Key factors determining the development of SARS-CoV-2 testing strategies in EU countries: a mixed-methods study

Area of Science:

• Public Health
• Epidemiology
• Laboratory Science

Background:

• The World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) recommended extensive COVID-19 testing.
• National responses and diagnostic testing strategies varied significantly across European countries.
• Differences in national laboratory capacities impacted pandemic management.

Purpose of the Study:

• To identify key factors influencing the development of national SARS-CoV-2 testing strategies in European countries.
• To understand the evolution and implementation of diagnostic testing approaches during the pandemic.

Main Methods:

• A mixed-methods approach combining expert interviews and a cross-sectional survey.
• Interviews with 12 European experts in laboratory, policy-making, and public health.
• A survey of 15 ECDC National Focal Points (NFPs) for Preparedness and Response and/or Microbiology.

Main Results:

• Key factors identified include evolving testing goals, epidemiological situation, laboratory capacity, resource availability, and quality management.
• Experts highlighted the importance of stockpile management, expert networks, and centralized decision-making.
• Survey results confirmed that testing strategies broadened over time, involving key actors like Ministries of Health and public health officials.

Conclusions:

• National SARS-CoV-2 testing strategies generally expanded in scope as the pandemic progressed.
• The study identified critical factors contributing to the development and implementation of these strategies across Europe.
• Effective coordination, accountability, and governance were pivotal for successful testing strategies.