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The WHO has advocated for the "test, trace, treat" strategy in the mitigation of COVID-19 49 pandemic [1] . Rarely has sophisticated laboratory diagnostics been set up at this pace and extent. As 50 the epidemiological situation evolved quickly, the laboratory capacity building over the past few 51 months played a key role in the epidemic response in each country. At the same time, laboratory-52 based surveillance can provide high quality data for public health management. By using laboratory 53 registry data, the aim of this study was to characterise age-and sex-specific sampling frequency and 54 positivity rate, and to characterise laboratory capacity building of SARS-CoV-2 RT-PCR testing in 55 Greater Helsinki area in Finland during February-June 2020. (THL) were retrieved to calculate age-specific incidence.
The respiratory specimens were subjected to one of the following methods: a protocol based on CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
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Of the 86,927 specimens sent to HUSLAB for SARS-CoV-2 RT-PCR testing between 1 February 76 and 15 June 5,061 were excluded as they originated outside of Greater Helsinki. Additional 1,075 77 specimens were excluded as they gave repeatedly an invalid test result, or were never analysed due The highest proportion of positive cases was found in the age group 50-59 years (6.7%), and the CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
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While the number of test positive cases was similar in males and females, the positivity rate in 113 males was significantly higher than in females in our study. This may, to a small degree, be 114 explained by the overrepresentation of healthcare workers and female predominance in the elderly.
However, our data suggest that men pursued SARS-CoV-2 testing much less frequently than 116 women. Consequently, a subset of COVID-19 infections in men may have gone undetected.
Abundant evidence shows that women generally seek more health care services than men [8, 9] .
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The copyright holder for this preprint this version posted July 4, 2020. shortages on reagents and plasticware, the need to deploy several independent methods was evident 141 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted July 4, 2020. . https://doi.org/10.1101/2020.07.03.20145615 doi: medRxiv preprint to secure laboratory services and capacity building. The Amplidiag® COVID-19 tests were 142 deployed as of mid-April, and the Novodiag® sample-to-answer test as of mid-May. 143 In preparation for the potential next epidemic waves of COVID-19 pandemic, the difference in 144 health-care seeking behaviours between men and women needs to be accounted for to facilitate high is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted July 4, 2020. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted July 4, 2020. is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted July 4, 2020. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
The copyright holder for this preprint this version posted July 4, 2020. 234 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted July 4, 2020. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted July 4, 2020. . https://doi.org/10.1101/2020.07.03.20145615 doi: medRxiv preprint