GEORGE NEWS - Following the cyberattack and subsequent security breach of information technology (IT) systems of the National Health Laboratory Service (NHLS) on Saturday 22 June, Eden District Health Services has asked patients waiting for non-urgent and non-critical test results to be patient.

Under normal circumstances, laboratory reports are automatically generated and sent to clinicians or made available on WebView, but the incident has disabled that function.

Nadia Ferreira, district spokesperson for the Western Cape Health Department, said the system breach affects all public sector test results.  "However, there is a manual system in place where urgent and critical test results are communicated directly to clinicians via telephone."

The NHLS said the breach has endangered the safety and well-being of millions of public health patients. 

IT systems and infrastructure have been impacted and the networked laboratory system is heavily reliant on the information technology systems that have been disrupted. However,  a preliminary investigation indicated that no patient data has been lost or compromised. 

An incident response team consisting of internal experts and external cybersecurity professionals was activated soon after the breach.

An investigation indicated that a ransomware virus was used to target selected points in the NHLS IT systems, rendering them inaccessible and blocking communication from the laboratory information system and other databases to and from users. 

Sections of the system have been deleted, including in the backup server. The affected parts have to be rebuilt, but this will take time. 

Alternative measures

On Thursday 4 July, the NHLS in an update on the situation said it continued to implement alternative strategies and measures to ensure business continuity. 

Head of communications Mzi Gcukumana said, "On the service delivery or testing side, all laboratories are functioning although providing test results to the clinicians is still a challenge ... all urgent results are communicated telephonically to requesting clinicians."

A critical test list has also been distributed to all health facilities to limit the volume of test requests, allowing laboratories to cope with the workload. "However, this does not imply that routine tests will not be performed," said Gcukumana.

Innovating to communication results

"We have come up with innovative ways of making TB and HIV viral load historical test results available to clinicians. More tests, prioritising those on the critical test list, will be made available. 

"In addition, we are in the process of developing an electronic registration system for registering new samples and providing test results electronically. Access to laboratory results will be the same as the historical TB and HIV viral test results."

The NHLS is also focusing on bringing all its systems back online. The estimated time to initiate end-user access is mid-July.

"The NHLS is handling this challenge with extreme urgency to ensure the timely and secure recovery
of all affected operations," said Gcukumana. 

A case has been opened with the South African Police Service. "In addition, we have informed all the relevant regulatory bodies about the breach."

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