Coronavirus In RI: State Health Lab Rises To The Occasion

PROVIDENCE, RI — The staff at Rhode Island's State Health Laboratory hasn't taken a day off since the first coronavirus case was confirmed March 1. Employees are working overtime to process hundreds of tests per day to meet the unprecedented demand of the new coronavirus.

The lab is working with commercial and hospital labs throughout the state to test samples collected from Rhode Islanders suspected to have COVID-19. Ewa King, the lab's associate director of health, said that the department is almost exclusively focused on coronavirus testing, though some other essential processes such as air and water quality continue.

"Almost everyone who works in my center has been drafted for COVID-19," said Richard Huard, the chief clinical laboratory scientist at the lab's Center for Biological Sciences. He added that some retired and former employees have been brought it to assist with the effort.

The scientists working with the samples are "used to working with clinical specimens," King said. Test swabs arrive at the facility throughout the business day and are processed as they are received. Most test results are determined within 24 hours, and results are sent to the patient's primary health care provider. If the test is positive, the Rhode Island Department of Health is also notified for contact tracing efforts. Unlike other routine tests, such as HIV, the COVID-19 test is not very automated.

The lab is able to complete about 300 tests a day, though it has processed as many as 450 in a day. It is working closely with hospital and commercial labs such as East Side Laboratories, which are also processing hundreds of test swabs per day.

While many scientists are needed to actually test the samples, the greatest need for manpower is for data entry, King said. While the lab now has enough people, its academic partners might be asked to send volunteers to assist if the need arises.

While the response to this crisis has been "unprecedented," Huard said, the preparation began back in January, when the first person-to-person transmission was reported in China. Although there has been no other response like this in memory, he continued, the lab always has a plan in place for large outbreaks of the flu and other diseases.

"We're drawing some lessons form the H1N1 [influenza] outbreak, although this has already surpassed it in magnitude," King said.

Under normal circumstances, tests are always run the same way, using the same methods, to ensure consistency, Huard said. To address equipment, reagent and personal protective equipment constraints, multiple methods have been employed, and a special supply chain team from Gov. Gina Raimondo's office has been assigned to the lab.

"It's been a challenge to make sure we have enough supplies at any given time," King said, adding that the lab often only has a few days' worth of supplies on hand at any given time. So far, the lab has not yet run out of supplies.

False negatives are a "great concern," Huard said, especially considering this is a new test with the science still in development. For this reason, those with symptoms of COVID-19 who test negative should consider getting re-tested.

"I'm sure there are [false negatives], no test is 100 percent perfect, ever," he continued.

Despite the massive effort, the lab's leaders don't think there will be a shortage of staffing as Rhode Island approaches its projected coronavirus peak. So far, no employees have fallen ill with the virus, Huard said, and employees are working as many as 14 hours per day.

"We have a lot of dedicated people," Huard said. "This is what we signed up for."