FEATURE
COVID-19 caught the world off guard— including many public health laboratories. Aging laboratory infrastructure, along with a lack of high-containment laboratory capacity to keep pace with the surge, impacted testing and response nationwide. Supply chain issues and rigid contracts meant some public health laboratories didn’ t have timely access to needed equipment. Shortages of staff properly trained for surge response led to laboratory team burnout.
How can public health laboratories ensure their infrastructure is ready for the next emergency? Lessons learned from the COVID-19 pandemic— and strategic use of pandemic-era funding and flexibility— are helping today’ s public health laboratories prepare for tomorrow’ s challenges.
Adjust Where Possible
Managing emerging needs during a pandemic surge can create challenges for public health laboratories. One such example is the need to train new staff members quickly.
Perry said it’ s impossible to train team members brought in during a surge in every task. A strategy that worked well for him was training for specific, limited roles— like accessioning, extractions or reviewing results— to keep work moving.
Readiness also requires constant assessment and improvement of workflows. Kayle Cirrincione, health, safety and preparedness manager and biosafety officer for the Dallas County Health and Human Services Public Health Laboratory, said workflow adjustments can help laboratories maximize surge capacity.
During COVID-19, her team set aside time to batch prep work for extractions that required premixing certain chemicals.“ Instead of doing it in real time, we’ d prepare what we needed for certain measurements so we could grab and go as we were putting runs together,” she said.
Invest in Future Readiness
Many public health laboratories have used COVID-era funding to make changes that support readiness and response. Christina Egan, chief of the Biodefense and Mycology Laboratories and deputy director of the Division of Infectious
Diseases at New York’ s Wadsworth Center, said her division used COVID funding from the US Centers for Disease Control and Prevention( CDC) and Prevention Epidemiology and Laboratory Capacity Program to address equipment needs identified during COVID.
“ We acquired many computers,” she said.“ We brought in all these people during COVID, but they needed computers. We also acquired tablets, which offered flexibility for tasks such as inventory, laboratory surveys and inspections.”
The pandemic required everyone from senior scientists to new hires to pivot quickly to unfamiliar workflows. We realized how important it is to maintain a baseline of readiness across our entire workforce, not just among the specific response team.”
Michael Perry, DrPH, MEd
Management software was another critical investment, according to Egan.“ These tools help track projects, inventory and personnel,” she said.“ There’ s so much that goes into running the laboratory outside of testing. We tried to be thoughtful in how we used these funds, anticipating our future needs.”
Cirrincione, who recently moved into a newly built facility, said she kept future readiness and response in mind when designing her space.“ Our new laboratory has multiple autoclaves, so we’ re not dependent on just one,” she said.“ We also have flexible use spaces and training areas that we can turn into functioning laboratories if needed. We also have some shell space that we can turn into whatever we need. It gives us a lot more flexibility to respond.”
Flexibility and Redundancy
The COVID-19 pandemic demonstrated the importance of flexibility and redundancy in public health laboratories during emergencies. Procuring critical reagents, equipment and biosafety materials was often problematic. Planned redundancy can help ensure future readiness.
Cirrincione is using different equipment options to better manage supply chain issues that could affect laboratory operations.“ Now, if one pipette tip is on backorder, we can switch to another,” she said.“ I also now fit, train and test my people with two different types of respirators. We use N95s, but we also use powered air purifying respirators. We have both options because we ran out of N95s during COVID and now we can switch back and forth.”
Flexibility in contracts has also proved critical to managing both supply chain issues and needed personnel. In California, laboratorians who test specimens are required to have a state public health microbiologist license that requires a six-month training course and board exam— a requirement that severely limited capacity, said Jeremy Corrigan, DrPH, MS, director of agency operations and laboratory director at the San Diego County Public Health Laboratory.“ During the federal public health emergency, some personnel requirements were waived,” he said.“ That opened doors for me to bring in bachelor-level scientists to support the surge.”
A key responsibility of Corrigan’ s role is overseeing contracts and agreements.“ Flexible language in contracts— such as the broader term‘ pathogen of concern’— and in data use and material transfer agreements is important,” he said.
Corrigan knows a thing or two about flexibility. Four weeks after moving to San Diego in 2022, his public health laboratory building was closed for structural deficiencies amid the COVID response. He stood up a temporary laboratory and recently opened a new, fully modernized laboratory building.
“ This space is designed to be flexible, and to support new instruments,” he said.“ We know the instruments we use today are not the instruments we’ ll use tomorrow.”
12 LAB MATTERS Winter 2025 PublicHealthLabs @ APHL. org
APHL. org