Published originally in The Oklahoman on Sun, March 29, 2020 5:00 AM
The following sentence will not come as news to anyone: Oklahoma has a coronavirus testing problem.
In this, our state is far from alone. From the outset of this pandemic, the U.S. has struggled to build the testing infrastructure necessary to track and control the virus known technically as SARS-Cov-2.
A stumbling start
The country got out of the gate slow, hamstrung by problems with the tests developed by the Centers for Disease Control. Meanwhile, the Food and Drug Administration refused to cut the extensive red tape that surrounds the approval of laboratory-developed tests.
That effectively kept other players like state health departments and private laboratories on the sidelines. So the CDC remained the only game in town.
By late February, reports from ERs, doctor’s offices and a nursing home outside of Seattle made it clear the virus had been spreading silently in communities around the country. Finally, the FDA relented, allowing clinical labs to begin using their own Sars-COV-2 tests.
Rome, though, wasn’t built in a day.
The crisis mounts
State health laboratories scrambled to scale up their operations. Private labs began rolling out new tests, but demand overwhelmed supply. As a result, the situation on the ground remained the same: Virtually no tests to be found.
In Oklahoma, the CDC initially provided the state with only 250 test kits, and the Utah Jazz and their entourage chewed up 58 of those when Rudy Gobert tested positive. The CDC subsequently sent another 500 tests, but 692 tests don’t even begin to scratch the surface for a state that counts nearly 4 million people.
A week ago, Gov. Kevin Stitt announced the state’s testing cupboards were almost bare, with enough materials remaining only to test 100 people. Only those in high-risk groups could get tested, including healthcare workers, those exhibiting severe symptoms, and people with known exposures. Everyone else would have to wait and hope.
Facing a surge in Oklahomans reporting symptoms and no way to test them all, the Governor issued an emergency order allowing labs at the University of Oklahoma Health Sciences Center and Oklahoma State University to begin testing.
And that’s when scientists at the Oklahoma Medical Research Foundation saw an opportunity to help.
Led by Dr. Joel Guthridge, a team of OMRF scientists have joined with OUHSC researchers to give a big boost to the state’s testing capacity.
The first step required a little muscle, as OMRF’s biomedical shop moved two of our DNA processors across the street to a lab at OU Medicine. One was a polymerase chain reaction machine, donated to the effort by OMRF’s Dr. Chris Sansam. That DNA processor will help the new emergency testing lab get up and running.
But the real game-changer is a high-speed PCR system, which can run circles around standard DNA processors.
Dr. Guthridge and Dr. Judith James built this system with internal funds from OMRF, plus grants from the Presbyterian Health Foundation and the Oklahoma Center for Adult Stem Cell Research, a program of the Oklahoma Tobacco Settlement Endowment Trust. The machinery carried a total price tag of about $400,000, and for years has helped our researchers analyze biological samples donated by research volunteers suffering from lupus and other autoimmune disease.
One thing that makes it special is that it can run up to 384 samples at a time. It also uses significantly fewer chemical reagents, which are incredibly difficult to come by at this time. So, scientists can run roughly 10 times as many tests with the reagents it would take to run one test on a standard PCR machine.
Ending the bottleneck
On Thursday, in a separate announcement, the state reported it had obtained kits and supplies sufficient to allow it to run 10,000 additional tests. That’s good news. But it only goes so far.
With a virus predicted by some experts ultimately to infect more than half the population, thousands of tests won’t do the trick.
Due to a lack of current processing capacity in Oklahoma, patients are now reporting waits of 5 to 8 days to receive test results. Unless we add significant new firepower, these waits only stand to worsen as we put more tests into the pipeline.
Happily, once we get it going, OMRF’s system can help end this bottleneck, decreasing wait times and vastly increasing the number of people we can test.
This is not an “off the shelf” set-up, so an OMRF research team has temporarily relocated to OU Medicine to do extensive validation testing and training of OUHSC staff to operate it. But when that process is complete — which scientists hope will happen in the space of a week or two — they should be able to process thousands of tests a day.
PHF and OCASCR probably never imagined their grant dollars being put to this use. Still, I’m confident they’ll be proud their investment in basic research paid this unexpected health dividend at a time of profound medical need.
When more testing becomes available, Oklahoma’s coronavirus numbers will almost certainly surge dramatically. But the sooner this team effort helps us get our arms around the true magnitude of this health crisis, the better we’ll be able to fight it.
A physician and medical researcher, Prescott is president of the Oklahoma Medical Research Foundation and can be reached at firstname.lastname@example.org.
Posted on March 30, 2020 at 5:29 pm