Initial Clinical Laboratory Response to COVID-19

A Survey of Medical Laboratory Professionals

Letycia Nuñez-Argote, MPH, CPH, MLS(ASCP); Dana P. Baker, MS, MBA, MLS(ASCP); Andrew P. Jones, MBA, MLS(ASCP)


Lab Med. 2021;52(4):e115-e124. 

In This Article

Abstract and Introduction


Objective: To explore the experiences of medical laboratory professionals (MLPs) and their perceptions of the needs of clinical laboratories in response to COVID-19.

Methods: We surveyed laboratory professionals working in United States clinical laboratories during the initial months of the pandemic.

Results: Overall clinical laboratory testing and overtime work for laboratorians decreased during the first months of the pandemic. Laboratory professionals reported better or unchanged job satisfaction, feelings toward their work, and morale in their workplace, which were related to healthcare facility and laboratory leadership response. They reported receiving in-kind gifts, but no hazard pay, for their essential work. Important supply needs included reagents and personal protective equipment (PPE).

Conclusion: The response by healthcare facilities and laboratory leadership can influence MLPs job satisfaction, feelings toward their work, and laboratory morale during a pandemic. Current COVID-19 laboratory testing management, in the absence of sufficient reagents and supplies, cannot fully address the needs of clinical laboratories.


The transmission of the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is the causative agent of the coronavirus disease 2019 (COVID-19), is a worrisome possibility in health care settings.[1] Because of the risk for health care workers becoming ill or having to take time off to provide care to sick relatives, the Centers for Disease Control and Prevention (CDC) issued strategies to reduce potential staffing shortages of health care personnel (HCP), such as identifying additional personnel to work in case of shortages and establishing testing and tracking protocols.[2] During this ongoing crisis, the concerns of HCPs for their health and safety are heightened by the lack of personal protective equipment (PPE) and limited laboratory-testing resources.[3] Although testing is required to secure a diagnosis, increased demand and shortages of basic necessities, such as test kits, reagents, and supplies, were some of the main concerns during the first months of the pandemic.[3,4]

At the intersection between adequate diagnostic testing and HCP shortages are medical laboratory professionals (MLPs). They are key actors within the health care team who provide essential testing of biomarkers that aid in the detection, diagnosis, and treatment of diseases, as well as facilitating efforts to monitor health and engage in disease prevention.[5] Staffing shortages of MLPs were severe before the COVID-19 pandemic.[6] The vacancy rates in United States (US) medical laboratories rose from 7.2% in 2016 to 8.6% in 2018, as reported by the American Society for Clinical Pathology (ASCP) Vacancy Survey. Also, hiring of qualified laboratory professionals and rates of burnout among individuals working in the clinical laboratory were the top concerns for staffing of laboratories.[7–9]

Shortages of clinical laboratory resources and trained staff members can have a critical impact in providing a sufficient response during a pandemic.[10,11] Previously, the College of American Pathologists (CAP) reported the clinical-laboratory response to the H1N1 pandemic by surveying at the laboratory level. Also, the Medical Laboratory Observer annual survey and ASCP satisfaction and burnout survey have documented individual satisfaction and perception of staff shortages among MLPs.[11–13] However, at present, little is known about the practice conditions of HCP on the front lines, particularly the individual perceptions and needs of MLPs associated with the COVID-19 response. We designed and implemented a survey to explore the self-reported practices and experiences of MLPs, and to document their perceptions of the needs of clinical laboratories at the start of the pandemic.