A health care worker screens a patient for COVID-19 at a drive-through coronavirus testing site on March 18, 2020 in Arlington, Virginia. Photo: Drew Angerer/Getty Images

Some academic labs are continuously reworking their coronavirus tests, or trying to make new tests altogether, in an effort to stay ahead of shortages in the supplies they need to make those tests.

The big picture: The U.S.' testing capacity has expanded as large commercial labs pledge to make tests, but we'll be right back to square one if we run out of the necessary ingredients.

Labs have been sounding the alarm about dwindling supplies of test ingredients like reagents, RNA-extraction kits and the swabs used to take samples from patients.

Driving the news: Stanford's clinical virology lab is in the process of validating its fourth RNA extraction method, medical director Benjamin Pinsky told me.

  • It's not as simple as just swapping one material for another. With each change, the lab has to make sure the test is still accurate.
  • “We have not had to do this, this rapidly with this many components of a particular test in my time in the laboratory," Pinsky said.

The University of California at San Francisco's clinical virology lab is working on five assays — which are essentially test recipes — as a response to supply shortages, medical director Charles Chiu told me, even though it already validated one earlier this month.

Other labs are developing tests with the potential for shortages in mind.

  • "Redundancy is key here," Harvard's Michael Mina said. "We are keeping redundancy very much on the back of our minds... There is a concern that some item might become out of stock and so as soon as we are live with our test, we will start validating other modifications."

Reworking existing tests isn't the only desperate attempt being made to ramp testing up. At-home kits are being developed and sold without FDA approval, the Washington Post reported last night, and testing sites are limiting who can be tested to conserve resources.

The bottom line: Continuously reworking tests isn't a sustainable long-term option. "I know a lot of the manufacturers are reporting that they are ramping up production and that these shortages are short-term, but we’ll have to see if that’s the case," Pinsky said.

  • "But certainly I hope that we don’t have to continue to keep changing reagents on a daily or weekly basis. That would be incredibly challenging for our lab.”

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