October 27, 2020
It was the novel coronavirus – by definition, a new virus. When it arrived in Kansas City, as had been the case in communities it affected first, it was unknown. We had not seen it before. We had not treated it before. We had not tested for it before.
As our infectious disease, pulmonary and intensive care teams worked to become as educated as possible to prepare for patients with COVID-19, the illness caused by the virus, it became clear that rapid, accurate testing would be crucial to better detecting, understanding and containing the infection.
From the ground up
Our laboratory team tackled COVID-19 testing, working around the clock to devise a brand-new solution.
The small but dedicated team partnered with vendors and our laboratory information systems team to repurpose existing lab equipment for a new use. A typically 3- to 6-month process spanned just 3 days – essentially, a long weekend. Out of the gate, the new SARS-CoV-2 testing system could run up to 180 tests a day. Our health system became the first hospital in Kansas City with in-house testing capability.
"It was truly an incredible team effort, and a department-wide effort," says Rachael Liesman, PhD, medical director of the microbiology and special chemistry laboratories, who spearheaded the effort to bring the virus testing in house.
In another contribution, the lab team also began hand-assembling testing kits, which were in short supply across the country. The lab team and others, with all hands on deck, began putting together thousands of kits, each including a biohazard bag, a flocked nasopharyngeal swab and a tube of transport media, which holds the swab after use on the patient. Within days, 15,000 swab kits were ready for use, and supplies for 10,000 more remained available.
While many of the kits were used locally, a number were distributed to county health agencies and partner healthcare organizations as well as to health system locations in Greater Kansas.
It was exciting to help with testing on a high-profile disease that hits so close to home in our community. – Kelsey WoodardMedical lab scientist supervisor
Taking it to the next level
It was an important and triumphant success – but it wasn’t enough. Scarcely pausing for breath, the lab experts moved forward, embracing the next challenge to accelerate the testing process and increase capacity.
Several local businesses, led by NorthPoint Development, sought an opportunity to contribute to Kansas City’s COVID-19 response. The company purchased 50,000 test kits and instrumentation and donated it all to the health system. The contribution was valued at about $1.2 million.
The lab team put the new equipment to use – making a home for it in space typically used as a locker room – and continued to push to test faster.
By late April, the lab’s daily capacity had risen from 180 tests to 450 (about half of those were submitted to the health system by county health agencies). By mid-May, the team could turn around 750 tests each day. In mid-July, the team could address 800-900 tests in a day and performed its 40,000th COVID-19 test. Today, having added instruments and staff, including an overnight shift, the lab can process more than 1,000 COVID-19 samples daily.
All in all, the testing function expanded the existing responsibilities of about 50 lab professionals in 2 labs, as well as dozens of others who support testing by receiving, packaging and registering specimens from county health departments, making specimen collection kits and providing antibody testing.
More and faster testing allowed care providers to move patients to the right level of care much more quickly. It increased the ability to conserve personal protective equipment – with less precautionary PPE used in providing care for patients who didn’t have COVID-19 but didn’t yet have test results to confirm it.
"We’ve always been very supportive of patients and their providers," says Kelsey Woodard, a medical lab scientist supervisor and colleague of Dr. Liesman’s. "But it was exciting to help with testing on a high-profile disease that hits so close to home in our community."
In October, 206 days after completing its first test, the lab team performed its 100,000th COVID-19 test.
"The pandemic has required us to pivot constantly around supply availability, testing methodology, changing government regulations and guidance, and new opportunities," says Arda Peterson, director of pathology and laboratory medicine. "The team has worked exceedingly hard to provide the highest quality testing to our region and our state. Their commitment has never wavered. I am so proud of our laboratory team and our healthcare team."
The work continues.