Coronavirus testing bottleneck unclogging in Arkansas

While testing for COVID-19 continues to be a major necessity for Gov. Asa Hutchinson to assess Arkansas’ response to the coronavirus crisis, there is progress being made on the front.

Earlier this week, Secretary of Health Dr. Nate Smith and University of Arkansas for Medical Sciences Chancellor Dr. Cam Patterson said they expected coronavirus testing in state to ramp up from 20 samples per day to a collective 440 per day. That goal may be substantially exceeded.

Lack of test kits and lateness in deploying them has been a major challenge for health officials nationwide. Despite knowing the tidal wave of need was headed toward American shores, the federal government has been late in coordinating resources.

In Arkansas, health leaders say they are getting what they need as they increase response to the deadly virus that has directly affected 22 people in the state and led to widespread community measures, such as remote work, school closures, commerce restrictions, and cancellations of many public and private events. As of March 17, there have been no Arkansas deaths related to COVID-19.

Dr. Katie Seely, assistant laboratory director at the Arkansas Public Health Laboratory, said technicians are processing test kits constantly through 12-14 hour shifts.

“Right now, we’re scaling up our lab capacity and our lab testing. When we come in, in the morning, we’ve got some microbiologists coming in at seven o’clock in the morning and they start extracting the samples that we received the night before. Then they continue extracting throughout the day,” she said.

The process at her lab is two-fold and takes about five hours to complete one test, although multiple tests can run at one time. After extracting samples, the microbiologists run what’s called a PCR – Polymerase Chain Reaction. That process amplifies the DNA from the sample and can read whether it matches COVID-19 cells. This process repeats all day long. Seely said the process could be further sped up by instrumentation that can automate part of the process.

“Some companies make what we call ‘high throughput instrumentation,’ where it’s automated. We would be able to run a lot more samples that way,” Seely said.

The test kits are pretty simple. They contain small tubes that include the DNA sample taken from a patient’s nose swab. The tubes contain primers, which are little DNA sequences that match the DNA sequence of the COVID-19 virus, which is what the lab professionals are testing.

Seely said the test kits they use are in accordance with the Centers for Disease Control and Prevention (CDC). They can be difficult to come by for some testing labs, but she said Arkansas is not experiencing that problem.

“We are fine here in Arkansas. We haven’t had any issues with getting supplies or anything like that. We are up and running, but some states depending upon what method they’re using, some of the companies are running low on reagents and supplies and haven’t been able to supply some of the other states,” she said.

When Arkansas was in its earliest stages of testing more than a week ago, citizens were told that our tests were “presumptive positive.” That means they needed CDC verification to acknowledge the state’s testing methodology was accurate. With CDC approval of its process, Arkansas no longer has to pass its results on. The Arkansas Public Health Laboratory and UAMS tests will be able to arrive at positive or negative conclusions.

To meet the 440 tests per day projection, state Health Department officials said Sunday they will ramp up to 200 tests per day this week, while UAMS leaders said their capacity will evolve to 240 per day by week’s end. But since that Sunday announcement, UAMS has been working on other solutions that will expand capabilities.

UAMS officials tell Talk Business & Politics they expect to receive a machine Thursday (March 19) that will allow them to process 140 tests per day. They will require test kits and there is an expectation that they will keep enough in supply from a key manufacturer.

UAMS has also developed a test for COVID-19 in its research laboratories they contend will allow them to process an additional 250 tests per day.

“We do not need the test kits for that,” UAMS Vice Chancellor for Communications and Marketing Leslie Taylor tells Talk Business & Politics.

“Turnaround time for both tests is 6-8 hours as compared with the current 48-72 hours. We hope to have both the machine and the tests we developed available by early next week,” Taylor said.

Seely said she thinks her lab will meet expectations for handling 200 tests per day.

“I believe so. We have not had 200 samples yet per day, so we haven’t tested the system yet. I feel like the system we have going on right now is pretty good,” she said, adding again that the high throughput instrumentation would help.

Whatever the threshold is for daily testing, Seely said she expects there will be lab capacity to meet demand.

“I sure hope so. We are talking about contingency plans right now in the laboratory and looking at other instrumentation where we could run a lot more than that, but we do not have that instrumentation on site. These are talks that we have just started today,” she said.