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dc.contributor.authorEl Hage, Jad
dc.contributor.authorGravitt, Patti
dc.contributor.authorRavel, Jacques
dc.contributor.authorLahrichi, Nadia
dc.contributor.authorGralla, Erica
dc.date.accessioned2021-08-03T13:20:22Z
dc.date.available2021-08-03T13:20:22Z
dc.date.issued2021-07-29
dc.identifier.urihttp://hdl.handle.net/10713/16287
dc.description.abstractTesting 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.en_US
dc.description.urihttps://doi.org/10.1371/journal.pone.0255214en_US
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.ispartofPLoS ONEen_US
dc.subjectdiscrete event simulationen_US
dc.subjectlaboratory operational processesen_US
dc.subjectSARS-CoV-2 RT-PCR testingen_US
dc.subject.meshCOVID-19 Nucleic Acid Testing--methodsen_US
dc.titleSupporting scale-up of COVID-19 RT-PCR testing processes with discrete event simulationen_US
dc.typeArticleen_US
dc.identifier.doi10.1371/journal.pone.0255214
dc.identifier.pmid34324577
dc.source.volume16
dc.source.issue7
dc.source.beginpagee0255214
dc.source.endpage
dc.source.countryUnited States


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