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. 2020 Jul 23;58(8):e01110-20.
doi: 10.1128/JCM.01110-20. Print 2020 Jul 23.

A Public Health Laboratory Response to the Pandemic

Kanti Pabbaraju  1 , Anita A Wong  2 , Mark Douesnard  2 , Raymond Ma  2 , Kara Gill  2 , Paul Dieu  2 , Kevin Fonseca  2   3 , Nathan Zelyas  4   5 , Graham A Tipples  4   6   7
Affiliations

A Public Health Laboratory Response to the Pandemic

Kanti Pabbaraju et al. J Clin Microbiol. .

Abstract

An outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) began in Wuhan, Hubei, China, in December 2019 and spread rapidly worldwide. The response by the Alberta Precision Laboratories, Public Health Laboratory (ProvLab), AB, Canada, included the development and implementation of nucleic acid detection-based assays and dynamic changes in testing protocols for the identification of cases as the epidemic curve increased exponentially. This rapid response was essential to slow down and contain transmission and provide valuable time to the local health authorities to prepare appropriate response strategies. As of May 24, 2020, 236,077 specimens were tested, with 6,475 (2.74%) positives detected in the province of Alberta, Canada. Several commercial assays are now available; however, the response from commercial vendors to develop and market validated tests is a time-consuming process. In addition, the massive global demand made it difficult to secure a reliable commercial supply of testing kits and reagents. A public health laboratory serves a unique and important role in the delivery of health care. One of its functions is to anticipate and prepare for novel emerging pathogens with a plan for pandemic preparedness. Here, we outline the response that involved the development and deployment of testing methodologies that evolved as SARS-CoV-2 spread worldwide, the challenges encountered, and mitigation strategies. We also provide insight into the organizational structure of how a public health response is coordinated in Alberta, Canada, and its benefits.

Keywords: COVID-19; RT-PCR; SARS-CoV-2; public health.

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Figures

FIG 1
FIG 1
Timeline for the evolution of the pandemic and ProvLab response. WHO, World Health Organization; GISAID, Global Initiative on Sharing All Influenza Data; E, envelope; RdRp, RNA-dependent RNA polymerase; RT-PCR, reverse transcriptase PCR; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
FIG 2
FIG 2
Samples tested for SARS-CoV-2 and positives detected. Total number of samples tested and positives detected from January 20 to May 24, 2020, are shown as bars. The percent positives are shown by a line graph on the secondary y axis.
FIG 3
FIG 3
Timeline for changes in the laboratory testing algorithm. ER, emergency room; RPP, respiratory pathogen pane; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COVID-19, coronavirus disease 19.
See this image and copyright information in PMC

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