SEATTLE — On an overcast day in Seattle, a few dozen medical staff members, students and emergency workers with symptoms of the fast-spreading coronavirus spent their lunch break driving to a parking garage.
The UW Medicine’s Medical Center Northwest has turned part of the first floor of their four-story parking garage into a mobile testing clinic. Think fast-food drive-through, but instead of getting served a juicy burger, nurses come to take a nasal swab.
In about a day, patients find out whether they have the coronavirus.
Delays in testing have set back the United States’ response to containing the coronavirus, and the mobile clinic that has operated since March 6 is one attempt to identify cases earlier in Seattle, the center of the nation’s outbreak.
“It’s been a crazy couple of weeks,” says Dr. Seth Cohen, who is leading the effort and is the medical director of infection prevention at the UW Medical Center.
It is difficult to screen a large volume of people for the coronavirus inside a hospital, Dr. Cohen said. The space would need proper ventilation, and patients should not be contained in a waiting area where they could infect one another.
Before patients are allowed to enter the drive-through clinic, they must fill out an online survey: Have they been experiencing cough, fever, shortness of breath, muscle aches, a runny nose or a sore throat? Did they have a specific exposure or recently travel to any countries with a current travel advisory?
Responses are screened, and those who seem to be candidates for testing are offered an appointment.
“This is a clinic for people who have symptoms,” says Dr. Cohen. At this moment, there is no way for people who are asymptomatic to be screened.
Dr. Dan Doherty, a developmental behavioral pediatrician at the Seattle Children’s Hospital, felt the onset of a cold last Wednesday when he woke up with a sore throat, which then progressed to a low-grade fever and congestion. “I did not have a known exposure, other than being in Seattle,” he said. In an abundance of caution, he got an appointment at the mobile clinic on Monday morning.
The samples are kept in a refrigerator until a courier comes to deliver them to the UW virology lab. Nurses then change their protective gear before examining the next patient. All told, it takes about five minutes for the nurses to test one patient, said Dr. Cohen. Within the two-hour testing block on Tuesday, the nurses were able to collect samples from 40 to 50 patients.
One man, as he pulled away from the nurses and tents, said to his child in the back seat, “Now we’re going to go home,” as if they had just picked up lunch.
The virology laboratory — a stone’s throw away from Amazon headquarters — has been operating 24 hours a day starting this week, turning what was once a research lab into an round-the-clock center for screening samples for coronavirus.
UW Medicine started gearing up in early January, after Dr. Keith Jerome, the head of virology, read about the outbreak in China and knew it was only a matter of time before the virus would show up in the United States. A team of about a dozen researchers started working to develop the capacity to screen hundreds of patient samples for coronavirus. Once they had a patient sample that tested positive for coronavirus, it was all hands on deck: While the process to validate a robust test would ordinarily take several weeks or months, they did it in just three days.
“We thought this is probably going to be a wasted effort,” Dr. Jerome said. “But you don’t want to wait until the last minute to start to prepare.”
The last time Dr. Jerome got a full night’s sleep was over two weeks ago, before the Food and Drug Administration announced on Feb. 29 that academic medical labs could test for coronavirus.
“It’s been nonstop since then,” Dr. Jerome said.
One medical laboratory scientist, Jina Chung, has pulled 15-hour days. Rohit Shankar, another technician, abandoned plans for his vacation next week to Bali, Indonesia, so he could help out.
Scientists extract the genetic material from all the patient samples, and load them into 96-well plates for coronavirus screening. Any positive samples are sent to the state for further analysis, and results are also communicated to the necessary hospital or doctors, who then follow-up with patients.
Nearly 900 samples were being processed on Tuesday afternoon, and Dr. Alex Greninger, assistant director of the virology lab, said the facility was preparing to handle up to 5,000 daily.
“Wow,” one laboratory technician said. “And I thought we were busy now.”
As of Thursday, the mobile clinic had already screened 476 patients, with eight cases testing positive for Covid-19, according to Dr. Cohen, with many more turning out positive for influenza.
Although mobile clinics are usually seen as something ephemeral, Dr. Cohen said, “I think we’re in this for the long haul.” And by that, he means months. “Until there’s another way to get people rapidly screened.”
UW Medicine is looking to set up a second location in the south part of the city. The priority for now is to ramp up the capacity to serve the patients and staff at UW Medicine, rather than serving the general public. A similar mobile clinic in Denver, open to anyone with a doctor’s order, had hourslong delays for testing this week.
But like hand sanitizer, bread and toilet paper, supplies for testing are running low. “We are running low on the swabs. That’s going to be the bottleneck for this clinic,” Dr. Cohen said. “But right now we’re just trying to test as many people as we can.”
