Author | Burn the plains
Up, down, or wavy... In the laboratory, Chen Bin is accustomed to seeing all kinds of curves expressing medical test results, but this time, he vaguely feels that the curve of his life is also upward.
Fifteen years ago, after graduating from university, Chen Bin worked in a public hospital in his hometown county. "8,000 yuan a month." Chen Bin said: "Compared with surgeons, the income of inspectors can only be regarded as lower than moderate. ”
Three years ago, after resigning from a public hospital, Chen Bin came to a medical testing institution in Shenzhen to work as a tester.
Unlike public hospitals, as long as the boss can make money, the space and freedom to send money is greater. Now, with a senior title, he "can get nearly 30,000 yuan a month." In the past three years, his boss has also become more and more angry.
This is related to the emergence of the new crown pneumonia epidemic at the end of 2019, accompanied by the vigorous development of third-party medical testing institutions. Among these institutions, there are a bunch of people who are focused on finding the new crown virus.
Behind the development of individuals and industries, there are also little-known risks, entanglements, struggles, tenacity and efforts.
01
Decide, do or don't do?
Ye Changqin is a native of Shaoguan, Guangdong Province, and studied medical testing at university. After graduating from university in 1993, he went to Dongguan Houjie Hospital to work in the laboratory department, and later served as the chief technician.
Later, he left the hospital. Four years ago, Ye Changqin founded Guangdong Mingzhi Medical Laboratory Co., Ltd. (hereinafter referred to as Guangdong Mingzhi) and served as the general manager.
After practicing in Dongguan for nearly 30 years, many people in the health system of Dongguan City are very familiar with him, and everyone is accustomed to calling him "Director Ye" -
"Director Ye, how much do you do every day now?"
"It hasn't been done yet." Ye Changqin replied.
This is the dialogue between Ye Changqin and the relevant staff of the Dongguan Municipal Health And Health Bureau on March 16, 2020. A week earlier, on March 9, 2020, Guangdong Mingzhi was the first batch of institutions approved by the Dongguan Municipal Health Bureau to carry out COVID-19 nucleic acid testing, but Guangdong Mingzhi did not carry out it in the first place.
"At that time, I wanted to drag it out and observe first." On April 8, 2022, at Guangdong Mingzhi Company, general manager Ye Changqin explained the reason for his hesitation to Nanfeng Window: "At the beginning, the virus was menacing, we were not familiar with it, and we had no bottom in our hearts. ”
"What if there is a leak in the laboratory?" Ye Changqin said, "I am responsible for everyone's safety." ”
On the third day that the Dongguan Municipal Health Bureau urged him, the staff of the Dongguan Municipal Center for Disease Control and Prevention called again, or the sentence: "Director Ye, how much are you doing every day now?" ”
"It hasn't been done yet." Ye Changqin told the truth.
"Why don't you do it yet?" Dongguan Municipal Center for Disease Control and Prevention was in a hurry.
"That's when I learned that I couldn't do it." Ye Changqin said bluntly: "We are not on, who is on?" ”
Subsequently, Ye Changqin led his colleagues to officially carry out the testing of the new crown virus.
In the Guangdong Mingzhi Medical Laboratory, inspectors are testing for the new crown virus (Source: Provided by the interviewee)
"The boss wrapped us tightly and smiled to cheer us up, but the moment we actually moved into the lab, the boss also burst into tears." Chen Bin told Nanfeng Window that as the first batch of testers to enter the laboratory to "salvage" the new crown virus, there was a feeling that "the wind is cold and the water is cold, and the heroes will not return once they go".
"After the outbreak of the new crown epidemic, everyone is in a state of fear." Liu Yonghong told Nanfeng Window that his choice was also not easy at the beginning: "When the city asked me if I could carry it out, I asked our director Zhou, and he said that there was no problem at the technical level. ”
Liu Yonghong is the chairman of Dongguan Lanwei Medical Laboratory Co., Ltd., and Director Zhou is Zhou Jianhua, director of Dongguan Lanwei Gene Amplification Laboratory. Before retiring, Zhou Jianhua was the DIRECTOR of PCR at Changping Hospital.
When the new crown virus first appeared, everyone avoided it, but when some people around them chose to have close contact with the virus and "salvage" the new crown virus as a business, their families naturally objected.
"When I first started the COVID-19 testing business, most of my colleagues were willing to take on and carry out this work, and a few colleagues left their jobs due to the opposition of their families." Liu Yonghong said that at that time, the conditions were relatively difficult and full of uncertainty.
02
Stress, outside of the virus
"Everyone in the family is against it, including my husband." Ye Liying said bluntly to the South Wind Window that at that time, her husband was very angry and opposed after hearing that she participated in the test, which gave her a lot of pressure.
Ye Liying was engaged in laboratory work in Dalingshan People's Hospital earlier, and in March 2018, she came to Dongguan Lanwei Medical Laboratory Co., Ltd. to work, and is currently the deputy director of Dongguan Lanwei Laboratory.
Dongguan Lanwei Medical Laboratory (Source: Provided by Respondent)
Recalling the situation of "salvaging" the new crown virus in early 2020, she said that because she was worried about her infection and passing it on to her family, she and her colleagues ate and lived in the company for more than 2 consecutive months, "did not dare to go out of the company's door, and did not dare to go home." ”
Like Ye Liying, who lives in the company, there are laboratory technicians and more than 50 colleagues responsible for the delivery of specimens. For nearly 3 months, they slept in the company's bunk at night.
"It's unreasonable to grow your hair, like a wild man." Wu Qian, director of Dongguan Lanwei Laboratory, told Nanfeng Window, "Because no one dared to get a haircut at that time, we didn't dare to let them go out to get a haircut." ”
After nearly 3 months, everyone gradually became familiar with the virus, and then dared to go home.
However, the pressure of work after that is still very high. "Often work overtime until 11 to 12 p.m." Ye Liying said that her husband could not understand this, "Go to work at 8 o'clock in the morning, it is time to leave work at 6 o'clock in the afternoon, why is it often busy until 11 to 12 o'clock in the evening and can't come back?" ”
"At 11-12 p.m., his husband often came to harass her by the phone." Chen Zeyu, assistant to the chairman of Dongguan Lanwei Medical Laboratory Co., Ltd., smiled.
"In his opinion, so many people in a company can work shifts, but you are the only one in my family." Ye Liying said that when doing the new crown virus test, there will be many unexpected situations, "such as the amount of specimens expected to be tested for 50,000 tubes today, and suddenly where there is an epidemic in which place, there is an additional batch of specimens, what to do?" ”
"Can't you not deal with it?" Everyone is waiting for this result. Ye Liying's husband later also figured it out: "Someone has to do things." ”
Photo taken at Lanwei Laboratory in Dongguan (Photo: Liao Yuan)
The main characteristics of the new crown virus test are that the specimen volume is large, the reporting time is tight, and the sampling is mainly carried out during the day, after which batches of specimens are shipped to the laboratory for testing, and the evening is the golden time for testing in a race against the clock.
Earlier, the superiors required 48 hours to produce nucleic acid test results, later required 24 hours to produce results, and then asked for results within 12 hours. "Especially in large-scale nucleic acid detection screening, the time requirements are shorter.
Wu Qian, director of The Lanwei Laboratory in Dongguan, remembers that some specimens have not yet been transported back to the laboratory from the sampling site, and Liu Yonghong began to urge him to ask for results.
"Mr. Liu! You're putting too much pressure on us! Wu Qian was not convinced and directly "protested."
"Don't talk to me about stress! I'm under more pressure than you! Liu Yonghong did not show weakness and cried out.
Later, Wu Qian also understood. He told reporters privately: "When large-scale nucleic acid testing was still in progress, many town leaders began to urge Liu Zong to get results, and Liu Zong was also under great pressure and lost more than ten pounds. ”
Because it is very busy, and the inspectors are mostly girls, there is no regularity in work and rest, and there is no regularity in the "menstrual leave" of more than ten girls.
The testers were mostly girls, and high-intensity large-scale nucleic acid testing caused many female testers to have a disordered menstrual cycle. Photo taken at Lanwei Laboratory in Dongguan (Photo: Liao Yuan)
Ye Changqin said that one night, it was very late, and a city leader called him and said bluntly: "You can't get the result, I can't sleep." ”
Ye Changqin said that after the official screening was exposed to confirmed cases, the leaders had to wait until the results were released to be assured.
For individual nucleic acid testing, it is also very urgent. "Individual testing is mostly in a hurry to travel or see a doctor, and if the results are delayed, it will affect others to travel or see a doctor." Ye Changqin said that the responsibility and pressure from outside the virus are very large.
False negatives or false positives are also a huge pressure on the industry. The policy requires testing institutions to "report every yang, the initial screening must be reported", but from a technical point of view, it is difficult to completely avoid false positives.
"It has a certain probability, especially when there are many positive specimens, the probability is relatively high." Chen Bin said that the false positive may be caused by a certain link, especially the experiment involves many steps and links are also artificial, if a link has a problem, it may lead to the experimental results are not so accurate.
"Some are problematic in the sampling link, especially in more important dangerous places such as isolation hotels, there may be gloves in the environment, and false positives will appear." Chen Bin said that for example, the nurse or the person in charge of the test, if the vaccine is not more than 48 hours away from the test, it is also prone to false positives.
At night, nucleic acid sampling is still in progress (Source: Provided by respondents)
"False positives in the initial screening are technically difficult to avoid, and can only be avoided as much as possible." Yuan Lin, the person in charge of Chen Bin's company, said bluntly, "But once there is a false positive, the people's lives are affected, the leadership pressure is very large, and they will also think that you have a problem with quality, from the province to the city, the relevant departments will come to you to check repeatedly." ”
"Quality is the lifeblood of the enterprise, and our testing agencies will certainly do their best to ensure that the company will not survive." Yuan Lin said, but from a scientific point of view, we can only try to "avoid false positives and eliminate false negatives."
"Especially false negatives," Yuan Lin said, the impact of false negatives is even greater, and if it is not found out, it will cause the virus to spread around, which will have a greater impact.
03
Found positive
Ye Liying still feels that she is "very lucky", which has to start from the first "salvage" of the new crown virus: it was March 5, 2020, when it was still a single tube sampling, Dongguan City Chashan Town sampled and sent 64 specimens, one case tested positive!
On the first day of testing positive, Ye Liying and her colleagues were very excited and felt "lucky". After all, this was the first time they had done this experiment, and earlier, everyone had no bottom in their hearts.
Ye Liying said that the reason why she feels lucky is also because the test results are yin and yang, only to know that the direction and operation mode of our testing are correct, and only then do we understand that our quality and results are guaranteed.
But after a short period of "luck", everyone was also afraid, because "once you do it, you will encounter a positive, and then you will be more cautious." Ye Liying said that for each specimen, they first disinfect the outer packaging, and then put it into the oven to bake. After baking, the inspector takes it out and enters the information for the next step.
Photo taken at Lanwei Laboratory in Dongguan (Photo: Liao Yuan)
"This virus is afraid of heat, and it may be killed at 100 degrees." Ye Liying said, but in a 56-degree environment, it takes 30 minutes to bake it to inactivate it. Therefore, before each test, they are inactivated with an oven.
Inactivation is to reduce the infectivity of the virus, but inactivation will not affect the negative and negative test results. "Even if the virus is dead, it can test positive for death." Wu Qian described it this way.
At that time, a standard "salvage" process took 4 hours to come down. Ye Liying introduced the whole process of "salvaging" the new crown virus operation to the south wind window ——
The first is sampling. This is followed by specimen transport. Again, it's time to get into the lab.
Laboratories are the most important sites for finding the coronavirus. After the inactivation process mentioned above in the laboratory, it is information entry, which involves information such as area, personal name, telephone, ID card number, etc., so that when there is a positive, the epidemic prevention personnel can quickly find the person.
After the information is entered, it is time to add sample extraction. Because the earlier specimen sampling was placed in the tube, the inspector also needed to take it out and put it on the extraction plate and extract it through the extraction instrument.
The principle of extraction is to complete the reaction between the specimen and the extraction reagent, followed by the reaction liquid. The inspector transfers the reaction liquid to the amplification plate, and the yin and positive can be detected after amplification by the amplification instrument.
"The whole process is based on the detection principle of PCR." Ye Liying said that with the improvement of technology and process optimization, the test results are also much faster.
Photo taken at Lanwei Laboratory in Dongguan (Photo: Liao Yuan)
Chen Zeyu, assistant to the chairman of Dongguan Lanwei, said that taking a single specimen as an example, if the on-site sampling is returned immediately after continuous detection, it can generally be made in 1.5 hours.
This is mainly due to the fact that the sampling tubes used today have the function of virus inactivation, which eliminates the need for a 30-minute inactivation process in the oven.
In addition, the reagent used to be used for 2 hours, but now the manufacturer has 1 hour and 10 minutes of reagent, shortening it by nearly 1 hour.
With the increase of equipment and personnel such as amplifiers, the amount of detection of testing institutions has also increased a lot.
04
300,000 tubes a day
From January to the end of March 2022, Guangdong Mingzhi successively participated in some nucleic acid testing work in Dongguan and Shenzhen, and a total of 11 cases were detected positive, including 10 cases in Dongguan and 1 case in Shenzhen.
"From the beginning of this year to the end of March, we inspected a total of about 3 million tubes, of which 1.2 million tubes were inspected in March." Ye Changqin said that because most of them are large sieves, the number of people tested far exceeds 10 million.
Guangdong Mingzhi staff is taking nucleic acid sampling (source: provided by the interviewee)
The characteristic of the large sieve is that most of them are mixed pipes, such as ten people mixing a pipe. In this way, the detection volume of about 3 million tubes also means that the number of people tested is nearly 30 million.
In the stage of just groping, Dongguan Lanwei can only detect more than 1,000 specimens a day. But now, "specimens under 50,000 tubes, we are not serious." Chen Zeyu said: "The specimen of 100,000 tubes asked us to make the results within 12 hours, and now there is no problem." ”
Coupled with the air film laboratory that is operating, Dongguan Lanwei's daily testing capacity has reached 200,000 tubes. In the future, with the renovation of the third floor of the experimental building and put into use, another 100,000 tubes of detection capacity can be added.
In this way, Dongguan Lanwei alone, its detection capacity can reach 300,000 tubes a day.
Source: Courtesy of respondents
The enhancement of detection capabilities is the result of the rapid development of the industry and the rapid expansion of instruments and technicians.
The main equipment for the detection of the new crown virus is the amplification instrument, before the emergence of the new crown virus, including Dongguan Lanwei, the third-party testing institutions mainly serve the major hospitals, the third-class hospitals, the second-class hospitals or the grass-roots health service centers of some of the higher-cost testing items samples, intensive to the third-party institutions for testing, hospitals and institutions through the cooperation of the sharing model, to solve the problem of sinking high-quality medical resources.
At the end of 2019, Dongguan Lanwei has no more than 10 amplifier equipment, and the company employs no more than 60 people. Affected by the new crown pneumonia epidemic, Dongguan Lanwei now has 200 amplifiers and more than 200 regular employees, including 129 professional and technical personnel. In addition, the company also has about 600 part-time staff such as nurses and logistics.
"Part-time workers are paid once every half a month. Every half a month, we pay more than 3 million yuan for the salaries of part-time workers alone. Liu Yonghong told the South Wind Window, "The salary of the sampling personnel is 50 yuan an hour, including food and housing, and the workload of a day is generally 8 to 10 hours." ”
Guangdong Mingzhi was registered in July 2017, and obtained a practice license on April 4, 2019, focusing on early tumor screening and personalized medication guidance.
However, less than a year after the company's official operation, it encountered the new crown virus, and it has rapidly developed and grown in serving the society and participating in the "salvage" of the new crown virus.
"In accordance with the requirements of the government, our company has also developed in serving the health of the people." Ye Changqin said that the company started with 11 people, now there are 114 people, and the laboratory's amplification instrument has also developed from 1 at the beginning to 58 in use. Recently, the company added 20 more units to use; pcrr labs have changed from 1 to 3.
Inspectors use amplification instruments to test samples (Source: Visual China)
Dongguan Lanwei is a holding subsidiary of Shanghai Lanwei Medical Co., Ltd. (hereinafter referred to as Lanwei Medical), and the annual report released by the company on March 28, 2022 shows that in 2021, Lanwei Medical achieved a total operating income of 1.778 billion yuan, an increase of 43.62% year-on-year; and achieved a net profit attributable to the shareholders of the listed company of 204 million yuan, an increase of 84.68% year-on-year.
Chen Zeyu said that when the new crown first came out, everyone did not dare to try, for the unknown, everyone is also very afraid, in early 2020, the Guangdong Provincial Health Commission issued a document allowing Dongguan Lanwei to do new crown testing, there are only six in the province, Dongguan Lanwei is one of them. At present, there are thousands of institutions in Guangdong Province that do COVID-19 testing.
"We shouldn't just see the growth of the company's wealth, we also pay a lot." Chen Zeyu said, "We have resisted a lot of pressure to help the government share its worries and serve the people, so we have seized an opportunity to achieve rapid development." ”
"Take a big risk!" Chen Zeyu said: "First of all, is it safe? Many of the company's technicians were girls who were crying at the time. Secondly, from the perspective of the company, is it profitable? When the situation was not clear, we had no choice but to do so. ”
Source: Courtesy of respondents
(Chen Bin and Yuan Lin are pseudonyms)
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