Mark Turra is the Head of the Microbiology and Infectious Diseases, Public Health and Epidemiology Unit at SA Pathology. He has over 20 years of experience in the field, starting out in the private sector before moving into the public domain.
While he has experience in multiple pathology disciplines, the vast majority of Mark’s time is spent on infectious diseases, in which he focuses on the development of Nucleic Acid Tests (NAT) and optimisation of laboratory workflows.
Mark has been responsible for developing a number of diagnostic NAT assays by investing many years in the design and implementation of a scalable high volume infectious diseases testing laboratory that would manage high-volume testing during pandemic events.
Mark is the recipient of the SA Health – Minister’s Research and Innovation award, as well as the SA Premier’s Award for Excellence in Service Delivery – Emergency Response, for his role in the development and implementation of SA Pathology’s in-house NAT testing system for COVID-19.
What prompted you to develop SA Pathology’s own testing procedures for COVID-19?
The decision to develop in-house PCR assays for the detection of SARS-CoV-2 was predicated on an existing scalable, modular molecular testing system that the SA Pathology Virology laboratory had developed in the preceding years in preparation for potential viral pandemics.
The testing system was designed to allow new assays to be included with minimal impact, with critical components such as staff training, testing infrastructure, reagents and laboratory information system integration requiring few or no changes.
How were you able to successfully develop a test in such a short time?
The SA Pathology Virology laboratory has an extensive history of investing in in-house PCR assay development and upskilling of scientists, this experience enabled us to make informed decisions regarding the assay design for SARS-CoV-2.
With known parameters for assay design, dictated by the laboratory testing system, the assay design was a relatively straightforward process. A SARS-CoV-2 reference genome became available on the 13th of January 2020, using this sequence we were able to develop 3 Real-time PCR assays in less than a day and immediately place orders with multiple oligonucleotide manufacturers.
The early versions of these assays were first to run in early February 2020.
Were there any issues that you faced during that period?
While the design of the PCR assays was straightforward, it quickly became apparent that the global demand for testing resources dictated that we adapt our current testing system.
There was a period of months early in 2020 where we validated and optimised a large number of new reagents and optimised workflows to ensure we could continue to provide an effective COVID-19 testing service.
We continue to forward plan, anticipating upcoming challenges so that we may adapt quickly depending on future demands.
How were you able to lead your team when there was a surge of outbreaks in the state?
I am very grateful to have an excellent team around me, the management group, clinicians, scientists and technicians were exceptional under the pressure of surging test numbers, many long days were had.
Importantly, many of us had experienced the 2009 H1N1 pandemic and the testing surges associated with it. While the associated test volumes were not as high compared to the current pandemic, the experience gained provided a framework for decision making going forward.
This, coupled with a confidence in our testing processes, meant that there was a relative sense of calm during those first days of COVID-19 testing.
What are your current plans with SA Pathology moving forward?
SA Pathology’s Virology laboratory COVID-19 testing success to date is very much a function of previous investment in scientist training and ongoing development of the laboratory testing system.
Therefore, it is important that I and others continue to guide and develop our young scientists to ensure that the SA Pathology Virology laboratory can continue to provide a quality, flexible testing service into the future.
Much of the ongoing development and optimisation associated with the SARS-CoV-2 PCR assay has wider applications in the laboratory. So in the short to medium term, many of the improvements will be incorporated into existing assays.
I have an interest in laboratory workflow optimisation so no doubt work in that area will continue. There are always new challenges in the laboratory and no doubt at some point in the future another pandemic/epidemic will occur to keep me occupied.