An 'All Hands on Deck Approach' for UI's COVID-19 Testing

PHOTO: Susan McClellen Bradley Ford

It all begins with a swab up the nose. That's when the Clinical Microbiology Laboratory team at University of Iowa Hospitals & Clinics gets to work.

Since March 20, the Clinical Microbiology Laboratory—led by medical director Bradley Ford, MD, PhD—has been running approximately 120 COVID-19 tests a day. That's in addition to the 300,000 tests the lab runs in a year for anything ranging from urinary tract infections to strep throat.

Through innovation—as well as collaboration with private industry and the state's public health and environmental laboratory—Ford and his colleagues are helping provide a rapid clinical response to an unprecedented public health crisis.

"It's been an all-hands-on-deck approach," says Ford, who helped UI Hospitals & Clinics become the first Iowa hospital to administer COVID-19 testing in its own laboratory. "We have a core team of six to eight people doing COVID-19 testing, with 12 trained in total. That means the remainder of our 25 people are pulling a ton of extra weight."

UI Hospitals & Clinics began planning to administer COVID-19 testing in February to help lessen the burden on Iowa's primary testing site at the State Hygienic Laboratory, which is also located at the university. When the Food and Drug Administration gave emergency use authorization for the lab to use a test component from Integrated DNA Technologies—a UI spinoff company in Coralville founded by UI adjunct professor of biochemistry Joseph Walder, MD, PhD—it was full steam ahead.

In less than 10 days, the Clinical Microbiology Laboratory brought together all of the instruments, processes, and personnel necessary to administer the test; created safety and training protocols; and reported results to the Iowa Department of Public Health. Before testing hospital patients, lab staff prepared by working with known positive and negative samples borrowed from the State Hygienic Laboratory.

Medical supply shortages have plagued facilities all around the country, and UI Hospitals & Clinics has not been immune—lacking enough swabs to collect patient samples, materials to extract DNA and RNA from the samples, and other components for the test. But, Iowans all around the state have stepped up.

"It's been a very Iowa-like experience because we've had people come forward to donate items—whether it's swabs, masks, or various things they found in closets, drawers, or back rooms—so that we can keep testing going long enough for orders to start coming in again," says Ford, a clinical associate professor of pathology.

In the coming days, Ford is hopeful that automated testing will come online, allowing his team to produce results in as little as 30 minutes. "We're also working on bringing on more well-trained staff, so that we can run tests on nights and weekends, and to have a deep pool to pull from if we need to meet a surge in manual testing," says Ford.

UI Hospitals & Clinics continues to collaborate with the State Hygienic Laboratory to learn more about people who are immune to COVID-19. Also, Iowa's researchers are set to begin a clinical trial to see if antibodies from a person who has recovered from COVID-19 can help treat patients diagnosed with COVID-19. Having testing in-house allows UI Hospitals & Clinics to rapidly identify case patients who may consent to helping others through donations of plasma or through development of new tests and treatments.

It's a collaborative effort with one goal in mind: keeping Iowa healthy. 

"The University of Iowa is at the forefront of innovation, and we're responding to the needs of our state," says Ford. "Of all institutions in Iowa, we're able to partner with places like Integrated DNA Technologies and the State Hygienic Laboratory to do the best we can for Iowans."

To support University of Iowa health care workers who are on the frontlines of the COVID-19 pandemic, give now at givetoiowa.org/uihc.