MADISON, Wis. (SPECTRUM NEWS) — In his time as director of the Wisconsin Veterinary Diagnostic Laboratory, Keith Poulsen says he’d never seen the lab perform a test on a human sample — until the pandemic landed on their doorstep.
The lab, which sits on UW-Madison’s campus, mainly serves the agriculture industry, checking animal samples for disease. But as the COVID-19 pandemic swept across the world and loomed large over back-to-school plans, Poulsen and his team took up the call from campus leaders, adding humans to the herds and flocks they work to keep healthy.
“We’re happy that we’re at the table, that we’re able to assist,” Poulsen says. “We know that there’s extra work involved, and we all have our limited resources and time. But we’re happy to be involved.”
Now, the lab is processing around 1,200 to 1,400 samples each day from students, faculty, and staff as they track down bits of the coronavirus’s genetic material to help contain its spread.
The WVDL makes up a big piece of the pandemic strategy at UW-Madison, which, like colleges and universities across the country, has had to adapt to an unusual — and unusually precarious — fall semester. Poulsen and his team are part of a major cross-disciplinary effort on campus to bring up testing numbers and catch the virus in its tracks.
“The biggest consideration for us is being able to test as many people as we can on campus,” says Kelly Tyrrell, director of research communications for the school.
Shortly after students returned to campus, UW-Madison saw major spikes in case numbers. In mid-September, the seven-day positivity rate average rose past 10% as thousands of students quarantined in dorms and Greek houses.
Since then, the positivity rate has steadily declined to below 1%, even as the school has resumed more in-person activities. In total, 3,174 students and employees have tested positive.
Part of the school’s adapting response has involved scaling up testing. Previously, the school had been outsourcing all of its PCR tests to Exact Sciences in Madison.
Tyrrell says the school’s initial target was 6,000 tests per week; now, if necessary, the WVDL can process up to 2,000 tests each day. As of Tuesday, the campus had processed more than 8,500 tests in the past week, according to its Smart Restart dashboard.
At a September media briefing, Chancellor Rebecca Blank said getting the WVDL up and running played a big role in decreasing turnaround times for results, which allowed the school to be “much more aggressive” in testing and isolating any infections.
“The faster we can turn that around, the more effective our testing regime is,” Blank said.
The school is conducting weekly surveillance testing on all students and staff in residence halls, Tyrrell says. Other tests — some of which are still being sent out to Exact Sciences — come from voluntary surveillance programs for staff and off-campus students, or from those who make appointments after feeling symptoms or possibly being exposed.
Anyone who tests positive is instructed to isolate, and their close contacts, identified by a new team of contact tracers, are sent to quarantine.
Poulsen says the WVDL has been able to get the vast majority of results back within the same day that students get swabbed, with a guarantee of 48 hours maximum wait time. A big chunk of the samples usually come into the lab around 3 p.m., he says, and technicians run the tests until late at night, usually getting results out by 1 a.m.
Getting to this level of testing capacity has been a “monumental task,” he says. They’ve hired about a dozen new staffers to support the added COVID-19 workload and worked with the school to get the right equipment and supplies in place.
Plus, workers had to go through extra training to deal with human samples, like on HIPAA rules and patient privacy — things that aren’t required for animal testing. The lab is certified for its human testing through a partnership with the State Laboratory of Hygiene.
“It’s new and exciting,” Poulsen says of the COVID-19 testing. “And it also creates its challenges and problems.”
While Poulsen says the WVDL is serving as the “gold standard, core testing lab” on campus — and the PCR tests they use remain widely accepted as the diagnostic basis for COVID-19 — other testing models are also being used and researched at the school.
The Big Ten has implemented daily testing for football teams across the conference, including the Badgers, using rapid antigen tests that are quicker to process but may be less accurate. Tyrrell says any positive antigen results are sent for PCR testing for confirmation. (The two tests check for the virus in different ways: While PCR looks for bits of viral RNA, antigen tests seek out a protein on the virus’s surface.)
Researchers are also collecting wastewater at two sites on campus to check for the virus’s genetic material near residence halls. And another group of scientists, led by married professors Dave and Shelby O’Connor, have been looking into saliva-based LAMP testing as an option for wider surveillance testing.
The LAMP process uses a different set of chemicals to check for viral genetic material, and doesn’t require as much equipment or training as traditional PCR tests, Dave O’Connor says. Plus, it uses a different supply chain, which is useful in an “economy of scarcity” as labs scramble to get enough testing materials.
“You take saliva or a nasal swab, and you heat it up, and then you put it into a reaction and then it changes colors,” he says. “As molecular biology goes, it doesn't get much easier than that. It's about the simplest assay you can do.”
Like the antigen tests, these LAMP tests may be slightly less sensitive than PCR, and don’t have the same level of FDA approval. But Shelby O’Connor says these could prove useful for high-frequency screening to catch cases early on, and can be easily decentralized into pop-up test sites.
Still, for the moment, Tyrrell says the campus is continuing to rely mainly on its PCR tests for its isolation and quarantine decisions — while keeping their eye on the ever-expanding testing landscape.
“I think that all options remain on the table for us, depending on how needs shift,” she says. “That’s been a common theme in this pandemic: So much changes on a daily basis. Part of being responsive is being nimble and keeping options open.”
These days, Tyrrell says the school’s testing capacity is meeting demand with some room to spare, though they're remaining vigilant especially as case numbers keep climbing in Wisconsin and the regular flu season is fast approaching.
At the lab, Poulsen says they’re settling into their new role as pandemic responders while continuing to provide “mission critical” testing within their normal sphere of cows, chickens, and other animals. He says some of the main challenges now include dealing with strained supply chains and preventing burnout for employees working long hours in these stressful times — even just by giving little gifts or reminding everyone that their work matters to the campus’s pandemic response, a “machine with many cogs and moving parts.”
While testing humans for a world-altering disease isn’t part of the lab’s normal work, Poulsen says in the end, there’s a lot of connection between his field and other disciplines on campus. Those collaborations, he says, have been a valuable part of the school’s COVID-19 response.
“Human, animal, and environmental issues don't happen in a vacuum,” Poulsen says. “They're all very intimately related.”
And Dave O’Connor, whose usual work also focuses on animals — primates, to be specific — says he and his team felt a real responsibility to use their skills in some way and address the crisis of the moment.
“We are not a diagnostics lab. This isn't what we do,” he says. “But when the house is on fire, you don't look around to figure out who's going to grab a fire hose.”