Contributing to a rapid COVID-19 test
in just two months

NIHR Southampton CRF laboratory team’s pandemic response enabled the progression of a rapid COVID-19 test from idea to frontline clinical use in just two months, underpinning nationwide rollout of rapid COVID-19 tests in December 2020,  cutting in-hospital transmission across the NHS.

Key facts
  • Our laboratory team supported Dr Tristan Clark,  including by setting up a dedicated COVID-19 studies laboratory, so he could deliver his trial of a rapid COVID-19 test in just two months

  • This trial showed the test cut diagnosis times from 21 hours to 1 hour 40 minutes on average, greatly reducing the time patients with and without COVID-19  spent together and the risk of infection

  • The technology was immediately implemented as the hospital's frontline testing method for all admissions, and has remained so in subsequent waves, preventing large numbers of hospital acquired cases

  • January 2021 saw all acute NHS trusts having access to rapid testing, in time for the most severe pandemic pressures yet

Diagnosing COVID-19 faster 

In March 2020 COVID-19 cases were rising exponentially. Despite tireless efforts by hospital laboratories, doctors were often waiting 24 hours or more for patients' test results. Each of those passing hours saw increasing infection risk for non-COVID-19 patients held in cohort alongside those with COVID19 , and delay of specific investigations and treatments for non-COVID-19 respiratory infections.

Just two months later Dr Tristan Clark delivered a solution to these challenges for his clinical colleagues, by pivoting his world-leading work with Point of Care Testing (POCT) technologies, that give results at the bedside in 70 minute, to target coronavirus. Through his longstanding collaboration with manufacturer Qiagen, Tristan accessed a new test panel incorporating SARS-CoV-2, whilst NIHR Southampton CRF, BRC and local R&D teams moved at unprecedented speed to open his 500 patient study within two weeks.

Hospital-wide adoption

The study was complete by the end of April, with the Qiagen equipment and sample handling located in the quality assured, specifically set up COVID-19 studies laboratory of the CRF. Demonstrating a cut in diagnosis times from 21 hours to 1 hour 40 minutes on average, the test saw COVID-19 patients isolated on dedicated wards in just eight hours, down from 30, giving them access to trial treatments two days earlier on average. 

The emerging results were so compelling that the technology was immediately implemented as the hospital's frontline testing method for all admissions, reducing frontline staff and non-COVID patient exposure in acute and assessment areas. It has remained an essential part of the UHS diagnostic strategy during the subsequent waves, preventing large numbers of hospital acquired cases.

National influence

Tristan was subsequently seconded to a Department of Health & Social Care(DHSC) working group tasked with implementing wide scale POCT testing across all acute NHS trusts. By October 2020, that deployment was in gear with POCT in place at seven acute hospital Trusts, and  January 2021 saw all acute trusts having access to rapid testing in time for the most severe pandemic pressures yet.

Critical to this responsiveness and flexibility was the highly integrated management and operations across Southampton’s CRF, BRC and wider clinical research laboratory infrastructure. Not only did that integration underwrite the rapid setup of COVID-19 specific facilities, expansion of staff and coverage, but for COVIPOC it included years of support for Tristan’s POCT trials in influenza, and more recently gastroenteritis.

NIHR’s long-term investment in research infrastructure in Southampton, and the collaborative, integrated approach of Southampton’s research leadership over the years yielded exactly the responsiveness and relationships needed to meet the coronavirus challenge.