China is struggling with chaos in normalized Covid mass testing as it conducts its strict “zero-Covid” policy. 

Covid testing industry booming

China’s choice of a consistent “Zero-covid” policy has created a windfall for the Covid testing industry.

According to Reuters, in 2022, Chinese authorities will spend more than 52 billion dollars this year on testing, new medical facilities, monitoring equipment, and other anti-covid measures. Analysts said this payment would benefit some 3,000 companies, creating a market worth over 15 billion dollars a year for test-makers and providers.

Some testing companies, such as Dian Diagnostics Group Co Ltd, made the most of the opportunity and boosted their revenue by over 50%. Like Rival Adicon Holdings Ltd, some companies have profited so much that they are becoming public companies in a short period.

However, the booming of the Covid test industry comes with reports of widespread malpractice and scandals. 

According to Eight AM Health News—a China’s health news site—there have been at least 5 cases of Covid testing violations in Beijing since the outbreak began in April. 

They include: 

  • Three-tube mixed-tube testing for multi-tube samples; 
  • Document records and laboratory tests; 
  • The number of self-reported tests does not match; 
  • The original test data is significantly less than the number of samples tested; 
  • Use of expired sample preservation solution; 
  • Forgery, purchasing of a nurse’s practice certificate, and fraudulently obtained testing sampling qualifications.

In just 10 days, three testing companies in Beijing were under investigation, and their operating license was revoked.

Since January, the three provinces of Henan, Hebei, Fujian, and the megacity of Shanghai have also been going through Covid testing chaos.

One notable case involves two medical testing laboratories, Hefei Hehe Medical Technology Co. Ltd. and Hefei NovelGene Technology Service Co. Ltd. These two labs covered the testing in one district and overtaxed their capacity in April. So they issued a test report well after the required time, which affected the timely judgment of the epidemic situation in Hefei city. More importantly, this situation occurred many times before. On a few occasions, their test results are “false-positive,” which is a big deal under China’s strict ‘Zero-Covid’ policy. 

Another testing company, Shanghai Runda Medical Technology Co., Ltd., is also dealing with multiple “false positive” cases. As a result, its testing capability is under question. 

Fast, mass testing exposes loopholes 

Eight AM Health News reported that the current testing false positive rate is 1% – 2%, an acceptable range. However, the ombudsman of the China Medical Administration and Hospital Authority said that the specificity is 100% in a press conference. But in reality, contamination during the sampling process or experimental operation often occurs, creating false positives.

The report mentioned that a university conducted vaccinations in its gym. The next day all the nucleic acid tests turned out positive. But these were all false positives caused by aerosol contamination.

These were all preventable, as the test manual said that when the remixed tube test is positive, they would have to use a more sensitive nucleic acid detection reagent and re-test the original sample. Then, after 2 to 3 rounds of collection, the tester can rule out any chance of false positives.

However, many local authorities require that the test results be released within only 6 hours, and that’s too fast for accurate results. 

Eight AM Health News also pointed out that many areas have canceled the review mechanism in the current Shanghai outbreak. As a result, many false-positive cases have been forced into quarantine after the frequently failed large-scale mixed tests.

According to Dr. Meng Lingzhuo from the Sidi Diagnostic Laboratory, the continuous 24/7 mass testing laboratories usually are overloaded. As a result, they can’t control the quality of consumables, instrument calibration, and even the hygiene of the testing environment.

According to Eight AM Health News, many labs use illegal operations to deal with mass testing. Their intention is to conduct more mass testing faster and more cheaply. They also want to get test results quickly. 

Professor Jin Dongyan is a virologist at the University of Hong Kong. He noted that most screening tests in mainland China use oral sampling. However, the oral environment is extremely unstable, and the sampling quality will be affected by diet, mouthwash, and drinking water. 

He also mentioned factors that might change the results and require customized tests. Those factors include the low viral load of Omicron, the early time for infected people to develop resistance, and most people have already received three doses of the vaccine, among others.

Eight AM Health News also pointed out that normalized mass testing needs to consider “money, people, time, and testing quality.” In general, testing companies must ensure low-cost but high-quality tests. In addition, local governments must have enough budget to pay for it. Besides, there must also be enough testing manpower. 

Faced with these difficulties, poor regions lacking resources cannot handle mass testing and must rely on central government aid. 

The lack of testing staff is one problem. However, many places offer testing training. And in some areas, there’s even no need for a proper medical background. For example, a person might get a testing license in two weeks through online training for 1,500 yuan or through in-person training for 800 yuan. In some places, one can get a PCR testing license after only three days of training and one hour of sitting exams.

In terms of finance, many local governments complain that they do not have enough money to do normalized mass testing.

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