Behind-the-scenes look at MUSC Health's COVID-19 testing

April 09, 2020
A sticky note lets people in the molecular pathology lab know that this diagnostic instrument is ready to test for COVID-19. Photos by Sarah Pack.

A behind-the-scenes tour of COVID-19 testing at MUSC Health at the Medical University of South Carolina revealed a tightly regulated process that churns out about 850 test results a day and has the capacity to ramp up for a surge of cases.

Medical technologist Nancy Leonard 
Clinical lab scientist Nancy Leonard prepares samples to be tested for COVID-19. She wears a face shield and gloves for protection because she is handling material that may contain the virus and will transfer patient samples into smaller tubes for testing.

“The testing process is highly complex,” said Frederick Nolte, Ph.D., vice-chairman for the Department of Pathology and Laboratory Medicine and medical director for both clinical laboratories and the molecular pathology lab. “There are a lot of moving parts. Specialty expertise is required to pull this off successfully.”

Medical lab technician Tanisha Dickerson puts saline solution into trays to prepare diagnostic instruments for testing. 
Clinical lab scientist Tanisha Dickerson puts saline solution into trays to prepare diagnostic instruments for testing. She does not need a face shield for protection during this part of the process since she is not handling any viral material.

That expertise was on display on a tour that began in an area marked “Laboratory Central Receiving.” It’s where thousands of nasal samples collected for testing arrive via courier, FedEx, and in the case of patients who are hospitalized at MUSC Health, an internal tube delivery system.

April Kegl, left, and Betsy McLaughlin load COVID-19 samples for testing. 
Clinical lab scientists April Kegl and Betsy McLaughlin load COVID-19 samples into a machine for testing. While Kegl is wearing a face shield, it is not necessary during this part of the process since the virus is safely sealed in tubes.

At least a dozen people, from medical technologists to pathologists, took it from there. In-house testing at MUSC Health is now running seven days a week to keep up with the demand for COVID-19 results. 

The testing requests come not only from MUSC Health but also multiple hospitals, medical centers and patients across the state.

Clinical lab assistant Sara Shealy was working in the entry area, getting the samples logged in. Clinical lab scientists Nancy Leonard and Pauline Nelson then prepared the samples for analysis and routed them to the lab for nucleic acid extraction to determine whether they were infected with the coronavirus that causes the illness COVID-19. 

Dr. Julie Hirschhorn, associate director of molecular pathology laboratory. 
Dr. Julie Hirschhorn, associate director of the molecular pathology laboratory, sanitizes part of one of the diagnostic instruments that runs COVID-19 tests. The white gown, face shield and gloves are part of her uniform during much of her work in the coronavirus pandemic.

“We have a great team, everybody’s risen to the occasion,” Nolte said.

He emphasized the importance of making sure the MUSC Health lab has multiple options for testing. That way, if one goes down, they have alternatives. “Right now, we’re in a pretty good position in terms of handling the volume of testing in the clinical labs,” Nolte said.

Medical lab technician Glenda Rebl prepares samples for testing. 
Clinical lab scientist Glenda Rebl loads specimens for COVID-19 testing.

“We’ve gotten tremendous support from the hospital administration. Basically, from the top down, they’ve said, ‘Just tell us what you need, and we’ll get it to you,’ and that’s happened.”

The lab leadership team is talking with MUSC researchers about using some of their equipment for testing if needed. “We’ve identified the laboratory space, the instrumentation, the assay (test) that we’re going to use. That would be another pivot point for us, should we have to activate that part of the contingency.”

About the Author

Helen Adams

Keywords: COVID-19