the CFX Maestro after a PCR run. 
COVID-19 Support to Fiji
Establishing PCR testing Facilities in Nadi
The Pacific Pathology Training Centre (PPTC) is currently working with the World Health Organization (WHO) and the Fiji Ministry of Health and Medical Services (MOHMS) to design and construct a mobile/container laboratory system which will be established in Nadi, capable of RT-PCR testing and a range of other necessary tests near this port of entry. This laboratory would be expected to perform up to 200 COVID-19 tests a day by RT-PCR.
As part of this contract, the PPTC is also responsible for the implementation of appropriate validated and verified items of equipment as well as the provide reagent supplies and testing kits that would deliver the set testing menus, required by the medical laboratory service for Nadi.
The construction of the 4 unit mobile/container laboratory is now well underway and its footprint will be sufficient for the delivery of RT-PCR testing to include two thermocyclers, two semi-automated RNA extraction analysers, three biosafety cabinets, two PCR work stations and all other equipment associated with the provision of this service. Testing procedures will be in line with existing Fiji and international standards. Initially, the RT-PCR laboratory will be set up for COVID-19 testing. It will however have sufficient scope to expand on the molecular diagnostic capacity in the future.
Reagent, Consumables and Equipment Support to Fiji CDC – Suva
Due to the recent spread of COVID-19 through community transmission in Fiji in April 2021, MFAT requested PPTC to supply gloves, gowns, masks, nasopharyngeal collection swabs and VTM, biohazard specimen bags, PCR reagents, a Thermo Cycler for RT-PCR and refrigerated centrifuges to the Fiji Centre of Communicable Diseases (Fiji CDC) to further strengthen their testing capacity. The PPTC has been responsible for the procurement, delivery and installation of the laboratory equipment and consumables to support RT-PCR testing in Fiji. This included logistical and technical advisory support to ensure safe transportation and installation.
The PPTC has been able to procure most of the items and is currently waiting for the delivery of the centrifuges. Through these activities, the PPTC continues to work in partnership with MFAT in responding to and strengthening the Pacific’s health system, including Fiji.
Setup of Bio-Rad CFX96 Thermocycler by Medica Pacifica Staff and Fiji CDC staff receiving the “turn-key” CFX96 on Tuesday 25 May 2021
COVID-19 Support to Kiribati
The Pacific Community (SPC) and Ministry of Foreign Affairs and Trade (MFAT) on behalf of the Government of Kiribati (GoK) engaged the Pacific Pathology Training Centre (PPTC) to oversee the refurbishment of shipping container units, to be used as a mobile PCR laboratory. As part of this project, the PPTC worked with the container supplier to ensure that the testing laboratory was fit for purpose, with remodelling based on detailed specifications discussed with the Kiribati Health team, SPC and the Doherty Institute.
The PPTC was also responsible for the final shipping and transportation of the container units locally within New Zealand and internationally, to Tarawa, Kiribati. The container units departed New Zealand on 14 April and arrived in Kiribati on 1st May 2021. A number of setup items were also provided to the GoK to help set up the units in Kiribati. The PPTC has delivered multiple remote sessions with the GoK staff to help connect the units together and have them functional.
Above: Initial placement of container laboratory onto a constructed platform Below: Inside view of the container PCR laboratory in Kiribati – Extraction room.
Electricity and plumbing now awaits completion as does the unpacking and installation of all PCR equipment. Once the laboratory is functional, coordinated training will be provided to dedicated staff by VIDRL (Victorian Infectious Diseases Reference Laboratory) and the Doherty Institute located in Melbourne.
COVID-19 Support to Niue
The PPTC through the support of WHO, designed and arranged the construction and delivery of a mobile/container laboratory, with the inclusion and implementation of appropriate validated/verified equipment. The PPTC was also responsible for the provision of specialist training of staff as well as the provision of essential reagents and kits to ensure that all laboratory test menu requirements had been met for Niue’s Foou hospital.
Wellington celebration of the mobile/container laboratory completion before its journey to Niue.
Inside view of the container laboratory