Adrian Smith, general manager, Hologic UK and Ireland, explains how the pandemic has helped the industry act with clarity and determination to revolutionise UK diagnostics.
The COVID-19 pandemic has shown us the importance of building a health service focused on prevention rather than cure and technological advances in the diagnostics sector, including automated on-demand molecular testing, is set to significantly improve the health outcomes of millions of patients.
We know that preventing disease has many benefits over curing it. The UK Government published its vision in 2018 to transform the UK’s approach, stating that around £14 of social benefit comes for every £1 spent across a broad range of areas of prevention. But despite this clear benefit, the government’s own findings showed that we spent 60% of public funding for healthcare on cure and rehabilitation, and only 5% on prevention. That amounted to £97 billion a year on treating diseases, and only £8 billion on preventing them.
So, where should the focus lie when it comes to redesigning a health system that prioritises prevention?
At the heart of earlier detection, diagnosis, and prevention lies diagnostics, also echoed in the government’s Life Science’s Vision. And if you look at the innovation in the molecular diagnostics field, you will see three powerful forces reframing perceptions of what is possible.
The speed of innovation
During the pandemic, we’ve seen how governments cut red tape to set up vast testing infrastructures and collaborate with academia and the private sector to fund and create the vaccines that have saved millions worldwide.
In the past, clinicians had to wait for sample cultures to be grown in labs before causes of a disease could be identified or ruled out. Now the world knows about the effectiveness and speed of a PCR test for COVID19, it should not be much of a leap to envisage how useful this molecular diagnostic approach could be used for other diseases.
Pioneers in this space are using advanced testing instruments that can test for multiple disease-causing agents from a single sample. This “high multiplexing” approach gives clinicians much greater certainty than before. It was not long ago that tests could only return results on a few disease markers which meant lots of retesting, trial and error and waiting for cultures to grow before a diagnosis was found. In the meantime, patients could often be prescribed antibiotics for the wrong condition, leading to longer treatment times, prolonged illness, and a higher risk of antibiotic resistance.
The technology is now available for clinicians to immediately test for multiple causative agents of a disease from a single test. This gives clinicians the answers they need with much greater confidence and within a shorter timeframe, something that is so often critical in these circumstances.
And with the potential of difficult winters ahead, with high levels of flu, RSV and COVID-19, being able to diagnose specific respiratory illnesses quickly and easily, which all have similar symptoms but different treatment pathways, is now possible.
Reducing the time to answer
The other significant benefit of this new, advanced testing is how quickly a clinician can arrive at a diagnosis. If you take a typical blood stream infection in a critical patient, using traditional methods the best-case scenario would be a diagnosis within 14-20 hours, if not longer. In that time the clinician will begin treatment based on their experience and the patient’s history, and hope for the best. New technologies can reduce this time to answer to two hours. When you think that five people die from sepsis every hour in the UK, the need for accuracy and speed is clear.
The rise of automation
The final evolution of modern diagnostic approaches is the ability to do on-demand testing within hospital labs, without having to send samples away for analysis. Because the latest equipment is highly automated and so simple to use, even hospitals facing recruitment challenges across specialist areas can deliver much faster results in non-specialist settings.
Increasing adoption of new molecular diagnostic platforms
Of course, with every new technology, there are challenges to overcome. These new approaches are more expensive and moving away from traditional tried-and-tested approaches always takes time. But the direction of travel is clear. Modern molecular diagnostic platforms are quickly rising to the ascendancy when it comes to identifying infectious and testing diseases.
The investment already made in COVID testing infrastructure gives us a chance to test at scale serious threats including tuberculosis, meningitis, other respiratory diseases and to detect and avoid the ever-present threat of antimicrobial resistance.
The Government, health officials, and industry must work together to ensure that advances and achievements precipitated by the pandemic are locked in to create the most resilient and advanced diagnostics sector possible. Not only will this improve patient outcomes, but will reduce pressures on clinician workflows, while delivering more accurate diagnoses that will prevent conditions needing expensive cures.
