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Shortage of Test Components Forces Labs to Beg, Borrow and Improvise

The Wall Street Journal. logo The Wall Street Journal. 4/6/2020 Brianna Abbott
a woman preparing food in a kitchen © Alyssa Summers

Facing looming shortages of supplies needed to conduct coronavirus tests, some laboratories are taking matters into their own hands.

Labs at places such as New York University and Stanford University are starting to make their own chemical mixtures because they can’t buy enough. A high-school lab in Tennessee managed to set up testing operations, with two science teachers leading the charge to reduce turnaround time in their area. And Northwell Health, a hospital network in New York, said it is making its own 3-D printed swabs to take samples from patients’ throats or noses.

“The biggest problem in the last couple of weeks has been how to get the 10-cent swab to put into somebody’s nose to get that sample out of somebody and into a test,” Michael Mina, assistant professor of epidemiology at Harvard T.H Chan School of Public Health, said during a webcast Tuesday. “That’s something that hospitals across the globe are really trying to problem-solve around at the moment.”

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As diagnostic testing continues to pick up speed in the U.S., shortages of some supplies and a backlog of samples have pushed hospitals, academic medical centers and labs to create their own patchwork solutions, including assembling volunteers, making their own reagents—ingredients used in a chemical reaction—or even crowdsourcing instruments.

“Doing any testing requires four things: space, staff, instrumentation, reagents,” said Steve Miller, a professor of laboratory medicine at the University of California, San Francisco. “We found that all four of those have had to be dealt with and expanded.”

To increase capacity, UCSF paired with a nearby research institution to take advantage of its high-throughput machines and expertise, and the institution says that the combined team can now run upward of 1,000 tests a day if necessary.

Some kits that extract genetic material from a patient sample went into short supply weeks ago.

Stanford had representatives meeting with companies around the world, closed-down research labs donating whatever kits they had, and a department chair delivering a batch of kits to the clinical labs in her SUV, said Yvonne Maldonado, an infectious-disease physician at Stanford Medicine. The institution is also making its own kits, which is “as creative as it gets,” Dr. Maldonado said.

A global shortage of swabs has also been a bottleneck for rapid testing, as one of the key suppliers, Copan Diagnostics Inc., is based in the hard-hit Lombardy region of Italy. The company couldn’t be reached for comment.

The U.S. Food and Drug Administration has offered a list of potential alternatives, as the swabs can only be made of certain materials to ensure the most accurate results, but some labs are stretching beyond even those suggestions.

Northwell Health, which said its maximum output of 3-D-printed swabs is 2,000 to 3,000 a day, plans to distribute them within its health system and has teamed up with other institutions and manufactures to increase production and distribution. Other institutions such as Beth Israel Deaconess Medical Center in Boston are working on 3-D-printing swabs as well.

Another scarce resource is the viral transport media, the chemical mixture that accompanies the swab and preserves genetic material in the sample. Many institutions and labs are starting to make it themselves, sometimes using materials and expertise from closed research labs. On March 21, the Centers for Disease Control and Prevention posted a do-it-yourself recipe for the product online.

“I’m looking across the street, and I’m seeing buildings full of researchers where, on our shelves, we have the [materials] to make some of these critically short reagents,” said Alan Wells, the medical director of the University of Pittsburgh Medical Center’s clinical laboratories. “We can borrow from that.”

The FDA so far has given emergency authorization to at least 24 diagnostic tests, each with slightly different instrumentation and supply chain. Lab managers say this has helped ease stress on the system, with some labs switching the system they use based on available reagents.

At New York University, the huge medical and academic center pulled instruments from across its labs, which involved moving one six-foot-long machine. Testing is running on platforms from two companies and they are working on getting two others online, said Joan Cangiarella, the vice chair of clinical operations in the pathology department at NYU Langone Health.

Research labs at the institution have helped source everything from large equipment to small tubes, said Dr. Cangiarella. “People are just coming forward and saying, ‘I’ve got this equipment, here are the keys to my lab,’” she said.

The university also is screening a pool of about 100 volunteer Ph.D.s to see who could jump into testing with minimal training. Graduate students and postdoctorates from UCSF and Columbia University in New York have also offered to pitch in at their institutions.

There is a limit to how much this patchwork can reduce the overall testing burden, lab-medicine experts say. Research labs often don’t have a deep well of supplies, either, which need to match the specific platform. The requisite equipment and expertise are often incredibly specific and don’t always translate across disciplines. But those working to increase capacity say every bit helps.

In Tennessee, two science teachers, both also Ph.D. research scientists, validated a test in their high school’s lab and rushed to get necessary certification. The Baylor School lab is now processing about 75 tests a day and helping reduce turnaround time in the area, according to Becky Barnes, the health-department administrator for Hamilton County, Tenn.

“This is just one way we can help the community and provide a patch,” said one of the teachers, Elizabeth Forrester, who is also a cancer biologist. The small lab is also trying to scale up its operations, but the equipment needed is currently on back order, Dr. Forrester said.

Write to Brianna Abbott at


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