20 Million Tests a Month to Help Protect the World Against COVID-19
Innovation and action during a global pandemic
In 2020, the world was rocked by COVID-19, a potentially life-threatening and highly infectious respiratory disease, caused by a novel coronavirus. COVID-19 was labelled a global pandemic by the World Health Organization in March 2020. In the immediate outbreak, countries across the world grappled with the devastating effects of the virus on their citizens, public health systems and economies. Eurofins acted quickly to develop and ramp up testing capacity to support governments to safeguard public health and innovated to bring urgently required tests to the market to support the fight against COVID-19.
In 2020, Eurofins’ laboratories and colleagues pulled together to contribute to the ever-changing global efforts to safeguard global health and societies during the COVID-19 pandemic, the effects of which reached every corner of the world. Widespread testing was a cornerstone of the strategies developed by governments and national health authorities across the globe to protect their societies from the virus. The World Health Organization declared COVID-19 to be a pandemic in March 2020, and by May 2020, Eurofins companies had already created a large range of products and services to facilitate over 20 million patient tests per month globally. Eurofins’ support included optimized SARS-CoV-2 (the virus that causes COVID-19) specific probes and primers, used by a number of independent kit producers.
Eurofins teams worked round the clock to establish and ramp up COVID-19 clinical testing capacity to identify those carrying the virus, using the real time reverse transcriptase polymerase chain reaction (RT-PCR) method, and returning results within 12-24 hours. This meant expanding Eurofins laboratories’ testing capacities, but also developing new products that would allow operators to perform the actual testing (nucleic acid extraction kits, RT PCR kits, etc.).
As the pandemic progressed, antibody testing played an increasingly helpful role, by identifying people who may have been exposed to the virus, possibly without even noticing, and allowing health authorities to evaluate population exposure and immune response. This provided insights to inform policy decisions such as vaccination strategies for example, by indicating the most vulnerable groups, and, at a time when vaccines were not very widely available, determining which groups should receive the vaccine first. Eurofins developed antibody testing services and kits so that those who may have been sick, but could not be tested at the time could determine if they already had antibodies as a result of exposure to COVID-19. Eurofins launched particularly fast rapid point-of-care finger-prick testing devices which identified antibodies in just 10 minutes, with a sensitivity of 94.5% from 19 days following the onset of symptoms.
Eurofins also developed T-cell assays, which facilitate the detection of the T-cells specific to the virus in a patient. This is important because variations in T-cell populations have been reported to provide insights about the outcome of disease progression, and these help doctors to plan for ICU bed and ventilator capacity, especially in times where there may have been shortages.
During the initial outbreak of the virus, governments across the world chose to “lock down” economies and societies. As economic and social activity returned, it was obvious that ongoing surveillance would be necessary to quickly identify any resurgence in COVID-19 cases and monitor the spread of the disease across all types of environments and workplaces. Eurofins developed monitoring methods and kits such as environmental surface testing, wastewater testing, air testing and worn mask testing methods that could detect the presence of SARS-CoV-2 at very early stages, and, as a result, minimise spread.
Eurofins research showed that workplaces with SARS-CoV-2 contaminated surfaces were 10 times more likely to have COVID-19 positive employees than locations with no or very few contaminated surfaces. Environmental surface testing methods allow for early warning of potential virus outbreaks by detecting the presence of pre- or asymptomatic virus spreaders at a site or in an environment without the need for invasive and costly human clinical testing. Asymptomatic people are persons infected with the virus, but without symptoms of disease, and pre-symptomatic are those who are harbouring the disease but have not yet shown symptoms. Both may unknowingly transmit viruses to others.
Eurofins was the first commercial laboratory in Europe to offer COVID-19 wastewater testing. Testing wastewater can provide an early indication of the presence of viruses in a specific community or at a work site. Faeces from people infected with the SARSCoV-2 virus can contain genetic material (RNA) from the virus, and that viral RNA can be detected in sewage and wastewater. Studies have shown wastewater testing capable of detecting a community COVID-19 prevalence rate as low as a 0.02%- 0.1% (i.e. between 2 virus shedders per 10,000 persons and 1 virus shedder per 1,000 persons). In Denmark, for example, Eurofins’ wastewater testing method detected SARS-CoV-2 in wastewater two days before the first official COVID-19 case was confirmed in the country. This technology was also successfully used to detect asymptomatic spreaders on college campuses. Wastewater testing in sewage plants is commonplace in many countries around the world, and so this method can be easily rolled out and provide crucial information to communities. Like environmental surface testing, wastewater testing allows for the identification of asymptomatic spreaders, and supports organisations to monitor the safety of their environments. Eurofins also made its wastewater testing kits available for purchase to other laboratories as well as state and public health authorities.
Environmental surface, air and worn mask testing as well as wastewater monitoring allowed for human clinical testing to be focused where virus presence was likelier, allowing for the allocation of capacity-constrained human COVID-19 testing where it was most needed.
Besides carrying out testing in their own laboratories, several Eurofins companies received approval for their laboratory-developed tests to be used for the detection of SARS-CoV-2 in patients by public and private laboratories. Eurofins also developed dedicated reagents to support the entire testing process: from nucleic acid extraction kits, to PCR kits for SARS-CoV-2 detection and for specific variant identification, to kits for SARS-CoV-2 sequencing, antibody testing and T-cell monitoring, including equipment and point of care solutions. Eurofins sites created capacity to provide primers and probes to be incorporated in millions of SARS-CoV-2 testing kits worldwide. Besides developing kits for Eurofins and other laboratories to carry out PCR testing, Eurofins also developed a unique SARS-CoV-2 detection kit utilising sequencing equipment common in molecular testing and Genomics laboratories. This method, which is as sensitive as PCR testing, resulted in much needed additional testing capacity.
During the pandemic, Eurofins companies also facilitated the sequencing of SARS-CoV-2 to identify new virus strains or Variants of Concern as they emerged. The company opened a high-throughput sequencing laboratory to analyse the full genome of SARS-CoV-2 and support the European Center for Disease Control. Between February 2021 and February 2022 more than 250,000 viral genomes, extracted from samples collected in 24 countries, were fully sequenced and analysed thanks to this collaboration, contributing to the identification and tracking of emerging virus strains.
Early detection of particularly virulent variants with increased transmissibility was key to delaying their introduction and spread within the population. With this objective in mind, Eurofins companies developed more than 15 CE marked clinical kits and more than eight water surveillance and surface tests for variant screening, all of which were brought to the market in record time. On the day that Omicron was officially designated a Variant of Concern by WHO, Eurofins companies launched a screening solution to identify the variant.
Eurofins laboratories also carried out emergency testing of medical devices, such as respirators, and Personal Protective Equipment (PPE) during the pandemic.
Eurofins’ unmatched global network of BioPharma Product Testing laboratories ramped up capacity to support some of the largest global pharmaceutical and biotechnology companies developing products to fight COVID-19 and launched products and services aimed at supporting the research necessary to develop novel vaccines and therapeutics.
The science behind
Real time reverse transcriptase polymerase chain reaction (RTPCR), the method used in COVID-19 detection tests, is a laboratory technique which combines reverse transcription of RNA into DNA and subsequent amplification of the molecules. Thereby minute traces of virus material can be detected. RNA is the molecule the SARS-CoV-2 virus uses as genetic information. New variant screening worked by detecting single nucleotide polymorphism (SNP), a variation at a single position in the viral RNA sequence, to identify the variant responsible for the infection.
The unique fragment length analysis (FLA) SARS-CoV-2 detection kit utilises Sanger sequencing, an alternative to RT-PCR. The method detects the reverse transcribed, amplified viral RNA on Sanger capillary sequencers and can help to ramp-up testing capacities.
The serological test, a blood test that looks for antibodies, detects infection after the immune system has produced antibodies (IgA, IgG or IgM) against the virus, which remain in the bloodstream for some time after the patient has recovered.