Lab-in-a-van: Rapid SARS-CoV-2 testing response with a mobile laboratory

Susan A Ballard; Maryza Graham; Debra David; Tuyet Hoang; Angela Donald; Michelle Sait; Nicole Isles; Amelia Matlock; Sarah Yallop; Mark Bek; Benjamin P Howden; Timothy P Stinear

doi:10.1016/j.ebiom.2022.103983

Lab-in-a-van: Rapid SARS-CoV-2 testing response with a mobile laboratory

EBioMedicine. 2022 May:79:103983. doi: 10.1016/j.ebiom.2022.103983. Epub 2022 Apr 8.

Authors

Affiliations

¹ Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia. Electronic address: susan.ballard@unimelb.edu.au.
² Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia; Department of Microbiology and Infectious Diseases, Monash Health, 246 Clayton Rd, Clayton, Victoria 3168, Australia.
³ Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia.
⁴ Department of Health, State Government of Victoria, Australia.
⁵ Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia; Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia; Department of Infectious Diseases, Austin Hospital, 145 Studley Rd, Heidelberg, Victoria 3084, Australia.
⁶ Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne 3000, Australia.

Abstract

Background: High testing rates and rapid contact tracing have been key interventions to control COVID-19 in Victoria, Australia. A mobile laboratory (LabVan), for rapid SARS-CoV-2 diagnostics, was deployed at sites deemed critical by the Victorian State Department of Health as part of the response. We describe the process of design, implementation, and performance benchmarked against a central reference laboratory.

Methods: A BSL2 compliant laboratory, complete with a class II biological safety cabinet, was built within a Mercedes-Benz Sprinter Panel Van. Swabs were collected by on-site collection teams, registered using mobile internet-enabled tablets and tested using the Xpert® Xpress SARS-CoV-2 assay. Results were reported remotely via HL7 messaging to Public Health Units. Patients with negative results were automatically notified by mobile telephone text messaging (SMS).

Findings: A pilot trial of the LabVan identified a median turnaround time (TAT) from collection to reporting of 1:19 h:mm (IQR 0:18, Range 1:03-18:32) compared to 9:40 h:mm (IQR 8:46, Range 6:51-19:30) for standard processing within the central laboratory. During deployment in nine rural and urban COVID-19 outbreaks the median TAT was 2:18 h:mm (IQR 1:18, Range 0:50-16:52) compared to 19:08 h:mm (IQR 5:49, Range 1:36-58:52) for samples submitted to the central laboratory. No quality control issues were identified in the LabVan.

Interpretation: The LabVan is an ISO15189 compliant testing facility fully operationalized for mobile point-of-care testing that significantly reduces TAT for result reporting, facilitating rapid public health actions.

Funding: This work was supported by the Department of Health, Victoria State Government, Australia.

Keywords: Mobile testing; Point-of-care; Rapid testing; Real-time PCR; SARS-CoV-2; Turnaround-time.

MeSH terms

Australia
COVID-19 Testing
COVID-19* / diagnosis
COVID-19* / epidemiology
Humans
Point-of-Care Testing
SARS-CoV-2*
Sensitivity and Specificity