A survey on laboratory capacity, testing practices, and management during COVID-19 pandemic response in Korea: a cross-sectional survey study

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impactedglobal infrastructure. We surveyed laboratories to analyze the changes in testing methods andprocedures to improve future pandemic preparedness. Methods: This study surveyed laboratory physicians and technologists in South Korea andanalyzed responses from 126 of 323 institutions. The survey was conducted in May 2023using the proficiency test of the Korean Association of External Quality Assessment Serviceand examined the diagnostic procedures, personnel, equipment, and quality control. Thesurvey comprised 15 questions covering respondent demographics, public-private proficiencyprojects, COVID-19 testing procedures, and laboratory status. Results: Of the 126 laboratories, 66.7% performed bacterial smear and culture, 65.9% hadbiosafety level 2 facilities, and 39.7% had separate nucleic acid extraction areas. Furthermore,98.4% of the laboratories had biological safety cabinets, the median number of PCR machineswas four units, and 77.8% had autoclaves. The median numbers of personnel managing andconducting tests were one and three, respectively. Additionally, 88.1% of the laboratoriesfound the COVID-19 proficiency test helpful, with key benefits in terms of accuracy and skillimprovement. COVID-19 tests were primarily used for symptomatic or contact person testing,pre-admission screening, and periodic proactive testing. Specialized testing laboratoriesconducted up to 50,000 tests daily, and tertiary hospitals conducted up to 1,500 tests. Emergency, pooled, and rapid antigen tests were widely used. Most respondents wantedfuture tests for respiratory viruses, bacteria, and viral diarrhea, indicating a willingness toparticipate. Conclusion: Aggressive testing and collaboration between health agencies and laboratoriesare crucial for managing emerging diseases. Systematic preparations are essential to maintain and strengthen laboratory capabilities for future infectious disease outbreaks.