The COVID-19 pandemic has seen molecular testing technology and capabilities accelerate at an extraordinary pace. Between the need for real-time PCR equipment to detect the virus, and DNA sequencers to identify strains of the virus, there have been significant investments in testing capabilities and labs the world over.
- India scaled from one COVID-19 testing lab in January 2020, to over 1,596 testing labs by August 2020.
- Between March and October 2020, demand for molecular-diagnostic assays increased 20-fold in Europe and the United States alone. The United States doubled its level of national COVID-19 testing from under a million tests per day in September 2020, to around 2 million per day in January 2021.
- Bangladesh gained 109 testing laboratories in the eight months to October, with the World Health Organization assisting to train over 17,000 laboratory staff, sample collectors, and transporters. WHO also assisted in deploying around 100 vehicles to support mobilise COVID-19 testing.
- In February 2020, there were only two COVID-testing laboratories in Africa. By June of that year, there were 750 laboratories testing across the WHO African Region.
- The World Health Organization was fast to ship reagents and supplies for SARS-CoV-2 PCR tests to over 150 labs around the world, while the International Atomic Energy Agency (IAEA) rapidly dispatched testing equipment including Mic to 120 member states.
Laboratories all over the world now have molecular testing instruments – and expertise – in place where they might have previously had limited capabilities or none at all. So what of the future? What will become of these capabilities as vaccines roll out and as we move into future phases of the pandemic?
In the immediate future
Of course, it’s reasonable to expect that the SARS-CoV-2 virus will be around for some time. In a Nature survey of immunologists, infectious-disease researchers and virologists, almost 90% believe that the coronavirus will be endemic. Lower income countries could be waiting years to be fully vaccinated, and even developed countries are seeing delays due to logistics and even ‘vaccine hesitancy’ (In France for example, only 41% of the public is willing to receive a vaccine). The emergence of new and more aggressive mutations may also extend the necessity of testing, whole-genome sequencing and vaccine development into the long-term future.
It’s therefore realistic that expanded testing equipment and expertise could be in use for COVID-19 testing over the next five or ten years or longer, and safe to say that investments in molecular testing facilities won’t be rendered ‘redundant’ overnight.
In the long term
While testing equipment gathering dust will be a positive sign that we’re getting on top of this virus, there will no doubt be further use and repurposing for lab equipment as the pandemic’s power fades over time.
- In the case of university laboratories, expanded molecular testing equipment could provide an exciting opportunity for more students and graduates to gain hands-on experience within their chosen fields of study and research.
- While smaller hospitals and laboratories might have once outsourced their molecular testing to a larger hospital or lab, they might decide to keep testing in-house now that they have the capabilities to do so. This could have benefits for timely treatment of other illnesses as well as diverse research.
- Just as some remote testing labs were converted from HIV, Hepatitis C and tuberculosis-testing facilities to COVID-19-testing facilities, some COVID-19 lab equipment might also have a second life helping to identify and manage future infectious disease outbreaks.
- The most portable laboratory instruments could be used for mobilised labs in vehicles or shipping containers; not only providing transportable diagnostic tools for COVID-19, but also for any future disease outbreaks in humans or animals in remote or regional areas.
- Scalable systems could be scaled down as needs dictate. For example, while several Mic thermal cyclers can be purchased and run together with outstanding reproducibility for mass testing, the second or third units could later be repurposed to scale testing operations down.
- Lab instruments could be repurposed for use in other sectors. Just to provide a few examples, our Mic thermal cycler and Myra liquid handling system are being used across agriculture, archaeology, wildlife and livestock management, public health, product development and many other areas.
The important factor of flexibility
The one question that’s been common amongst lab and facility managers investing in new lab equipment over the past year is how to ensure their investments won’t be wasted as testing needs and situations change. Our recommendation is to focus on flexibility. This includes:
- Cost flexibility
That is, choosing a system that can be scaled up and down as needed, rather than simply buying the largest thermal cycler or liquid handling system to suit today’s relatively high needs.
- Operational flexibility
That is, choosing compact and robust lab instruments that can be taken out into the field and easily mobilised, with simple or no calibration needed, and no expensive service contracts.
- Lab flexibility
So in the case where a thermal cycler or liquid handling system is to be used for a different testing purpose, lab users can easily access and save to an assay library and define their own tube type if needed.
Speed is one other important factor for future-proof lab equipment, particularly in a testing environment. And above all, outstanding accuracy is the crucial factor to ensure lab users can be confident in the results they’re producing.
After more than a year of enhancing and expanding their capabilities for both COVID-19 testing and research, many laboratory managers are trying to both meet immediate needs and make practical choices for the future. By choosing equipment and systems that offer the flexibilities above, they can maximise both the resale and repurposing value of their investments.
Coming next: the lessons learned about accessibility
In the midst of accelerated expansion and rapid rollouts of testing equipment, there have been several lessons about making lab equipment accessible for all who need it. Stay tuned for our next article in this series, where we’ll discuss what’s been learned about molecular testing accessibility during the COVID-19 pandemic.