CONTAIN: An open-source shipping container laboratory optimised for automated COVID-19 diagnostics

Walker, Kenneth T.; Donora, Matthew; Thomas, Anthony; Phillips, Alexander James; Ramgoolam, Krishma; Pilch, Kjara S; Oberacker, Phil; Jurkowski, Tomasz Piotr; Gosman, Rares Marius; Fleiss, Aubin; Perkins, Alex; MacKenzie, Neil; Zuckerman, Mark; Danovi, Davide; Steiner, Helene; Meany, Thomas

The COVID-19 pandemic has challenged diagnostic systems globally. Expanding testing capabilities to conduct population-wide screening for COVID-19 requires innovation in diagnostic services at both the molecular and industrial scale. No report to-date has considered the complexity of laboratory infrastructure in conjunction with the available molecular assays to offer a standardised solution to testing. Here we present CONTAIN. A modular biosafety level 2+ laboratory optimised for automated RT-qPCR COVID-19 testing based on a standard 40ft shipping container. Using open-source liquid-handling robots and RNA extraction reagents we demonstrate a reproducible workflow for RT-qPCR COVID-19 testing. With five OT2 liquid handlers, a single CONTAIN unit reaches a maximum daily testing capacity of 2400 tests/day. We validate this workflow for automated RT-qPCR testing, using both synthetic SARS-CoV-2 samples and patient samples from a local NHS hospital. Finally, we discuss the suitability of CONTAIN and its flexibility in a range of diagnostic testing scenarios including high-density urban environments and mobile response units. Visual abstract