Preparedness of public health laboratories for respiratory threats: Evidence from an ECDC study

Abstract Background Public health laboratories (PHLs) play a key role in detecting and responding to public health threats. ECDC commissioned a study on the preparedness of PHLs in the EU/EEA. This study collected evidence on challenges during the pandemic, how they were addressed, and how to improve long-term preparedness for respiratory infectious diseases. Methods We conducted a rapid evidence assessment followed by interviews and a survey with public health authorities. We also facilitated an ECDC technical meeting with EU institutions and EU/EEA Member States. The study will be finalised May 2025. Results PHLs faced intense pressures during the COVID-19 pandemic, including high levels of demand and challenges around the workforce, supply chains, procurement and infrastructure. Data sharing and coordination were significant challenges, which affected the timeliness, efficiency and comprehensiveness of surveillance. To help address challenges, PHLs hired and trained staff, implemented new ways of working, and developed guidelines and standard operating procedures. PHLs also drew on capacities in other laboratories and sectors, procured supplies from new sources, and formed networks and collaborations during the pandemic. Evidence is needed on how to improve preparedness efficiently, including on “right-sizing” genomic surveillance, best practices in integrating wastewater surveillance, and what evidence is most needed from PHLs to inform decision making at different time points during emergencies. PHLs would also benefit from preparedness planning and rehearsing how and when to scale up and scale down capacity. Conclusions EU institutions can support PHL preparedness by providing funding, collating evidence around best practices in PHLs, and filling evidence gaps in how to conduct surveillance that meets decision-maker needs and makes the best use of resources. There is also scope for EU-level action to address supply chain issues and EU-wide preparedness exercises. Key messages • Public health laboratories faced intense pressure during the COVID-19 pandemic, and there is now an opportunity to learn from their experiences to improve long-term preparedness. • Improving preparedness in public health laboratories during peace time is essential to supporting timely, relevant insights to inform decision making at different points during emergencies.