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Setting up the new COVID testing lab at Imperial

Imperial College London has set up a new COVID testing lab, with capacity for 3,000 tests a day. Professor Graham Taylor leads the lab, and led the work to set it up as part of the MedCity’s Testing Alliance. We spoke to Graham about the lab and his experience of the process.

How are things going at the new Imperial COVID testing lab?
We only actually moved into the new lab on 1 February due to delays receiving some of the equipment. But since we moved, things are going really well. We have a good team on board and the new recruits have settled in.

The lab is on the South Kensington campus of Imperial College London, and we have half of one floor in the Flowers Building. We sat down with an architect and almost a blank sheet of paper and designed what we needed and the workflow, from receipting the samples, unpacking them, taking them into a contained laboratory space where we inactivate them, passing them through to our RNA extraction room, and finally to the PCR room. It’s designed to do this and nothing else, so we’re not competing for that space with anybody else.

We’ve ramped up our numbers. We offered the Department of Health and Social Care (DHSC) 3,000 tests a day, 365 days a year. The demand is not there at the moment, as it’s a relatively quiet time in lockdown, but we’ve received just over 2,800 samples in one day and shown that we can manage that volume.

Professor Graham Taylor

Could you tell us how this project came about?

Back in March 2020, I contacted my colleagues in North West London Pathology (NWLP) (who provide the diagnostics for St Mary’s Hospital and other hospitals in the Imperial College Healthcare NHS Trust) and asked whether there was anything we could do to help.

At that time, getting a SARS-CoV-2 test was very difficult. Setting up a PCR diagnostic assay is relatively simple; we run diagnostics for other viruses already. Aileen Rowan, a post-doc, set up the assay and we managed to validate it quickly with help from NWLP. On its own, that wouldn’t have got us very far. An important moment was the arrival of Paul Freemont and his team, particularly Michael Crone and Marko Storch, with an automated liquid-handling machine called a Felix. They had configured it for RNA extraction, which meant we could do enough testing to make it worthwhile.

In April we were doing this entirely with volunteers, processing patient samples from NWLP. We were essentially an extension of the hospital’s pathology service. When we got our results, they went straight into the patient record and also into the public health reporting system.

Later in the year, we started joining the MedCity calls. By then, MedCity had approached DHSC to see what the academic sector could offer. In the meantime, the Trust had responded very well to the demands and with significantly increased capacity they didn’t need our help, so we were pretty much ready to shut up shop on the SARS-CoV-2 work. But on one of those calls we learned that DHSC had asked MedCity to set up a London “Lighthouse” lab, but one that was a consortium rather than a single place. The rest is history!

What’s it been like working collaboratively as part of the Testing Alliance during the pandemic?

What we’re doing now just wouldn’t have happened without that alliance. We didn’t go in with plans to offer tens of thousands of tests and we probably wouldn’t have gone down this route alone. But being part of the alliance and being part of a significant offer of testing meant the whole was greater than the sum of the parts.

The alliance offers a useful exchange of information. We all have our individual contracts with DHSC now, but we continue to speak as one. People are supporting each other in different ways and hopefully that will continue. I think there’s an alignment of ideas, which is critical.

How different is it operating as an NHS testing lab, from your usual activity as a university laboratory?

It’s not as different as you might think. Although we are not an NHS testing lab in the first instance, we are a UKAS-accredited diagnostic laboratory. The difference here is the scale and of course we’ve had to build a new lab to house it, but the principles are the same.

We still keep our research approach to it all. We are providing a testing service for DHSC, but we’re also looking at next steps: where do we go now; innovation; what are the opportunities; and what are the research questions around that.

What was the biggest challenge to overcome in setting up the lab?

The first challenge was finding space. Finding 200m2 in a building that was constructed in a way that would take a lab was really challenging. Once we’d found the space and the leadership of the college was on board with the project, then it was amazing to see how quickly things could move. Unbelievably quickly! There have been challenges, but the way they have been overcome has been extraordinary. It was delivered on time, on budget and it was exactly what we wanted.

Getting reagents and consumables remains challenging. We’ve almost got used to there always being a global shortage of something.

What are you most proud of and what do you think will be the legacy of this work?

I’m most proud of the people. The way in which everyone rallied around. Whenever things haven’t gone quite right, they’ve stayed and fixed it. I think the pulling together that we’ve seen in our setting just shows what is going on in the NHS in general and the demand that is being put on people.

It’s too early to talk about a legacy yet, but I think this is quite an interesting area. Pathology services in the NHS have moved away from being like the labs we run in the college, which are research focused, and have become more centralised and automated. One legacy from this experience might be to rekindle the relationship between colleges and the NHS, focused on improving patient care by addressing together new diagnostic challenges. I think the seeds have been sown and there’s an enthusiasm for it on both sides.

Whether we continue to do high-throughput testing of pathogens, I have no idea. But academia has demonstrated, right across the country, that they are there and capable. It would be good if that relationship between the NHS and academia continued.

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