Impact of the COVID-19 pandemic on clinical laboratories in Japanese hospitals and preparedness for the next pandemic: A nationwide questionnaire survey.

Publication date: Nov 01, 2026

During the coronavirus disease 2019 (COVID-19) pandemic, clinical laboratories faced urgent testing demands for severe acute respiratory syndrome coronavirus 2 amid resource shortages. However, few descriptive studies have documented the challenges faced by hospital laboratories during the pandemic. This study investigated the changes in laboratory and diagnostic capacities in Japanese hospitals before and during the COVID-19 pandemic to help identify issues relevant to pandemic preparedness. Two nationwide web-based surveys were conducted using Google Forms: Survey 1 (November-December 2022) and Survey 2 (November-December 2023). One representative response per institution was requested. Survey items covered laboratory personnel, diagnostic equipment, test implementation across epidemic waves, resource sufficiency, specimen types and collection, and preparedness for future pandemics. A total of 298 hospitals responded to Survey 1 and 176 to Survey 2; 149 responded to both. The median bed size was ≥400, and most facilities provided emergency care and infection control services. Compared with pre-pandemic levels, both the number of technologists engaged in nucleic acid testing and the adoption of automated nucleic acid amplification test (NAAT) instruments increased significantly. In-house NAAT availability rose from 32. 2% (Wave 1) to 96. 0% (Wave 8). Early shortages in equipment and knowledge improved, but human resource shortages persisted until Wave 8. Japanese hospital laboratories expanded NAAT capacity during the pandemic, but initial shortages in equipment, knowledge, and staffing impeded testing. Sustaining NAAT capacity, ensuring trained personnel, and supporting smaller institutions with knowledge and infrastructure are critical priorities for preparedness against future pandemics.

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