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Supply shortages and delays have been a major issue throughout the COVID-19 pandemic, with especially pronounced effects on consumable supplies such as plastic ware. During conversations and outreach with member laboratories, staff in APHL’s Newborn Screening & Genetics program started hearing about challenges sourcing pipette tips for routine testing.

Newborn screening is a relatively small-scale service at public health laboratories, representing just 0.5% of national pipette tip usage across testing disciplines, but with outsized impact on lifelong health. And while many non-COVID-19–related services were slowed or put on hold during the pandemic, that isn’t an option for newborn screening. “Babies are born every day, no matter if there’s a hurricane, a global pandemic, the lights go out, or the staff is sick, and those babies need to be tested,” said Sikha Singh, MHS, PMP, deputy director of Newborn Screening & Genetics. “Screening for these rare disorders, by detecting them at birth, can save lives or reduce morbidity across the lifespan.”

Uncertain supplies threatened the health equity and benefits provided by universal screening. APHL worked with laboratorians to assess their supply needs, which vary widely by jurisdiction. The team compiled a full assessment of the number of tips needed to maintain continuity of newborn screening across the country.

With that data, APHL leadership prepared a memo to take to the Testing and Diagnostics Workgroup of the Department of Health and Human Services outlining the small share of the total pipette tip market needed by newborn screening programs and the detrimental impacts on newborn public health of limiting their supply. With this effort, they were able to secure prioritization for the full supply of needed pipette tips for public health laboratories to maintain universal newborn screening.

“With this collaboration between the federal government and APHL leadership, rallying on behalf of our state public health laboratory members, we were able to make a small step toward ensuring the continuity of the newborn screening program throughout the public health emergency,” Singh said.

As laboratories are starting to look beyond the public health emergency, staff in newborn screening programs have a chance to reflect on lessons learned and pandemic adaptations that may improve services and procedures in the future. For nearly two years, laboratorians who work in newborn screening have been able to share ideas and advice via an APHL-hosted webinar series. “Now we are talking about which of our in-the-moment solutions should be enduring,” Singh said.

For example, longer operating hours and staggered shifts began as a way to achieve physical distancing in laboratories, but they introduced efficiencies that allowed testing to be completed more quickly, reducing the time to results and reporting. Video trainings and online modules can offer on-demand education for hospital staff on specimen collection. Ways to approach testing insufficient specimens may enable screening for a baby who might otherwise be lost to follow-up. “Now we are working to sustain the good,” Singh said.

Overall, these adaptations and other efforts largely allowed newborn screening programs to maintain services throughout the pandemic. Anticipated backlogs did not materialize as fully as feared despite nationwide postal delays that slow specimen transport. And although the percentage of babies born in the US who did not get screened or were lost to follow-up rose by about 2% in 2020, based on states reporting data to the NewSTEPs Data Repository, Singh noted, “there are data elements that we expected to worsen that simply didn’t.”