Strengthening Respiratory Laboratory Networks
By Maureen Sullivan , MPH , manager , Respiratory Diseases
The emergence of SARS-CoV-2 and the ongoing COVID-19 pandemic have changed the landscape of respiratory virus testing and surveillance . Historically , public health departments and public health laboratories worked together to develop robust partnerships with clinical laboratories and clinician offices to create influenza specimen submission networks . Leveraging these existing networks to develop a more comprehensive respiratory virologic surveillance system that includes influenza , SARS-CoV-2 and potentially other respiratory viruses , is essential for robust virologic surveillance ; however , these networks have been disrupted by the pandemic . Staff turnover , overtaxed healthcare and public health systems , and changes to the way individuals seek testing have all contributed to the challenges with maintaining public health access to specimens .
What can laboratories do to remedy the situation and meet the shifting demands for surveillance data on not just influenza , but SARS-CoV-2 , respiratory syncytial virus ( RSV ) and the next emerging respiratory pathogen ? Communication is at the center of establishing and maintaining all successful specimen submission networks . Building relationships with clinical laboratory partners and engaging in routine lab to lab conversations helps cultivate sustainable relationships .
“ An overarching emphasis on our communication with clinical labs is that they are part of public health , and the surveillance and outbreak response that we do is all dependent on their involvement – we thank them a lot for this !”
--Al Bateman Wisconsin State Laboratory of Hygiene
Public health laboratories foster these relationships in a variety of ways . Several publish quarterly newsletters or annual surveillance summary reports to share information back to submitters underscoring the importance of clinical laboratories ’ contribution to public health surveillance efforts . Other common strategies include delivering training and education , providing annual specimen submission guidance and highlighting the importance of clinical laboratory engagement in the public health system .
For example , the Wisconsin State Laboratory of Hygiene ( WSLH ) has created a Clinical Laboratory Network ( WCLN ) and coordinates a 10-member Laboratory Technical Advisory Committee ( LabTAG ), both of which have been instrumental in their success . Cinical laboratory representatives from across the state help determine what continuing education topics are most important for clinical microbiologists , and then WSLH offers numerous P . A . C . E . ® accredited webinars and one-day in-person meetings on the suggested topics . This level of partnership contributes to its success .
Public health laboratories use incentive programs to encourage and motivate their partners to submit specimens . Some states have successfully recruited COVID-19 testing sites to join their specimen submitter networks . Others have leveraged existing programs , coordinating with epidemiologists throughout the state and using the newborn screening courier systems to connect new providers to the surveillance network . Anything the public health laboratories can do to minimize barriers for submission including providing free , easy-to-use specimen collection kits with clear and comprehensive instructions
Anything we can do to make the process less burdensome , it ’ s a win-win situation !”
--Kate Fitzpatrick , Arizona State Public Health Laboratory
have been helpful . For laboratories with electronic lab portals , the ease and speed of the specimen submission process and result tracking may be an incentive . The Arizona State Public Health Laboratory offers the flexibility and support of their surveillance network , including electronic test ordering for all influenza submissions with a batch entry field . It also provides the option to order collection supplies for surveillance activities and free courier service for specimen delivery , which allows rural or resource restrictive sites to participate in the surveillance system .
Collaboration , communication and coordination between public health epidemiologists , clinical and hospital laboratories , and public health laboratories can enhance current respiratory virus surveillance networks to go beyond influenza and SARS-CoV-2 . By working together and focusing on comprehensive respiratory virus surveillance networks , we will better understand and respond to emerging threats and protect the public ’ s health . g
This article was 100 % funded with federal funds from a federal program of $ 2,880,738 . The production of this article was supported by Cooperative Agreement # NU60OE000104 , funded by the US Centers for Disease Control and Prevention ( CDC ). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of , nor an endorsement by , CDC , HHS or the US Government .
26 LAB MATTERS Winter 2023
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