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===4.5 Public health lab directory===
===4.5 Public health lab directory===
* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/
 
* https://www.aphl.org/membership/Pages/memberlabs.aspx
* [https://www.alabamapublichealth.gov/bcl/ Alabama Bureau of Clinical Laboratories]
* [http://dhss.alaska.gov/dph/Labs/Pages/default.aspx Alaska Division of Public Health Laboratories]
* [https://www.azdhs.gov/preparedness/state-laboratory/index.php Arizona Bureau of State Laboratory Services]
* [https://www.healthy.arkansas.gov/programs-services/topics/arkansas-public-health-laboratory Arkansas Public Health Laboratory]
* [https://www.cdph.ca.gov/Programs/OSPHLD/Pages/Home.aspx California Department of Public Health Laboratory]
* [https://www.colorado.gov/cdphe/lab Colorado Laboratory Services Division]
* [https://portal.ct.gov/DPH/Laboratory/Laboratory-Home/Katherine-A-Kelley-State-Public-Health-Laboratory Connecticut Department of Public Health, Dr. Katherine A. Kelley Public Health Laboratory]
* [https://www.dhss.delaware.gov/dph/lab/labs.html Delaware Public Health Laboratory]
* [https://dfs.dc.gov/page/public-health-laboratory-division-phl District of Columbia Public Health Laboratory]
* [http://www.floridahealth.gov/programs-and-services/public-health-laboratories/index.html Florida Bureau of Public Health Laboratories]
* [https://dph.georgia.gov/lab Georgia Public Health Laboratory]
* [https://health.hawaii.gov/statelab/ Hawaii State Laboratories Division]
* [https://healthandwelfare.idaho.gov/Health/Labs/tabid/99/Default.aspx Idaho Bureau of Laboratories]
* [http://dph.illinois.gov/topics-services/lab-testing-services Illinois Department of Public Health Laboratory]
* [https://www.in.gov/isdh/22421.htm Indiana State Department of Health Laboratories]
* [http://www.shl.uiowa.edu/ Iowa, The University of, State Hygienic Laboratory]
* [https://www.kdheks.gov/labs/ Kansas Health & Environmental Laboratories]
* [https://chfs.ky.gov/agencies/dph/dls/Pages/default.aspx Kentucky Division of Laboratory Services]
* [http://ldh.la.gov/index.cfm/page/483 Louisiana Office of Public Health Laboratories]
* [https://www.maine.gov/dhhs/mecdc/public-health-systems/health-and-environmental-testing/ Maine Health & Environmental Testing Laboratory]
* [https://health.maryland.gov/laboratories/Pages/home.aspx Maryland Department of Health Laboratories Administration]
* [https://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_5103---,00.html Michigan Bureau of Laboratories]
* [https://www.health.state.mn.us/about/org/phl/index.html Minnesota Public Health Laboratory]
* [http://www.msdh.state.ms.us/msdhsite/_static/14,0,188.html Mississippi Public Health Laboratory]
* [https://health.mo.gov/lab/ Missouri State Public Health Laboratory]
* [https://dphhs.mt.gov/publichealth/laboratoryservices Montana Laboratory Services Bureau]
* [http://www.nphl.org/ Nebraska Public Health Laboratory]
* [https://med.unr.edu/nsphl Nevada State Public Health Laboratory]
* [https://www.dhhs.nh.gov/dphs/lab/index.htm New Hampshire Public Health Laboratories]
* [https://www.state.nj.us/health/phel/index.shtml New Jersey Public Health and Environmental Laboratories]
* [https://nmhealth.org/about/sld/ New Mexico Department of Health Scientific Laboratory Division]
* [https://slph.ncpublichealth.com/ North Carolina State Laboratory of Public Health]
* [https://www.ndhealth.gov/LAB/ North Dakota Division of Laboratory Services]
* [https://odh.ohio.gov/wps/portal/gov/odh/about-us/offices-bureaus-and-departments/bureau-of-public-health-laboratory/welcome-to Ohio Bureau of Public Health Laboratory]
* [https://www.ok.gov/health/Prevention_and_Preparedness/Public_Health_Laboratory/ Oklahoma Public Health Laboratory]
* [https://www.oregon.gov/oha/PH/LABORATORYSERVICES/Pages/index.aspx Oregon State Public Health Laboratory]
* [https://www.health.pa.gov/topics/Labs/Pages/Laboratories.aspx Pennsylvania Bureau of Laboratories]
* [https://health.ri.gov/programs/detail.php?pgm_id=146 Rhode Island Division of State Laboratories and Medical Examiners]
* [https://www.scdhec.gov/health-professionals/public-health-laboratory-phl South Carolina Public Health Laboratory]
* [https://doh.sd.gov/Lab/ South Dakota State Public Health Laboratory]
* [https://www.tn.gov/health/health-program-areas/lab.html Tennessee Department of Health Laboratory Services]
* [https://www.dshs.state.tx.us/lab/default.shtm Texas Department of State Health Services Lab]
* [https://uphl.utah.gov/ Utah Public Health Laboratory]
United States Virgin Islands Department of Health
Vermont Department of Health Laboratory
Virginia Division of Consolidated Laboratory Services
Wadsworth Center, New York State Department of Health
Washington Public Health Laboratories
West Virginia Department of Health & Human Services
William A. Hinton State Laboratory Institute
Wisconsin State Laboratory of Hygiene
Wyoming Public Health Laboratory
 
* [https://www.chcc.gov.mp/laboratory.php Commonwealth of the Northern Mariana Islands, Commonwealth Healthcare Corporation Laboratory]
* [http://www.salud.gov.pr/Pages/Home.aspx Puerto Rico Public Health Laboratory]


===4.6 National and global resources===
===4.6 National and global resources===

Revision as of 23:07, 1 May 2020

4. Final thoughts and additional resources

4.1 Final thoughts

In the relatively brief time since it has started, the COVID-19 pandemic has brought with it numerous challenges for society to face. How poised is a state and national government to truly lend assistance to its citizens in the face of a crisis? How does the increasing divide between the "haves" and "have nots", and the associated economic structures that lend to them, reveal the fragility of our society? What more can be done to fund epidemiology research? How can we improve our healthcare system to be better equipped to handle communicable disease response and better funded to provide more social services to a broader base of people? And what lessons can be learned from the successes and failures of providing accurate, responsive laboratory testing during pandemics?

We've learned that the family of coronaviruses can be disruptive to humanity with past brushes with SARS and MERS, yet we arguably haven't done enough to research these and similar viruses to be more prepared. We were perhaps fortunate in some ways that SARS wasn't worse than it proved to be. However, responses by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and other organizations and agencies around the world during the SARS and MERS outbreaks laid the foundations for laboratory testing a novel coronavirus like SARS-CoV-2. Reverse transcription PCR (RT-PCR) is again proving to be a useful diagnostic tool for identifying the virus in patient specimens. Other methods such as lateral flow assays (LFA) borrow from more rapid methods of identification, lending support to testing. And while confusing—particularly given the unknowns surrounding the predictive ability of antibodies conferring immunity—serology antibody tests appear to have their place as well.

These and related tests can be complex, as evidenced by the CLIA approval status of a strong majority of emergency use authorized (EUA) test kits. Performing these tests on complex instruments and then effectively using the data they provide require clear workflows that can be at least partially automated. This is particularly vital given the paltry 13 percent of CLIA-certified U.S labs that are certified to perform moderate- and high-complexity testing. Additionally, given the value of test result data to governments agencies, epidemiological researchers, and patients, it's important that reporting is clear, timely, and moderated. Laboratory informatics systems such as laboratory information management systems (LIMS) and laboratory information systems (LIS) can go a long way towards ensuring laboratory testing and reporting of commmunicable diseases goes smoothly.

Choosing just any informatics system and implementing it haphazardly in the laboratory doesn't automatically ensure improvements, however. Many elements of the system should be carefully considered. Does the system have a provider portal that is flexible in its ability to handle providers from many different healthcare facility types entering test orders and reviewing results? How well does it address the workflow of COVID-19 and other types of respiratory illness testing? Does it interface with the instruments you're using to test such illnesses, and at a reasonable cost? How well does it handle internal and external reporting requirements, as well as any data visualization and dashboarding you require? During outbreaks and pandemics, the system should improve your laboratory workflow, not slow you down. This includes the element of reporting, which is not only critical but also challenging even in relatively peaceful times of health. And how interoperable is the system with other clinical systems such as electronic health records (EHR) and radiology information systems (RIS)? As we found out, academic and research laboratories wanting to assist with testing have at times been locked out due to their informatics system not interfacing cleanly with a hospital EHR.

Hopefully this guide has provided important background in several areas, from COVID-19's historical impact and challenging health issues, to the current state of laboratory testing, reporting, and informatics applications being applied to fight its spread. As we said in the beginning, this pandemic and how humanity is dealing with it is rapidly changing us, as we try to keep up with ways to fend it off. That means information changes rapidly. An effort will be made to update this content as new information comes to light. In the meantime, stay safe and consider your informatics solutions with care.

4.2 Key guidance documents













4.3 Web portals

4.3.1 U.S. agency portals

4.3.2 U.S. state and territory portals

U.S. territories

4.3.3 Other national and multinational portals

World Health Organization (WHO) and regionals

4.4 Key journal articles


  • Iwen, P.C.; Stiles, K.L.; Pantella, M.A. (2020). "Safety considerations in the laboratory testing of specimens suspected or known to contain the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)". American Journal of Clinical Pathology: aqaa047. doi:10.1093/ajcp/aqaa047. PMID 32190890. 


  • Loeffelholz, M.J.; Tang, T.-W. (2020). "Laboratory diagnosis of emerging human coronavirus infections – The state of the art". Emerging Microbes & Infections 9 (1): 747–56. doi:10.1080/22221751.2020.1745095. PMID 32196430. 




4.5 Public health lab directory

United States Virgin Islands Department of Health Vermont Department of Health Laboratory Virginia Division of Consolidated Laboratory Services Wadsworth Center, New York State Department of Health Washington Public Health Laboratories West Virginia Department of Health & Human Services William A. Hinton State Laboratory Institute Wisconsin State Laboratory of Hygiene Wyoming Public Health Laboratory

4.6 National and global resources

4.7 Public health laboratory informatics solutions