A look inside laboratories responding to COVID-19

The World Health Organization is helping countries boost testing capacity for SARS-CoV-2, the virus that causes COVID-19. This includes supporting laboratories around the world. Here’s a glimpse at some of that work.

Tawiah-Yingar and Pasagio Tetteh work at the Veterinary Services Directorate in Accra, Ghana, which has been repurposed to support SARS-CoV-2 testing. © WHO / Nana Kofi Acquah

Since January 2020, WHO has emphasized the importance of diagnostic testing as part of a comprehensive strategy to control COVID-19. Tests show us where the virus is hiding, which is key to stopping the chains of transmission.

SARS-CoV-2 samples at the National Public Health Laboratory in Singapore, part of the COVID-19 Reference Laboratory Network. © WHO / Juliana Tan

In order to strengthen global diagnostic capacity, in early 2020 a COVID-19 Reference Laboratory Network was established across the six WHO regions. Laboratories with limited experience have been supported by this network.

Technicians Jose Pablo García Ruiz and Carmen Flores Aguilar work in the Virology Laboratory at the Institute of Epidemiological Diagnosis and Reference (InDRE) in Mexico City, a WHO Collaborating Centre. © WHO / Lisette Poole

Within two weeks of WHO learning of the first cases of the novel coronavirus, China shared the genetic sequences with WHO and the wider world. Working with a partner laboratory in Germany, Charité University, WHO then published the first instructions on how to set up a validated polymerase chain reaction (PCR) test for this new pathogen. This enabled the roll out of testing around the world at unprecedented speed.

A laboratory technician cuts a piece of gel used in a conventional PCR method before being analyzed in a thermal cycler at the Thai Red Cross Emerging Infectious Diseases-Health Science Centre at Chulalongkorn University in Bangkok. © WHO / P. Phutpheng

By the third week of January 2020, WHO had contracted the manufacture of reagents and supplies needed for SARS-CoV-2 PCR tests. By late January, WHO began shipping PCR tests to over 150 labs around the world, enabling countries to detect and monitor the virus.

Health workers test saliva samples for SARS-CoV-2 at the Torlak Institute in Belgrade, Serbia. ©WHO / Martyn Aim

In February, only two laboratories in the WHO African Region could diagnose a COVID-19 case. Now, 750 laboratories across the region can test for the virus. Crucially, testing has been decentralized in many countries, including Benin, Gabon and Nigeria.

Today all 194 Member States can test for SARS-CoV-2.

Dr Mokshanand Fhooblall works with RNA samples extracted from throat swabs at the Candos Virology Lab in Mauritius. © WHO / Gilliane Soupe

Demand for tests has exceeded supply and led to international shortages. Amidst reduced flights and a complex web of travel restrictions, procurement and logistics teams from WHO and partners continue to work around the clock to get laboratories the reagents and supplies they need.

As of 9 November 2020, members of the Diagnostics Consortium for COVID-19 had procured 31.1 million tests, of which 23 million have been delivered.

Medical technologists Yen Chun Ya Tom and Poh Wan Yee Justina process SARS-CoV-2 samples at the National Public Health Laboratory in Singapore. ©WHO / Juliana Tan

While PCR is the gold standard of SARS-CoV-2 testing, other types of tests have also been developed, including rapid antigen detection tests. These are faster, easier to administer and considerably cheaper. Although they are not a replacement for PCR tests, they can provide an important boost to countries’ testing capacity under the right circumstances.

In October, the Access to COVID-19 Tools (ACT) Accelerator announced that they would make 120 million of these antigen tests available to low and middle income countries.

A laboratory technologist manages samples in a freezer at the Institute of Epidemiology Disease Control And Research Field Laboratory in Cox’s Bazar, Bangladesh. WHO assisted the laboratory to increase SARS-CoV-2 testing capacity from around 100 tests per day to over 1500 per day. © WHO / Fabeha Monir

WHO continues to develop guidance and technical briefs to assist policymakers and laboratories on testing for SARS-CoV-2. And by regularly convening a diagnostics and laboratories global expert network, new knowledge is shared quickly across the globe.

Thanks to our Member States, foundations, other multilateral and private sector organizations and individuals, WHO has been able to support laboratories around the world. You can help by donating to the COVID-19 Solidarity Response Fund.