The Global Shortage Of Lab Supplies Through Covid-19

COVID-19 brought unpredictable challenges to every field, including the clinical laboratories. The laboratories struggled and strived hard to produce accurate and quality results, but uncertainty and scarcity of lab supplies was the main barrier affecting day-to-day operations, and therefore,  reducing productivity. This negatively affected the ability to increase the number of tests executed (American Society of Microbiology, 2020).

Diagnostic research is an important aspect of ensuring effective health care and regulating the transmission of infectious diseases. Since early spring, shortages of SARS-CoV-2 laboratory materials due to the strong demand for COVID-19 research have disrupted the laboratory’s supply chain and prompted several clinical laboratories to switch their energies and redistribute capital (Hagen, 2020).

American Society for Microbiology in association with Supply Chain Management

ASM has worked with the Association of Supply Chain Management to create a survey to gather the position of test suppliers for both COVID-19 testing and other microbiological tests to demonstrate and eventually resolve these crippling supply chain problems. Starting September 11, ASM started individually gathering data on shortages directly from clinical laboratories, and therefore,  bringing the attention to the data generated by laboratory directors and clinical microbiologists without external influence. The data collection period was prolonged to six weeks, and it was updated each week.

127 CLIA-certified laboratories responded to the survey and recorded a mean test potential of 42.8% for COVID-19. As a subset of clinical microbiology laboratories in the U.S., this data demonstrates that supply shortages are still a problem.

The Results

The following results were extracted from the research survey:

• 50 percent of laboratories have a lack of commercial test kits for SARS-CoV-2.
• 30 percent of laboratories lack non-COVID-19 laboratory facilities to diagnose regular bacteria (including bacteria that cause strep throat, pneumonia, bronchitis, and urinary tract infections).
• 42.9 percent of laboratories lack supplies for molecular identification of sexually transmitted diseases.
• 28.6 percent lack materials for mycobacterial research (including tuberculosis supplies (TB), Buruli ulcer, and pulmonary non-tuberculous mycobacterial condition testing).
• 50 percent of laboratories are experiencing a lack of materials for regular fungal monitoring (from shallow, isolated skin disorders and deeper tissue infections to severe lung, blood (septicemia) or systemic diseases) (American Society of Microbiology, 2020).

The Estimated Demand

To take this into account, the existing global potential for molecular research within laboratories is predicted to be between 14 million and 16 million experiments per week, with the real number of tests performed is less than 10 million per week (Behnam, 2020).

The projected amount expected varies from six million tests a week (if the country is to be partially reopened) to 20 million every day, covering 6% of the population per day (if it is to be completely re-opened but still monitoring outbreaks) (Safra, 2020).

Ways to overcome the scarcity

Five major tasks are in the way of providing laboratory-based molecular testing: sample collection, logistics, test execution, data management, and test capacity management.  All tasks must be carried out in a cohesive manner to maximize supply in a complex test ecosystem, but slowdowns can take place at each point.

Sample collection

A sample collection is necessary for all diagnostic tests. The scarcity of supplies required to collect samples (such as swabs and viral transport media) and a restricted number of test sites have sometimes led to long waiting times for the COVID-19 test and to the untested main parts of the population (such as healthcare workers).

Improvement has been made in resolving some of these problems. In order to increase the availability of swabs, conventional factories have expanded their production, modern manufacturers have been licensed, and some manufacturers are using 3-D printing. Moreover, certain health authorities have authorized substitute means of transport (such as saline) and various types of samples (such as saliva and lower-respiratory-tract samples). Studies suggest that the test findings from those substitutes could be as valid as those taken from them.

Logistics

Logistics firms play a vital role in two aspects of the supply chain research: the shipping of products from sources around the world to testing labs and the transfer of samples from storage locations to laboratories. Neither problem has proven to be as important a test restriction as the other problems outlined in this report. However, they could become more troublesome as countries (emerging economies) increase research, so both concerns should be closely observed.

Test Execution

Two major problems have led to a restricted capacity to carry out tests: a lack of laboratory equipment and qualified staff required to perform tests and a scarcity of the requisite reagents, mostly packaged as packages (such as research kits and RNA-extraction kits).

Constructing and upgrading new equipment takes time, which typically lies between 20 to 30 days, in the case high-performance equipment is to be produced, and at least three to five days to be assembled, configured, and tested for diagnostic testing. Newly installed equipment often requires additional trained staff to run it. Moreover, many countries’ financial limitations, such as government support for public health labs, will make it difficult to develop additional resources.

Testing-capacity management

In certain nations, balancing availability with demand was a problem, leaving sufficient laboratory research resources underutilized. Laboratories in different places across the United States, for example, have reported idle ability to perform further experiments, even though patients and health professionals experience challenges in receiving tests. A similar problem has occurred in the United Kingdom, where the number of tests performed has sometimes lagged below the recorded capacity.

Similar refers to stocks of chemicals, test kits, and other supplies. In April 2020, Brazil announced that seven laboratories cleared by health authorities were unable to process samples because they did not have chemicals, even if they were present on the market. Lack of cooperation, encountered in areas worldwide, has also contributed to unreasonable competitiveness for supplies between regions and between hospitals in a single region (Behnam, 2020).

References

American Society of Microbiology. (2020, October 30). Supply Shortages Impacting COVID-19 and Non-COVID Testing. American Society of Microbiology. https://asm.org/Articles/2020/September/Clinical-Microbiology-Supply-Shortage-Collecti-1

Behnam, M. (2020). COVID-19: Overcoming supply shortages for diagnostic testing. McKinsey & Company. https://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/covid-19-overcoming-supply-shortages-for-diagnostic-testing#

Hagen, A. (2020, October 15). Laboratory Supply Shortages Are Impacting COVID-19 and Non-COVID Diagnostic Testing. American Society for Microbiology. https://asm.org/Articles/2020/September/Laboratory-Supply-Shortages-Are-Impacting-COVID-19

Safra, E. J. (2020). Roadmap to Pandemic Resilience. Harvard University.