When nucleic acid becomes a part of daily life, for nucleic acid testers, time is measured in hours.
Beijing, with a permanent population of 21.886 million people, would need a testing capacity of at least 2.18 million tubes per day for the city’s third-party nucleic acid testing institutions if it tested once a day according to a 10:1 mixed collection method. According to regulations, each nucleic acid testing agency needs to issue test results within 24 hours after sampling, and some agencies have set higher requirements for themselves - the system will issue an early warning after 22 hours.
The huge amount of testing and extremely short time means the need for a large number of inspection personnel. Each agency is trying to attract inspectors from all over the country to join them with high salaries and benefits. In the recruitment group of third-party organizations, it has long been standard to have a daily salary of 1,500 yuan, food, food and housing, car pick-up and delivery, and six insurances and one fund. On the other hand, the standards for recruiting personnel have to be lowered again and again. Undocumented "experiencers" who are "familiar with the process and proficient in more than 2 experimental steps" can be employed the next day after an online interview.
Some chaos also occurs in this industry. On May 14, supervisors found that the original test data of Pushi Medical in Fangshan District, Beijing, was significantly less than the number of sample tests. Subsequently, the Fangshan District Health Commission revoked Pushi Medical's "Medical Institution Practice License". A few days later, the license of Beijing Jinzhun Medical Laboratory was also revoked because it illegally mixed multiple tubes of samples for testing, seriously violated quality and safety regulations and affected the accuracy of test results.
Zhao Jian (pseudonym) graduated from a key medical university with a major in laboratory testing and worked in a top-level hospital for nearly three years. He came to Beijing to visit relatives on May Day, and by chance, he worked part-time as a nucleic acid tester.
His work was as busy as a war. At most, he tested continuously for 16 hours. But for him, the intensity of work is bearable. The most uncomfortable thing is that the industry has become "chaotic".
He talked about how the nucleic acid testing laboratory operates and some phenomena he saw that puzzled him. The following is his dictation——
Text | Chang Fangfei and Li Qingyang
Editor|Chu Ming
Operation|Lizi 1
I am here Medical universities major in testing. After graduation, I successfully joined a tertiary hospital as a laboratory technician, and my daily job was to process samples. Under normal circumstances, the workload is not large. I saw that the actual number of people tested for nucleic acid testing in our hospital yesterday was 6,340. After ten people were mixed, that is, 634 tubes of samples were processed. The monthly salary can be just over 10,000 yuan. I'm quite content.
In fact, going to Beijing to do nucleic acid testing part-time was a complete mistake.
I came to Beijing to visit relatives during the May Day holiday, but on the second day after arriving, Beijing announced a halt to dine-in dining, and I knew the epidemic was serious. If I go back directly, the isolation cost and time cost are unknown. It is better to stay in Beijing and wait.
A friend here saw me coming and told me that many third-party institutions are now recruiting part-time nucleic acid testers and are in urgent need of people with dual certificates (tester and clinical gene amplification personnel employment certificates) .
Basically, the current price is 120 yuan/hour for dual certificates and 100 yuan/hour for experienced workers without certificates. The working time of one shift a day is 12 hours, and you can earn 1,440 yuan. I quickly applied to the hospital for a leave of absence without pay. It is better to make money than to wait here.
On the first day of work, after entering the laboratory, the laboratory team leader will ask me to provide my ID card, mobile phone number, laboratory technician certificate and PCR certificate issued by the Provincial Clinical Laboratory Center (Clinical Gene Amplification Personnel Employment certificate). I actually went in with the idea that I could earn a day's money. There was no five insurances and one housing fund, no contract was signed, and the salary was settled the next day.
After I started working part-time, I was also drawn into some PCR nucleic acid testing recruitment groups, and agencies were posting recruitment needs every day. In fact, at the beginning, inspectors were not required to be graduates of inspection majors or have a college degree or above. This was a new requirement only after the Parkstone Laboratory incident. Part-time nucleic acid samplers are generally required to have a nurse certificate, while part-time nucleic acid information entry workers have no special requirements, as long as they are in good health.
However, the information sent by intermediaries must be carefully judged, as many of them are unreliable. For example, some agencies said they could offer inspectors 150 yuan per hour and a daily salary of 1,800 yuan. Fangshan Pushi Laboratory hired many people with this salary, but everyone has seen the results.
Some agencies say that you can get a temporary PCR certificate for 3,000 yuan or 4,000 yuan. it's out of the question. If a candidate wants to get a PCR certificate, he first needs to be registered by a hospital laboratory department that is qualified to conduct PCR experiments, not just any hospital. The receipt after registration needs to be stamped by the director of the hospital's laboratory department.
In addition to theory, the nucleic acid testing qualification examination also tests candidates’ operational abilities. The Provincial Clinical Testing Center will provide blind samples, and when positive quality controls are added, the samples will show positive, strong, or weak positive reactions. Finally, the clinical testing center will check whether the positive samples selected by the candidates are consistent with the ones they set before the exam.
So this is a job with a high threshold. The inspector needs to understand the principles and steps of the experiment. It is not something that just anyone can do.
▲ The inspector is doing reagent testing. Picture / Visual China 2
Compared with clinicians, the testing profession is less popular. Most people who study laboratory testing don't know exactly what a laboratory technician does at first. Most of them "dropped out" because they were not admitted to their first clinical choice.
I am not.
I filled out the test for my first choice. Back then, my college entrance examination score was 597, which was enough for clinical studies, but I filled out the test for my first choice. I would rather face a sample than a person. People are too troublesome. The samples are very pure. As long as the test results are correct, no one will trouble me.
I passed the PCR certificate in 2019, before the epidemic started. I was doing other types of molecular experiments in the hospital and felt very relaxed. Who knew I would be so busy suddenly now.
Now the laboratory is scheduled for shifts every day, with each shift lasting 12 hours. I recently worked the day shift and was on duty in Zone 3.
The entire nucleic acid laboratory is divided into three areas. The first area is for preparing reagents, the second area is for adding samples and adding samples to the reagents, and the third area is for sample amplification and result evaluation.
The so-called "fast hand speed" required in the intermediary group refers to the speed of adding samples. After the Shanghai Screening, it is now generally required that the sample volume added per hour is no less than 4 plates (96 tubes/plate). I have fast hands and can fill one plate in 7 minutes. I can add 9-10 plates in 1 hour. Most experienced users need more than 10 minutes to add 1 plate.
Now all major screens in Beijing are undertaken by third-party organizations. The laboratories of the organization I work for are also located in various regions. Each laboratory updates its requirements in the work group every day. If the sample size for large-scale screening in a certain area is too large, part-time workers like us will be mobilized to temporarily cover the work for three to five days.
The most exaggerated time was when I was temporarily transferred to a shelter in Fengtai District. I entered at 4pm the day before and worked non-stop until 8am the next morning. I was tested continuously for 16 hours. I don't even care how many tubes I have done. Because I had to keep tightening the lid of the specimen for 16 hours, my fingernails were all red at the end of the day and I couldn’t lift my arms.
Many times it is bright when I enter the laboratory, and it is also bright when I come out. My concepts of time and space became blurred, and even when I went back to rest, I felt like I was still in the laboratory.
It was already 4 a.m. when the night shift ended. I was too tired to go home, so I went to sleep in a hotel near the laboratory. Because during the epidemic, hotels are also cheap, 119 yuan a day.
One time when I returned to the hotel after get off work, my roommate asked me to help him hang his clothes in the closet. I blurted out: "I have frozen the remaining half of the reaction solution in the freezer." I was All I could think about was the experiment, and I was stunned.
▲ The inspector will keep the nucleic acid sample in the refrigerator for one day in case of need for re-examination. Picture / People's Vision
Even under normal circumstances, I have to process at least 15,000-20,000 tubes of samples per shift, which is 150,000-200,000 samples. At least 1,250 samples have to be processed every hour, and the rhythm is non-stop, like a war. It’s impossible to catch fish while working every minute. The team leader would come behind us regularly to count the boards.
If the sample size is large, they will not be able to get off work within 12 hours, and they will need to work an average of thirteen or four hours a day. The time for eating in the middle is not fixed. The team leader looks at the progress of the test and says we can eat only when we can. Because we need to take off protective clothing when we rest and eat, we try to drink as little water as possible. What to do if you are thirsty? Bear with it. It's okay that I'm a boy, but it's more troublesome for girls to go to the toilet.
I have never thought that this industry can make people suffer from any diseases before.
Later, I participated in the big screening and the experiment lasted too long. Everyone was prone to frozen shoulder, and the finger joints and muscles were easily deformed and accumulated fluid due to long-term wear and tear.
There will always be various unexpected situations that occur during the big screening. Inconsistency in personnel information often occurs. The tube I scanned sent the result, and the corresponding position of each sample was scanned, but when it was time to upload, the system reported that there was no corresponding person information for a certain sample. In a mixed sample of ten, as long as one person's information is wrong, the system will prompt that the corresponding health treasure cannot be found. I need to contact the community to find the person who corresponds to the sample.
Residents are also anxious to get the results. The laboratory's phone number is posted at the nucleic acid testing site. Maybe just five hours after the sampling was completed, a resident called the agency's customer service number to request the results. The customer service staff would immediately come to the laboratory to ask about the progress. Every time they asked, I would say nothing. I don't know what to say. I also understand that residents may have pop-up windows or other urgent needs, but I really can’t do it any faster.
The shelter is also operating at full capacity.
In fact, the hardware configuration of laboratory cabins is all about ordinary sample throughput, but now almost all of them must handle high-throughput sample quantities. The general throughput is 10,000 tubes, but basically the sample volume received is about 20,000 tubes.
Fortunately, my laboratory has a sample release solution, and the RNA in the sample can be automatically released without re-extraction.
Under such circumstances, the equipment can basically keep up. The sample needs to be heated by the amplification instrument so that it can quickly replicate itself, making it easier for the inspector to view the sample results. One amplification instrument can process 90 tubes of samples at the same time. However, if this reagent is not available, an extraction step will be required, the experiment will take longer, and the results may not be available within the specified 24 hours.
Sometimes I feel irritable. It’s almost time to get off work and I’ve almost finished packing my reagents. At this time, people outside just said: "There are no more samples!" I just took a breath, and 2 minutes later, I opened the door again and threw in a bag of samples (90 tubes). Then I have no choice but to finish the test.
In fact, I have long been trained by this kind of work intensity.
In 2021, when nucleic acid screening has not yet been sent to third-party institutions, I will be more tired in the hospital than now. Sometimes samples of hundreds of thousands of people are done in one shift, and there are no partners at all. I need to go through the entire process and three areas by myself. From reagent preparation, sample addition, amplification, and viewing results, I am the only one doing it. Normally you have to work 14 hours a day.
I have been working part-time in Beijing for more than 20 days this time, and I have found a positive environmental sample once. After reading it, I immediately reported it to the CDC. I'm already used to positive samples.
When the epidemic was at its worst in 2020, I joined the medical team aiding Hubei. That year, Wuhan was closed during the Spring Festival. By March, various provinces were looking for people with nucleic acid test certificates from all over the world to support them. Every tertiary hospital has obtained quotas and wants to send all those with certificates to Wuhan. The atmosphere was particularly solemn and solemn. It was stipulated that those who were pregnant, those who were only children, and the rest had to go.
At that time, there were fewer people doing nucleic acid testing than now, so the work was very intensive. None of us have any working hours, so we just keep working and working, even if it exceeds 16 hours. Until someone comes in to take over. If you really don’t have the manpower, just keep doing it.
The first time I saw the positive result while on duty in District 3, my legs felt weak. In the next half month, I saw positive results every day, and over time I became desensitized.
I just came home from Wuhan in April. After that time, I felt that no work was tiring. Frankly speaking, compared with the intensity of work now in 2020, it is relatively easy.
▲ Inspection personnel are testing the nucleic acid samples submitted for inspection. Picture / People’s Vision 3
In fact, the intensity of work is bearable. What makes me most uncomfortable is that this industry has become very chaotic now.
On the first day of my part-time job, I entered the second area of ??the laboratory and asked the buddy who worked with me: "What major do you major in?"
It turned out that he had never studied testing. , I used to run Didi. He was able to enter the laboratory only because he had transported samples to the sampling site before. By chance, he met the intermediary and entered the laboratory. The driver was no stranger, and there was a real estate agent standing next to me.
When the laboratory recruits, it is said that every employee has a trial period, but those who do not understand the experimental principles and are testing nucleic acids for the first time can learn while watching the operations of the people next to them, adding samples, transferring After you become proficient in operating the board, you can handle the work in the second area.
A laboratory shift requires at least 7-8 people. Nowadays, every institution and laboratory is short of people. Generally speaking, they will not be kicked out.
People with recruitment authority will also recruit acquaintances and relatives. Our team leader is like this, he has very bad character.
He is very strict with us people, but he protects his relatives very well. In order to recruit this relative, I rejected a very capable colleague with dual certificates. But this relative really doesn’t know anything.
Once when he was taking a sample, he removed the contamination and added a positive quality control to the sample, and the sample became positive. The person on duty in the third area judged that the result might be a false positive, and the sample had to be returned to the second area for retest. I had to start all over again - add the sample again, load the machine, and amplify it.
There was another time that was even more thrilling. After the re-inspection was completed, I asked him to destroy the samples before plate No. 39, but he misunderstood and destroyed all the samples after plate No. 39. Those samples have not yet produced results. If the samples need to be retested, it will be impossible for me to find the corresponding location. In the end, I can only judge based on my own experience that the weak positive of a certain sample is caused by contamination, and there is no way to retest it.
▲ Picture/People's Vision
Sometimes, in the third district, I found the entire "flower board" in the second district (the whole board is full of contamination). It may be that the positive quality control was shaken. board, causing the entire board to show positive. The entire plate needs to be re-added with samples, re-installed on the machine, and re-tested.
I was very angry and yelled at him. As soon as he turned around, he went to the team leader to complain about me, saying that my attitude was so bad that he couldn't do his job.
Maybe I am a bit impatient. But I really can’t accept that you dare to come to the laboratory without knowing anything. Everyone is in it for money, but we can’t just muddle through like this. No matter what experiment is done, the experimenter should understand the experimental principle, which is the most basic.
Take my institution as an example. They have two reagents, one is the processing solution and the other is the reaction solution. Add the sample to the processing solution, and there will be an initial reaction. Then you need to transfer the plate, add the reaction solution, and the sample will automatically release RNA. If there is no reaction solution, the laboratory operator needs to manually extract the RNA from the sample. The entire experiment will become very tedious, and each step may contaminate the sample, resulting in a "false positive" sample.
I lost my temper because I didn’t want the industry to become such a mixed bag, not because I was being treated badly or because my personal interests were affected by outsiders.
I worked in Beijing for 20 days and received 30,000 yuan, which is equivalent to three months’ salary in the hospital. After Beijing recently inspected these nucleic acid testing institutions, those with dual certificate qualifications will be paid higher. Organizations need high salaries and benefits to attract these professionals.
I won’t really resign to do nucleic acid testing, I’m not that tough. Public hospitals are worth staying in. Although the monthly living expenses are small, they are stable. There is no overtime pay for working overtime, but applications for time off are approved every time. What else is there to be dissatisfied about?
I will probably finish this part-time job in a few more days. One minute ago, a news pop-up said that social screening in Beijing was zero, and restaurants would resume dine-in meals. Like everyone, I am looking forward to the day when normal life can resume.
▲ Beijing is gradually restoring daily order, and citizens are playing games outside. Picture / Visual China
The article is original by Daily People, and any infringement will be investigated.