Batches of COVID-19 tests expire due to clinic issues, inundated labs

Several people in Waterloo region have had to be re-tested for COVID-19 because their initial tests were never processed, including one man who had to be tested a total of three times due to lab issues.

The tests were done at an assessment clinic in Waterloo and expired because the swabs were sent to labs in other Ontario cities and weren't processed in time.

A nasal swab is only valid for 72 hours, according to Public Health Ontario. The processing of the swab must happen within that time frame, unless it's frozen.

Dr. Joseph Lee is the clinical lead at the COVID-19 assessment site at Westmount Walk-In Clinic. That's where the incidents happened. He says the problem came down to a communication issue and lack of lab capacity.

"That's something that definitely should not happen," said Lee. "That would be an example where the system has let somebody down."

He said two batches of tests were affected in the last couple of weeks. The first batch, which had anywhere from 10 to upwards of 20 tests, according to Lee, wasn't picked up in time by the courier to be taken to London.

He said staff are now aware of the 72-hour time frame.

The second incident involved just a handful of tests, he said. It was shipped to a public health lab in London, but the lab was inundated with tests so it sent the swabs to a private lab in Brampton, according to Lee.

"It expired because of the timing," said Lee. "The testing is done out of town. That is one, I guess you could say, systemic issue."

Tests in Waterloo region are being processed in London, Hamilton, Toronto and labs around the GTA because of a lack of lab capacity in Waterloo region, according to Region of Waterloo Public Health.

'It's frustrating'

William Wallace was one of the unlucky people who was part of both batches of failed tests. He was re-tested this week for a third time. 

"It's frustrating in that goodness knows how many samples were ruined because they didn't get to the testing facility within 72 hours," said Wallace. 

His girlfriend, who he lives with in Kitchener, works at a long-term care home.

They were both experiencing flu-like symptoms late last month, so they got tested.

Her test was done at Cambridge Memorial Hospital and his at the Waterloo assessment site. She quickly found out she was negative.

About five days after the test, Wallace says he was asked to come in again for another test because it had expired.

After the second test, he got a call a few days later saying he was negative, according to Wallace. But then he got a call a few days after that apologizing for relaying incorrect information. He wasn't actually negative, his test just hadn't been processed again, he was told.

"There's got to be a better way — more efficient way to do this because it's not just my sample. What else is being missed?" said Wallace.

'Increasing complaints'

The region's acting medical officer of health Dr. Hsiu-Li Wang acknowledges she's seeing "increasing complaints and concerns" of lab tests that are not completed because they've been rerouted to another lab outside the region that's running over capacity.

"That's a sign we need to be cognisant of the limits of the current lab system that's being built to actually process those samples and turn them around in a timeline that people would find acceptable," said Wang.

Wang says all incidents of expired tests are referred to the provincial Ministry of Health.

CBC News asked the ministry how often tests are expiring.

They declined to provide that figure.

In a statement, the ministry said they understand the incident was unfortunate. 

"This situation has since been addressed so it will not happen again in the future. We regret the inconvenience and uncertainty that has been caused to this individual," the statement said. 

Most of the tests at the Waterloo assessment site are now being processed out of Toronto, where there seems to be more capacity, according to Lee.

'Don't want to do this again'

Lee said the testing issue at the assessment site shouldn't have happened and emphasized the overall work of staff has been incredible.

Staff are working long hours and creating a system that didn't formerly exist, one that brings together primary care and hospitals in the region.

It's a system Wallace is hopeful he won't have to navigate again in the near future. But he's not so sure yet.

After getting his third test, he walked out of the clinic and said it was the most painful swab to date.

"I don't want to do this again," he said. "Maybe third time's the charm."

Wallace doesn't know when he'll get the results, but until then, he'll keep doing what most people are doing — staying at home.