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Column: Hawaii’s medical lab pros diligent behind scenes

  • BRUCE ASATO / MARCH 3, 2020
                                DOH laboratory microbiologist Mark Nagata demonstrates the procedures involved in the extraction of nucleic acid in the testing for COVID-19 using the proper safety gear and within a biosafety cabinet.

    BRUCE ASATO / MARCH 3, 2020

    DOH laboratory microbiologist Mark Nagata demonstrates the procedures involved in the extraction of nucleic acid in the testing for COVID-19 using the proper safety gear and within a biosafety cabinet.

On behalf of the 1,000-plus medical laboratory professionals in Hawaii, please let me take a moment to clarify the role of medical laboratory scientists and technicians in this COVID-19 pandemic. Those parking lot “mobile testing centers” for the novel coronavirus, are not as called — they are “specimen collection” centers.

They are worked by brave and true health care professionals, but NO testing is done there. The actual testing is done in a clinical laboratory by clinical laboratory professionals.

We cringe whenever we hear the ads and the media promote “a simple blood test.” Almost all of those “simple tests” require sophisticated biomedical science. The tests are validated and performed using the latest technology, with extensive quality control and using mandated safety protocols.

Of course, this means that the shortage of gloves, masks and other personal protective equipment (PPE) affects the ability of the medical laboratory professionals to perform all laboratory testing, not just testing for COVID-19.

Did you know that we have college degrees, many with master’s or doctorate degrees? We have studied topics that most people have a hard time pronouncing: organic chemistry, molecular virology, infectious disease, immunohematology, clinical informatics, dyslipoproteinemia, thrombotic evaluation, flow cytometric studies, tissue banking, immunohistochemistry, pharmacogenomics, mycology, parasitology, viral optimization, etc.

When a patient’s specimen comes into the clinical laboratory, we don’t just “push a button” and the answer comes out.

Sometimes we collect the specimens ourselves, and we do use multi-thousand-dollar analyzers. But we also do complex manual testing requiring years of scientific study to get right and many with interpretive skills that most really cannot imagine (like telling a promyelocyte from an immunoblast, or telling Plasmodium falciparum from Babesia microti).

If a test takes hours/days/weeks to perform, that is how long it takes. We are not ignoring the patient’s or doctor’s needs. We manage to give every specimen the fullest attention (even though you may never have seen us). What we do just doesn’t work unless we do it that way.

You may think that to us, you are just a swab or blood or urine, but we know that there is a human being involved in that sample. We get specimens from all over the hospital and its clinics, and usually from individual physician offices.

We communicate regularly on highly technical scientific matters with the state Department of Health and/or federal Centers for Disase Control and Prevention, or other reference centers. We would like it if citizens out there know who we are, but that is not why we do what we do. We love science and want to serve the scientific needs of our patients however they enter the health care system.

That said, we are not that happy about being totally unknown. We need PPE as well. We are working extra shifts as well. We are stressed as well. We have shortages of all kinds of scientific materials, as well as a shortage of laboratory personnel.

You don’t have to think of us very often — but don’t think we are not there trying to help you, along with all those other people whom you hear about so often.


Marcia A. Armstrong, M.S., M.T., is professor emeritus at the University of Hawaii-Kapiolani Community College; and past president of the American Society of Clinical Laboratory Science.


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