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    Supporting scale-up of COVID-19 RT-PCR testing processes with discrete event simulation

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    Author
    El Hage, Jad
    Gravitt, Patti
    Ravel, Jacques
    Lahrichi, Nadia
    Gralla, Erica
    Date
    2021-07-29
    Journal
    PLoS ONE
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1371/journal.pone.0255214
    Abstract
    Testing is critical to mitigating the COVID-19 pandemic, but testing capacity has fallen short of the need in the United States and elsewhere, and long wait times have impeded rapid isolation of cases. Operational challenges such as supply problems and personnel shortages have led to these bottlenecks and inhibited the scale-up of testing to needed levels. This paper uses operational simulations to facilitate rapid scale-up of testing capacity during this public health emergency. Specifically, discrete event simulation models were developed to represent the RT-PCR testing process in a large University of Maryland testing center, which retrofitted high-throughput molecular testing capacity to meet pandemic demands in a partnership with the State of Maryland. The simulation models support analyses that identify process steps which create bottlenecks, and evaluate "what-if" scenarios for process changes that could expand testing capacity. This enables virtual experimentation to understand the trade-offs associated with different interventions that increase testing capacity, allowing the identification of solutions that have high leverage at a feasible and acceptable cost. For example, using a virucidal collection medium which enables safe discarding of swabs at the point of collection removed a time-consuming "deswabbing" step (a primary bottleneck in this laboratory) and nearly doubled the testing capacity. The models are also used to estimate the impact of demand variability on laboratory performance and the minimum equipment and personnel required to meet various target capacities, assisting in scale-up for any laboratories following the same process steps. In sum, the results demonstrate that by using simulation modeling of the operations of SARS-CoV-2 RT-PCR testing, preparedness planners are able to identify high-leverage process changes to increase testing capacity.
    Keyword
    discrete event simulation
    laboratory operational processes
    SARS-CoV-2 RT-PCR testing
    COVID-19 Nucleic Acid Testing--methods
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16287
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0255214
    Scopus Count
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    UMB Coronavirus Publications
    UMB Open Access Articles

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