In Pursuit of a Hidden Enemy: A Unique Testing Process

St. Jude teams unite to launch a unique process for COVID-19 testing of patients and  employees.

By Mary Powers & Carole Weaver Clements, PhD; Photos by Ann-Margaret Hedges & Justin Veneman

Every four seconds Kimberly Berg picks up a 15-milliliter vial in her double-gloved right hand. She unscrews the top, switches the tube to her left hand and positions it under a thin nozzle. The vial automatically fills with 3 milliliters of a clear solution. Then Berg screws on the top, places the vial into another tray and starts again. Before the day ends at the Children’s GMP, LLC, she and her colleague Rhonda Cooper will fill and label 2,000 tubes with viral transport media.

The tubes are destined for the Marlo Thomas Center Auditorium across campus at St. Jude Children’s Research Hospital. There, an employee COVID-19 testing program is underway. Each day, hundreds of staff members randomly selected for screening enter the auditorium, sit down at testing stations and have their noses swabbed. Meanwhile, patients and families undergo testing in another part of the hospital.

Nurses place the swabs into vials with transport media that has been produced and packaged at the GMP facility. The vials are then transported to the St. Jude Clinical COVID-19 Testing Lab, where pathologists test between 5,000 and 6,000 samples per week.

Innovation for protection

When the testing program began in March 2020, it was the only one of its kind in the world. The initiative combined an aggressive symptom-screening program with testing for asymptomatic employees. Although many hospitals already had symptom-screening programs in place, St. Jude took a giant leap forward by adding the testing component.

One danger of COVID-19 is that some individuals may be unaware they are infected and may unknowingly infect others.

“Those are the people we’re trying to catch—employees who assume they’re healthy but are actually infected,” says James Hoffman, PharmD, chief patient safety officer. “It’s exciting to be a part of something that’s innovative and helps protect our patients, families and employees.” 

 
 
Scientist in the lab
 
Female COVID-19 scientist
 
 

A well-oiled machine

In the early days of the pandemic, St. Jude scientists, clinicians, administrators and others began working to create a seamless testing process.

Scientists in the GMP facility began creating transport media to preserve any COVID-19 virus picked up during a nasal swab. Computer programmers designed software to identify which staff members would be tested each day. Workers transformed the elegant lobby of the Marlo Thomas Center into a screening facility. Nurses and other staff members were trained to collect the samples, and detailed procedures were developed to track the materials.

In the first week of the program, more than 700 employees received the new test. Today, hundreds of faculty and staff undergo random testing each day—a process that requires only a few minutes of their time.

Employee testing for COVID-19

Herman Robinson, chef de cuisine in St. Jude Food Services, receives a nasal swab for COVID-19.

Marching forward together

In March of 2020, Stacey Schultz-Cherry, PhD, and Richard Webby, PhD, of Infectious Diseases; and Paul Thomas, PhD, of Immunology temporarily shifted their focus from research so they could assist with the COVID-19 testing.

“This is what we do in our influenza surveillance programs at St. Jude: We look for viruses,” says Schultz-Cherry. “We’re already doing this kind of molecular diagnostic testing for research. That made it easy for us to say, ‘OK, we do this for flu all the time. We can do this for coronavirus.’”

Soon, researchers and their staff were able to return to their usual operations, as Pathology employees in the new Clinical COVID-19 Testing Laboratory assumed the responsibility for testing thousands of samples each week.

“We built an entirely new lab in a few weeks,” says Randall Hayden, MD, who directs the Clinical COVID-19 Testing Lab. “A lot of people worked around the clock to get the new space prepared, equipment installed, tests validated and running, and a supply chain in place. As a result, we had the capacity for patient testing well before most other centers in the country. We’re now able to process huge numbers of samples to support our employee testing program, which continues to grow as more staff return to work.”

Hayden says people throughout the institution helped make the effort a success.

“This has been a team effort that has shown not only the talent and dedication of our staff, but their ability to work together in the new ways that this challenge has demanded,” he says.

“St. Jude is a unique environment,” he continues. “Not only do we have the right expertise and laboratory space in close proximity, but we have very close working relationships between the research and clinical laboratories—it’s a setting that makes collaborative activities much faster and easier.”

From Promise, Autumn 2020

 

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