COVID-19 CRISIS

'This is the job we signed up for'

State's lab adapts to meet challenges of COVID-19 crisis

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Ewa King and Richard Huard, two of the leaders of the State Health Laboratories, were working when the state confirmed its first case of COVID-19 on March 1.

“Our laboratory has not stopped since,” King said during a Monday conference call with members of the media.

King, who serves as associate health director for the Rhode Island Department of Health, and Huard, the chief clinical laboratory scientist with the department’s Center for Biological Services, said the pandemic has placed an unprecedented strain on the lab and its staff.

Preparations for the crisis have been underway since January, when reports of person-to-person transmission of the virus emerged from China. And while earlier pathogens such as H1N1 provide some valuable lessons, King said the current crisis “eclipses that one by orders of magnitude.”

The State Health Laboratories provides a range of functions for the state, from the testing of drinking water and air samples to forensic duties for law enforcement. Since the start of the crisis, that work has continued – but at least 30 of the lab’s 80 staffers are now focused on the COVID-19 crisis, working shifts of up to 14 hours a day to process tests for the disease caused by the novel coronavirus.

Huard said a retired employee has returned to the lab to assist, while Department of Health staffers who previously worked in the lab but moved on to other roles have also been enlisted in the effort.

“Almost practically everyone who works in my center has been drafted into the COVID-19 test … We’ve really marshaled a huge effort in order to do this coronavirus testing,” he said.

Other laboratories across Rhode Island, including East Side Clinical Laboratory and hospital labs, are also involved in the state’s expanding testing effort.

King said specimens taken at sites around Rhode Island arrive at the State Health Laboratories continuously from 8 a.m. to 5 p.m. on any given day. Results for more, she said, are reported within 24 hours, although some samples that require re-testing can take more time.

The lab’s typical processing capacity is approximately 300 tests a day – a figure King said has regularly been exceeded, with as many as 450 samples processed. That represents an enormous increase since the earliest days of the crisis, when the daily processing numbers were in the single digits.

“We’ve not had, in my memory, such a huge response being needed for any particular pathogen,” Huard said.

There have been challenges in achieving the ramped-up capacity. There has been no time to provide proper training to new staffers, and those with existing clinical laboratory experience are needed to take part in the testing process. Additionally, the COVID-19 testing process is more intensive than the largely automated protocol in place for diseases such as HIV.

“We have involved many more scientists in this process than we normally would,” King added.

Huard said specimens go through a process called “extraction,” in which the genetic material from the virus is isolated and amplified for detection.

Huard said at this point, the lab’s scientists do not believe “false negatives” – tests that fail to detect the presence of the virus in a sample – are an issue. It is an issue that is being closely watched, however.

“The science is still developing … Whether there are false negatives? I’m sure there are, because no test is 100 percent, ever,” he said.

King said thanks to Gov. Gina Raimondo and the state’s leadership, the lab’s supply chain remains solid. She added, however, that the challenges of procuring all of the needed equipment has required the lab’s scientists to “really be much more flexible than we normally need to be.”

“It’s been a challenge to make sure all of those components are available to us at any given point … We’re doing OK right now, but that is subject to change literally every day,” she said.

She added: “Funding to respond has not been an issued for us … We are purchasing supplies and we are employing our scientists on an overtime basis without any restrictions.”

Modeling of the projected peak of the virus remains mixed, and King said the lab’s scientists expect to be “in this process for quite a while.”

“This is the job we signed up for … We’ve been very lucky, where we haven’t had anybody be sick who works in the laboratory,” she said.

She added: “We feel confident that we have enough trained staff to continue … for as long as needed.” 

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  • wwkvoter

    The peak, or apex, is in two weeks or maybe three. It goes down around the same rate, so that means in four to six weeks we will be back down to about what it is today.

    This has a couple MONTHS left in it. That being said, we;ll have fast available testing including to check those who have HAD it and now have some amount of immunity.

    And, we'll most likely by then have identified which meds can save most of the worst cases in ICU, reducing the ultimate risk.

    Between now and then, it's about isolation. I went out for necessary items (mask, isolated, curb pickup) and saw way too many subjects not doing their part.

    Friday, April 17, 2020 Report this