RT-LAMP is the right way to scale diagnostic testing for the coronavirus
by Kevin Fischer
kfischer $& gmail *( com
RT-LAMP compared to RT-PCR is a less versatile and more recently invented laboratory technique. LAMP is more suited to actual diagnostic testing at scale than PCR but never became industry standard despite its demonstrated superiority. Labcorp/Quest/One Medical use PCR for their coronavirus diagnostic tests and they currently have delays as long as two weeks for issuing results which is totally unacceptable for fighting this pandemic. Color in San Francisco has one of few widely available RT-LAMP tests for the coronavirus and they generally give results back in one to two business days and are not bottlenecked by laboratory procedure.
An open access RT-LAMP coronavirus diagnostic toolkit was published at the end of July and I believe presents a solution to scaling diagnostic testing to where it needs to be. A rapid, highly sensitive and open-access SARS-CoV-2 detection assay for laboratory and home testing
What steps can we take to help national testing capacity switch to RT-LAMP instead of RT-PCR? There are parallel approaches here -- bottom up development suggests distributed citizen science RT-LAMP labs to fill in gaps in testing capacity, top down distribution suggests convincing the major industry players to devote resources to switching to RT-LAMP over RT-PCR. I'm going to take the bottom up approach; can anyone else figure out how to help Quest and Labcorp switch over to the superior testing method?
Does anyone else want to set up their own RT-LAMP operation? I'm going to give it a try and will write a guide on what to buy once we're operational. One of my business partners was an innovator in LAMP primer design over ten years ago and we still own the lab equipment needed for the simple procedure. Presumably as non FDA approved citizen science it will have to be "for research only" and not for diagnostic testing purposes but it's possible the FDA is being cooperative and that actual FDA licenses could be issued on a timeframe that is reasonable.
I think until recent throughput issues PCR was basically good enough and some scientists were attached to their hard learned PCR skills, LAMP was new and scary and unfamiliar enough that lots of scientists just didn’t know it was easier and better. Primer design was a serious obstacle in the early days of LAMP but is easy with modern computer primer design tools.
LAMP is also only better than PCR for the things that it is better at. PCR has general applications to biological science and LAMP is only good for an important subset of possible PCR diagnostic tests. I think mainstream scientists lack the understanding of what LAMP can and can’t do and for something as sensitive as HIV testing I can understand that people don’t want to rock the boat and switch to LAMP from PCR.
It’s also relevant that LAMP is only recently leaving patent protection. I’m not sure what the licensing cost structure used to be but now there are no patent license fees pushing through adoption is simpler:
I am going to try and scale towards selling RT-LAMP kits to US states in very high unit amounts; I’m feeling optimistic.