Much like the rest of the world, for nearly a year Landstuhl Regional Medical Center has focused much of its attention on combatting COVID-19 through relentless testing for the virus via any available platforms.This week, as the largest U.S. military hospital outside the continental United States, LRMC surpassed 100,000 COVID-19 tests with a continued commitment toward diminishing the virus. This is evidenced by ongoing additions to its laboratory arsenal, such as the recent U.S. Food and Drug Administration-authorized Rapid Antigen Tests, or RAT tests. Using a RAT test, patients can read their results directly from the testing card, similar to home pregnancy tests.“We have come a long way since we completed our first COVID-19 (Polymerase Chain Reaction) test on March 6, 2020, approximately 11 months ago,” said U.S. Army Lt. Col. David Peterson, chief of LRMC’s Laboratory Department. “In the beginning we used a very tedious, time-consuming and highly complex testing platform that required experienced scientists to run, interpret data and certify patient results. Over time we have added additional equipment that is more automated and less complex, which allows laboratory technicians to process, run and certify results with only minimal oversight and the standard laboratory quality control checks in place.”As the parent organization of six outlying clinics expanding over three countries, LRMC receives COVID-19 specimens from all around Europe and beyond.“We received specimens from essentially every military facility in Europe, Africa, and Middle East,” explains Peterson. “Many of the sites that were submitting to us early in the pandemic now have equipment of their own and only rely on us when their volumes exceed instrument and supply capacities.”Armed with legions of test equipment, the hospital relies heavily on five analyzers for viral testing, ranging from the U.S. Centers for Disease Control and Prevention’s 2019 Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase (RT)–PCR Diagnostic Panel to a 72 inch by 32 inch high-throughput testing system with standalone capabilities of 1,000 tests per day, which has analyzed nearly half of all tests at LRMC.“Early in the pandemic we could only complete a dozen or so samples per day,” said Peterson, a native of Caldwell, Idaho. “Over time our capacity to test has markedly increased. To date our largest testing day was 1149 tests. Over the last several months, our daily testing average has been between 500 and 600 samples per day.”Although COVID-19 testing now represents the largest individual test by volume at LRMC, a large variety of clinical and anatomic pathology testing for hospital patients is still a mission laboratory professionals must meet. Additionally, LRMC’s laboratory is a reference laboratory for most military sites in Europe, Africa and the Middle East, meaning it handles many samples and a wide variety of tests from those sites.“Completion of this new mission requires the entire laboratory team and all hands on deck,” said Peterson. “The majority of our laboratory team have contributed directly to the COVID testing mission.”