The UK has faced criticism for its centralised approach to Covid-19 testing, which has resulted in a lack of country-wide testing. This was worsened by the UK’s relatively small diagnostics industry relative to other European countries, such as Germany, which lacks the physical capacity to ramp-up testing. When UK Health Secretary Matt Hancock said that 100,000 Covid-19 tests would be performed daily by the end of April, the announcement was met with some incredulity about how the UK would be able to meet such a target with its current diagnostics testing network. During the first week of April, when the announcement was made, the UK was only conducting 13,000 tests daily. Since then, efforts have been made to build the biggest network of diagnostic labs in British history. Three Lighthouse Labs, so-called mega-labs, were built in five weeks to process samples from 27 of the planned 50 drive-through testing sites have now significantly increased Covid-19 testing capacity in the UK to at least 100,000 daily tests.
These three Lighthouse Labs were rapidly established to meet the demand in testing capacity through a partnership with the Department of Health and Social Care, the Medicines Discovery Catapult, the UK Biocentre, and the University of Glasgow. The structure of these labs was designed based on automation. They will use industrial principals and expertise to establish a robust supply chain of equipment and consumables. The Covid-19 test of choice is Thermo Fisher’s TaqPath assay with high capacity data analysis, and the Lighthouse Labs will be staffed by skilled employees and volunteers around the clock. The labs’ development is being closely supported by both the National Health Service (NHS) and Public Health England (PHE), which offer clinical expertise and assay validation, as well as academic institutions across the nation who are supplying materials, advice, and volunteers. The Lighthouse Labs are also supported by pharma companies GlaxoSmithKline, AstraZeneca, and Thermo Fisher, which are providing access to data and resources to further increase the labs’ testing capacity since an extensive supply chain of resources is needed as the labs become fully operational and scale-up.
To rapidly deploy the Lighthouse Labs, rather than constructing new buildings, existing buildings were modified at three locations. The Milton Keynes lab is based at and managed by the UK Biocentre, an academic centre for biomedical research that was established in 2011 by the National Institute for Health Research. The Cheshire lab is led by Medicines Discovery Catapult, a tech incubator established by the non-government organisation Innovation UK, and based out of Bruntwood SciTech’s Alderley Park. The Glasgow lab is led by the University of Glasgow and is located at the city’s Queen Elizabeth University Hospital Campus. The Glasgow facility is supported by the Scottish Government, BioAscent (a provider of integrated drug discovery services), and the University of Dundee.
Strengthening the UK’s diagnostic testing network is not without its problems, and technical issues with a machine at a commercial laboratory run by Northern Ireland-based biotech firm Randox resulted in 50,000 Covid-19 tests being sent to an accredited lab in the US for processing to deal with the backlog and get test results to patients as quickly as possible. These tests would be validated in the UK before being returned to patients.
Normally, establishing a new testing lab takes many months, and during that time, thousands of dummy test runs are made to work out any issues. It is true that the labs running Covid-19 tests are relatively simple, as they are primarily running one test rather than the diverse menu of tests that diagnostic medical labs normally run. However, it is likely that labs processing high volumes of Covid-19 tests are implementing a level of automation and scale that is not seen in many other diagnostic labs. In this way, some operational issues are likely.
In the UK, testing capacity is now in place for 100,000 Covid-19 tests to be conducted daily via a large number of established, mostly public labs that carry out a small volume of tests such as the PHE/NHS pathology network, and a smaller number of labs that carry out a high volume of tests, such as the Lighthouse Labs. As such, a backlog in one of the large labs due to an operational failure (a common issue with testing networks using high-throughput machines without spare capacity) cannot be absorbed within the testing network. As such, short-term operational solutions are needed, such as replacement capacity outside of the network, such as via the US. In terms of a disruption occurring to operations again, this testing network is newly built, and a certain amount of lead time to supply, install, and set-up additional machines should be expected.