Hang Jianfeng, Sun Zhaohui, Li Linhai
Department of Laboratory Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):606-608. doi: 10.12122/j.issn.1673-4254.2020.04.25.
The outbreak of COVID-19 has currently been under control in China, but now the disease has rapidly evolved into a global pandemic. We formulated a prevention and control plan for clinical laboratories responsible for detection of the novel coronavirus infection. We analyzed the implementation of this plan and the problems arising from its clinical practice. We found that the layout of most clinical laboratories (including gene amplification laboratories for clinical samples) was inadequate in response to a major outbreak and did not meet the requirements for biosafety protection and etiology and serology testing; and laboratory staff showed insufficiencies in their awareness regarding biosafety protection; the functions and status of the laboratory in the fever clinic need to be enhanced to increase its detection capacity; the high density of military personnel, the low level of automation of clinical laboratory equipment, and the lack of biosafety cabinets and personal protective equipment all limit the performance of diverse military operations and major overseas missions. In view of these problems, we propose the following strategies and recommendations: the clinical laboratory needs to standardize the design and staff management according to the standards of P2 laboratory; the detection capacity and staffing of fever clinic laboratory in hospitals need to be strengthened, and a separate clinical gene amplification laboratory can be optimal; for those clinical gene amplification laboratories that fail to meet these standards, reconstruction and upgrade should be made according to the requirements of biosafety protection; for the clinical laboratory in the military medical system, in addition to enforcement of biological safety protection of the staff, sufficient supply of medical materials and biological safety equipment should be ensured and biological safety cabinets should be routinely equipped if possible.
新型冠状病毒肺炎(COVID-19)疫情目前在中国已得到控制,但该疾病现已迅速演变成一场全球大流行。我们制定了针对负责新型冠状病毒感染检测的临床实验室的防控方案。我们分析了该方案的实施情况及其在临床实践中出现的问题。我们发现,大多数临床实验室(包括临床样本基因扩增实验室)的布局在应对重大疫情时存在不足,不符合生物安全防护以及病原学和血清学检测的要求;实验室工作人员在生物安全防护意识方面存在欠缺;发热门诊中实验室的功能和地位有待加强,以提高其检测能力;军事人员密度高、临床检验设备自动化程度低以及生物安全柜和个人防护装备短缺,均限制了多样化军事行动和重大海外任务的开展。鉴于这些问题,我们提出以下策略和建议:临床实验室需要按照P2实验室标准规范设计和人员管理;医院发热门诊实验室的检测能力和人员配备需要加强,单独设置临床基因扩增实验室可能最为理想;对于不符合这些标准的临床基因扩增实验室,应按照生物安全防护要求进行重建和升级;对于军队医疗系统中的临床实验室,除加强工作人员的生物安全防护外,应确保医疗物资和生物安全设备的充足供应,并尽可能常规配备生物安全柜。