The case for animal health laboratories to collaborate as One Health laboratories

As we continue to navigate through the COVID-19 pandemic, the challenge of providing adequate testing persists. Some jurisdictions have ramped up testing for SARS-CoV-2 to high levels—nearly 10 million tests were completed in Wuhan, China over a 19-d campaign. ¹ Other jurisdictions, especially in North America, have been slower in ramping up their testing capacity. ³

An untapped resource in many jurisdictions is the provincial or state animal health laboratory (AHL). However, several veterinary laboratories have come to the aid of their local public health agencies, given the urgent need for testing, and the overwhelmed public health laboratories. An outstanding example is the testing of human samples being conducted daily by the Oklahoma State University Animal Disease Diagnostic Laboratory. ²

Many of the AHLs in North America are well equipped for high-volume, fast-turnaround testing for disease agents by PCR and detection of antibodies by ELISA. Our stock-in-trade is health monitoring of herds and flocks based on large numbers of samples. Testing is done within a comprehensive, standardized quality assurance program—all steps of the process are monitored carefully, trained analysts are certified through proficiency testing, tests are validated, appropriate controls are run, and results are scrutinized before release. Our laboratories are accredited for such testing by various agencies: AAVLD (American Association of Veterinary Laboratory Diagnosticians, ISO 17025 based), AALA (American Association for Laboratory Accreditation, ISO 17025), SCC (Standards Council of Canada, ISO 17025). The World Organisation for Animal Health (OIE) has released guidelines for performance of human testing by AHLs. ⁴ The OIE lists the key considerations for testing human specimens for SARS-CoV-2 in veterinary laboratories as: regulatory affairs (national level), business continuity and prioritization, types of test and testing requirements, scalability, quality assurance, biosafety, biosecurity, data management and reporting, personnel and logistics, and training needs.

There are multiple regulatory and logistical hurdles to overcome for AHLs to provide human testing during an emergency. Regulatory authorities need to proactively review and consider the equivalency and sufficiency of the quality assurance systems, personnel qualifications, and certifications in the AHLs. If necessary, timely use of proficiency panel testing assessment would ensure the competency and quality of these laboratories to provide emergency surge capacity. Such proficiency testing can also facilitate recruitment of additional staff, from the AHLs or research labs, to overcome one of the major capacity bottlenecks. The logistical challenges of AHL participation, including sample submission processes, patient confidentiality, reporting requirements, and billing complexities (e.g., insurance providers) support the need for AHLs to partner with human healthcare institutions that are already set up to handle such logistics. Of course, such arrangements should be in place in advance of, rather than in the face of, an emergency.

Like the screening testing that we perform for foreign animal diseases for federal agencies (United States Department of Agriculture, Canadian Food Inspection Agency), human tests would be run according to accepted protocols with validated tests and supported by successful completion of proficiency tests. Barcoding of samples, as for our animal accessions, would ensure traceability through the system. Electronic communication of results to the appropriate public health agency would occur just as it does with animal health agencies. Biosafety of staff could be further enhanced by submission of inactivated samples—only nucleic acid is needed for identification of viruses, not live virus.

As in the Oklahoma example cited above, the testing of human samples in AHLs is already underway successfully and could be expanded to include more AHLs and AHL staff. The alternative of managing “hot sites” that are fully equipped and ready to test is an expensive alternative. Why not use the capacity of existing sites? COVD-19 is unlikely to be the last pandemic that we will face and having alternative laboratories available for surge capacity testing makes sense. Collaboration of the public health system with AHLs would further put into practice the One Health concept.

Grant MaxieEditor-in-Chief