COVID-19 Response Efforts of Washington State Public Health Laboratory: Lessons Learned

Abstract

Laboratory diagnostics play an essential role in pandemic preparedness. In January 2020, the first US case of COVID-19 was confirmed in Washington State. At the same time, the Washington State Public Health Laboratory (WA PHL) was in the process of building upon and initiating innovative preparedness activities to strengthen laboratory testing capabilities, operations, and logistics. The response efforts of WA PHL, in conjunction with the Centers for Disease Control and Prevention, to the COVID-19 outbreak in Washington are described herein-from the initial detection of severe acute respiratory syndrome coronavirus 2 through the subsequent 2 months.Factors that contributed to an effective laboratory response are described, including preparing early to establish testing capacity, instituting dynamic workforce solutions, advancing information management systems, refining laboratory operations, and leveraging laboratory partnerships. We also report on the challenges faced, successful steps taken, and lessons learned by WA PHL to respond to COVID-19.The actions taken by WA PHL to mount an effective public health response may be useful for US laboratories as they continue to respond to the COVID-19 pandemic and may help inform current and future laboratory pandemic preparedness activities.

FIGURE 1—

A Timeline of Events and Laboratory-Confirmed COVID-19 Cases During the COVID-19 Response: Washington State; March 1–31, 2020 Note. 2019-nCoV = 2019-novel coronavirus; APHL = Association of Public Health Laboratories; CDC = Centers for Disease Control and Prevention; EUA = Emergency Use Authorization; FDA = US Food and Drug Administration; IMT = Incident Management Team; PHL = Public Health Laboratory; RT-PCR = reverse transcriptase polymerase chain reaction; WA = Washington State. Daily cases (gray bars) and cumulative cases (gray line) are shown. Key events are displayed in text bubbles; WA PHL (orange), CDC (gray), and Washington (blue). Source. Washington State Department of Health.

FIGURE 2—

Washington State Public Health Laboratory Adapted Incident Management Team Structure for the COVID-19 Response Note. BSL = biosafety level; CDC = Centers for Disease Control and Prevention; Epi/Lab = epidemiology/laboratory; PCR = polymerase chain reaction; QA = quality assurance.

FIGURE 3—

Cumulative COVID-19 Tests Performed by Local, State, and National Laboratories Supporting Washington Testing Capacity: March 1–31, 2020) Note. As of March 31, 2020, 15 local medical laboratories, comprising 3 nonprofit, 6 hospital, and 6 commercial laboratories, were supported by the Washington State Public Health Laboratory to onboard COVID-19 testing.