Nunavut, Nunavik roll out rapid testing for COVID-19

Tuberculosis testing machines already located in Nunavut and Nunavik are the next step toward rapid-result testing for COVID-19 in the North.

GeneXpert machines, made by the medical technology company Cepheid, test for infectious diseases including influenza and Ebola, as well as tuberculosis. They do this through specialized cartridges for each type of infection.

On March 20, the Food and Drug Administration in the United States granted emergency-use authorization of Cepheid’s SARS-CoV-2 cartridges for the novel coronavirus.

GeneXpert machines are already in place for TB testing in Iqaluit and Rankin Inlet in Nunavut, and in Kuujjuaq and Puvirnituq in Nunavik.

Nunavik has now begun using the CoV-2 cartridges for its machines, said Josee Levesque, a communications officer for the Nunavik Regional Board of Health and Social Services.

As of Tuesday, April 28, Nunavik’s health board said that the region has had 16 cases of COVID-19. Of those, 13 individuals have now recovered.

In Nunavut, which saw its first confirmed case of COVID-19 announced on Thursday, April 30, the GeneXpert machines are part of the Department of Health’s plans for developing novel coronavirus testing capabilities within the territory, said Alison Griffin, a communications officer with the department.

A SARS-CoV-2 cartridge for the GeneXpert machine. (Photo from Cepheid.com)

Working with both Cepheid and Canada’s National Microbiology Laboratory, Nunavut was able to access the cartridges this week, in time to begin testing contacts of the territory’s first case of COVID-19 in the community of Pond Inlet.

These tests are only being administered in emergency situations, such as the need to test the contacts of the individual with Nunavut’s first confirmed case.

Results from the GeneXpert machines in Nunavik are still being confirmed by laboratories down south, since it is new technology, said Levesque. And Griffin said a similar second confirmation would be required of tests in Nunavut.

Nonetheless, a positive result from the GeneXpert machine is being treated as positive, in that isolation measures apply immediately, said Levesque.

Using GeneXpert machines for COVID-19 testing is largely the same process as for tuberculosis, explained Michael Loeffelholz, senior director of medical affairs for Cepheid during a webinar on the GeneXpert system’s use for the novel coronavirus.

The webinar was hosted by the McGill University International TB Centre.

GeneXpert machines detect the virus that causes COVID-19 through respiratory samples from oral and nasal swabs, providing results in about 45 minutes.

The design of the CoV-2 cartridges was heavily based on Cepheid’s existing flu cartridge, Loeffelholz said. This allowed the company to rapidly develop the test for the novel coronavirus in just eight weeks’ time and garner its authorization from the FDA.

The test is usable in various settings as the emergency authorization does not require that it be done in a strict clinical laboratory setting, as there is no cultivation of the virus as part of the test, explained Loeffelholz.

And, importantly for both Nunavik and Nunavut, tuberculosis and COVID-19 testing can take place at the same time in the machine, he said, so the ongoing battle against TB doesn’t have to take a backseat.

With regard to the possibilities of transmission through the testing process, the highest risk point would be at sample collection, said Devasena Gnanashanmugam, also a senior director of medical affairs for Cepheid, during the webinar.

For this reason, she said the sample collector should be wearing proper protective equipment, which should at least include a gown, gloves and a face mask—ideally an N95 mask.

Gnanashanmugam said the market price for the cartridges is about $20 a piece.

With so much demand for the cartridges, Loeffelholz said the company’s two plants are manufacturing at full capacity to get more on the market.