Two Pandemics, One Challenge—Leveraging Molecular Test Capacity of Tuberculosis Laboratories for Rapid COVID-19 Case-Finding

T he ongoing coronavirus disease (COVID-19) pan- demic presents a massive challenge for healthcare systems globally (1,2).Rapid case-finding and patient isolation are crucial to limit transmission and avoid exceeding capacity limits of critical healthcare infrastructures.Therefore, the World Health Organization (WHO) (3) strongly advocates a large and rapid increase of global testing capacities to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA (2,4).This task is enormous, in particular in resource-poor settings without widespread availability of microbiological laboratories and, even more so, specialized virologic laboratories.For example, although other outbreaks such as the 2014-2016 Ebola epidemic in West Africa triggered substantial investments into surveillance and preparedness, many hospitals, clinics, and laboratories in sub-Saharan Africa were already operating at maximum capacity before the COVID-19 pandemic (5).Consequently, the WHO Joint External Evaluation reports suggest that the ability to respond to an international health hazard, such as the importation of an infectious disease like COVID-19, requires almost universal laboratory improvement across sub-Saharan Africa (6).With one quarter of the world's population infected with bacteria belonging to the Mycobacterium tuberculosis complex (MTBC), tuberculosis (TB) still represents a major global health threat (7).Substantial efforts have been made to scale-up highly sensitive and specific molecular diagnostic systems in highand low-resource settings, which greatly improved TB care globally (8).Strategies included programmatic implementation of (near) point-of-care, easyto-handle testing systems, such as the cartridge-based Two Pandemics, One Challenge-Leveraging Molecular Test Capacity of Tuberculosis Laboratories for Rapid COVID-19 Case-Finding