UPDATED: INVESTIGATION: How public laboratories redirect suspected COVID-19 patients to fee-charging private labs

Despite the announcement by the Lagos State government that residents with coronavirus-like symptoms can go to designated government-run facilities to get tested for free, these laboratories are instead redirecting patients to private laboratories where they are charged as much as N50,000 for the test.

This reporter deliberately exposed himself to cold for four days and came down with symptoms similar to those of coronavirus – cough, headache, runny nose and fever – and presented himself for testing at some public laboratories in the city but officials at the laboratories declined to test him.

Instead, they redirected him to private laboratories to get tested.

Yaba

After visiting several government-run laboratories, the reporter discovered how residents who might have caught the virus are routinely rejected or redirected to private laboratories.

“You must convince them well enough for you to have your test here. Although it is free, if your reasons aren’t strong enough, they would redirect you to private laboratories where you have to pay nothing less than N50,000,” a woman at the Yaba Infectious Disease Hospital (IDH), one of the public health facilities designated to offer the test for free, told this reporter as he waited to speak with a nurse.

The woman was also a patient at the centre and had been tested for the virus earlier that day.

“My husband has been isolated here and undergoing treatment here, so it was easy for me and my children to get tested. They wouldn’t agree to test anyone here but redirect you to the private laboratory where you have to pay money. I suggest you convince them well,” she added.

The reporter, heeding her advice, requested the registration process and was shown a web address written on the door of the lab. As the reporter tried to register, the same woman asked: “Are you here to know your status or do you think you have the virus?”.

“He has the symptoms because he might have had contact with someone who is already in isolation,” the reporter’s colleague who accompanied him to the health facility replied.

While struggling to complete the registration, the woman advised this reporter to approach officials of the facility for assistance.

“Go straight down to the office on your left, knock at the door and enter. You will see some nurses there, speak to them on the purpose of your coming, they will put you through the registration processes,” she said.

After 15 minutes of waiting to be attended to, a lab official, wearing a deep-green apparel, walked in and asked the reporter impatiently: “What are you here for?”

“I am here to get tested. I have been having symptoms like cough, dried throats and a runny nose for days and I think I might have the virus” the reporter replied.

“I haven’t heard you cough since you got here,” the lab official shockingly responded. “He had suffered these symptoms for days and might have had contact with someone already in the isolation centre,” his colleague quickly replied.

“Go and get a referral letter from your doctor or any hospital or go test yourself in a private laboratory,” the lab official said and walked away.

LUTH

This reporter also tried to get tested at the Lagos University Teaching Hospital, (LUTH) but he was also refused to test and redirected to a privately run laboratory.

At LUTH, a nurse led this reporter to the central laboratory besides the children emergency centre.

The reporter explained his symptoms to the doctor who attended to him.

“Have you collected your sample? If not, walk down to your left, you’ll see the laboratory where they do that,” the doctor swiftly suggested.

This direction led the reporter to SYNLAB, a private laboratory, located inside the hospital beside the Accident and Emergency Unit. Officials of SYNLAB told this reporter to register online explaining that the test will be conducted after 42 hours for a N50,000 fee.

SYNLAB handles the most laboratory services for LUTH following a concession agreement between both organisations.

Other centres

Within the week, the reporter visited four other public laboratories listed on the Nigeria Center for Disease Control website. While three redirected him to a private lab, one offered to test him after 24 hours of his registration.

At the International Organisation for Migration, Clinic, run by the United Nations, the security operatives, said the clinic had been shut down for renovations. “There are private labs around if you check online. You can go there because this place is no longer in operation,” he said.

At the Nigeria Centre for Disease Control (NCDC) Central Public Health Laboratory, the reporter was immediately stopped by the security operatives who redirected him to consult private laboratories or visit the IDH centre– where the reporter’s request for a test was earlier turned down.

“This place is not a testing centre. You can go to the Yaba IDH or check online to see any available private laboratories around,” the security operatives said.

He got the same response at the Nigeria Navy Reference Hospital.

Access into NIMR testing centre

After consulting all listed public laboratories, the reporter visited the Nigeria Institute for Medical Research (NIMR) and was offered to be tested for free.

Candidates would be required to register online via portal, www.nimr.covid.com.ng, after which a scheduled date would be sent to the email to have the test.

The Free Mobile Laboratory centre was made possible by NIMR, LifeBank, Sterling Bank, UTL, Dan Holdings, The Rising Tide Africa and Daystar Christian Center.

The reporter, after registering, visited that lab 24 hours later to have his test. COVID-19 test in NIMR is carried out on the open ground of the institute under two canopies– the first for registration and confirmation, while the second for testing.

“Where is your invitation form,” the security official stopped the reporter– as this was a major access into the laboratory.

The security official, after confirmation, directed the reporter to meet with a staffer of the lab who took down his details and requested that this reporter filled a seven-page online form.

“Take this form, and be careful holding it, go to the other canopy by your left, submit it there and have your test,” the staffer told the reporter.

At the lab, an official verified the form submitted and told the reporter to take a second look at the details submitted to be sure they were accurate.

The lab official wore her medical gloves, brought out two long swabs from a transparent plastic bag and collected samples from this reporter’s throat and nose.

The official placed the samples extracted from the reporter into a separate bag and labelled it with a special NVC code contained in the form.

“You can go, your test results would be sent to your mail within three days- 62 hours”, she told the reporter.

However, after two days of having the test, the reporter got his result, sent to him via his mail, testing negative for the virus.

Poor testing erodes fight against virus

The investigation revealed that out of six public laboratories listed on the NCDC portal, only NIMR was accessible to the reporter for free treatment despite suffering ‘COVID-like symptoms’.

This experience gives an insight into how public laboratories contribute to poor testing records of residents in Lagos thereby undermining the effort of the government.

ALSO READ: COVID-19 tests in govt laboratories not for travel purposes – Sanwo-Olu

The reluctance of public laboratories to offer free testing might be posing a threat to the state’s healthcare systems which in turn contributes to the spread of the virus.

Since the outbreak of the coronavirus pandemic, Lagos State has recorded the most cases in Nigeria.
The state had consistently led the COVID-19 chart pulling over 55,000 reported cases within a year since the index case of the virus was reported in Nigeria.

During this period, the state received funding and support from the federal government, private organisations, non-governmental bodies, and prominent individuals – who contributed resources and donated materials to help curb the virus.

The Central Bank of Nigeria said donations from individuals and corporate bodies in Nigeria to the Private Sector Coalition Against COVID-19 (CACOVID) Relief Fund surpassed N21 billion.

When asked if the financial expenses could be a major factor, the Director-General of the Nigerian Institute of Medical Research, Babatunde Salako, said the state government ”might be spending a lot of money to sustain the free testing operation”.

“The test cost N54k and for every free test, the government may be seen to be spending that amount on individuals doing the test for free.

“I imagine it may be a constraint especially running free tests for travellers who can afford the test for their business or holiday trips. Government should not be running their business for them.

“I believe the government should have allowed public laboratories to charge at cost price at least, making the test more available to a lot more people,” he said.

Reaction

Meanwhile, the Chairman of the Lagos State Chapter of the Nigerian Medical Association, Adetunji Adenekan, when reached for comments, said, “I may not be able to respond to the questions as I don’t have information on it”.

In separate reactions, the spokesperson to the NCDC, Emeka Oguanuo, and spokesperson to the Presidential Task Force on COVID-19, Willie Bassey, said the Lagos State government was in the best position to answer.

This investigation was carried out with support from BudgIT Foundation