Day-to-day operations in clinical labs have evolved rapidly to handle the sustained demand for large-scale COVID-19 sample accessioning and testing. However, demand for testing continues to outpace lab capacity. Therefore, testing labs must continue to transform operations in the face of this demand.

Two major needs have arisen: The need for reliable, mass-produced COVID-19 tests and supporting equipment, and the need for efficient sample accessioning workflows at testing facilities for rapid and accurate processing of these samples at scale. But as countries around the globe continue to struggle to find an accurate, scalable test that can deliver timely results, that second need offers numerous opportunities for optimization, including process automation, supplier management, and risk stratification.

Process automation

Open testing platforms are able to accommodate changes to protocols due to their flexibility to mix and match reagents and instruments. Labs running on a closed system are dependent on a sole supplier and are not able to quickly pivot when demand outpaces supply. With open systems, be sure to review all manual steps in SOPs and protocols for automation opportunities. Find a supplier with a robust supply chain of scalable reagents, so you can easily and reliably meet testing requirements if they change in the future. 

Supplier management

The disruption of supply and demand patterns calls for extra diligence in securing your supply chain. Here are three actions to alleviate supply chain pressure: 

1. Supply agreements: Request supply agreements from all critical suppliers. Some suppliers prioritize testing sites that agree to a supply agreement that smooths out ordering over time rather than placing infrequent large orders.

2. Back-up plans: Make the upfront investment to source and onboard multiple suppliers for critical test components. Develop protocols that allow testing staff to pivot quickly and easily.

3. New ideas: Many testing sites and assay developers are developing new testing methodologies to reduce reliance on limiting consumables. Consider tasking a member of your team with maintaining awareness of new options.

Risk stratification

Now is a critical time to reevaluate a lab’s COVID-19 testing protocols, not only in the context of lessons learned but also in the context of the demand in the lab’s service area. In areas where the infection rate is low, the lab may elect to leverage lower cost, high-level monitoring options such as pooled testing or wastewater surveillance. When primarily processing samples with a high probability of infection, labs may optimize protocols for speed and simplicity rather than sensitivity and precision. 

Sample prioritization is another option for labs facing a surge in demand. A tiered system with clear evaluation guidelines will allow a lab to identify which samples to process onsite and which to send to a reference lab. Labs that prioritize effectively can substantially increase the number of tests available to their service area. However, this process could potentially introduce another time consuming bottleneck. 

Call for coordination

Every clinical lab has protocols in place for disaster preparedness and emergency management. The current SARS-CoV-2 pandemic has challenged the limits of lab planning as well as the patience and stamina of clinical lab professionals. With no clear end in sight, lab leaders will benefit from shifting their focus out of their individual labs, organizations, and geographies, and instead looking towards standardization and shared operational best practices.