Portable pods bring testing to the people

November 24, 2020
a woman sits inside the blue shell of a portable toilet, wearing a mask over her nose and mouth, reaching her arms through built-in gloves to hold a specimen collection bag
Nurse Yasmine Graham secures a COVID-19 testing specimen during a test run of the prototype pod. Graham said it took some getting used to the gloves, which are thicker than the gloves she usually wears, but the system works well. Photos by Sarah Pack

There are times when you really need a portable toilet. Like at a music festival, for example. 

Other times, what you need is the shell of a portable toilet.

Like when you need to figure out a cost-effective, safe way to test for a highly infectious disease in a manner that brings the testing to where the people are. In other words: When you need to make COVID-19 tests accessible to communities across South Carolina.

Thus was born the mobile specimen collection pod, affectionately known by its creators and users as the “Port-a-Swabby.”

two women wipe down surfaces after a patient visit 
a woman sits behind plexiglass and reaches through specially constructed gloves to hold a biohazard specimen collection bag into which a patient is dropping a sample swab 
Top: Nurse Yasmine Graham and certified medical assistant Iletta Norris clean between patients. Bottom: Nurse Yasmine Graham conducts COVID-19 testing in a test of the prototype pod. The pod protects her from the elements as well as potentially infectious patients.

The testing pods got their start when MUSC Health’s Erik Modrzynski, Ambulatory environmental health and safety and emergency manager, teamed up with David Pastre, senior lecturer at the Clemson University School of Architecture, to document everything involved in setting up a drive-through testing site. They thought it could be helpful for other hospital systems to understand the thought process behind every stop sign and tent at the testing site that Modrzynski developed in the Epic Center parking lot in West Ashley.

But they also realized that a drive-through site doesn’t help people who don’t have cars. Further, people in low-income communities are more vulnerable to COVID-19, due to longstanding disparities in health and because they’re more likely to work at jobs that don’t allow for working from home or social distancing.

So Modrzynski and Pastre began experimenting with the plastic shells that usually house toilets. They sought to create a walk-up testing shelter that includes a barrier between the health care worker performing the test and the potentially infected people seeking tests.

Now, after several months of design and testing, MUSC Health is preparing to deploy 30 of these pods at its clinical locations throughout the state.

“I’m super proud of the team, super proud of MUSC Health and the Clemson collaboration that brought this to fruition,” said MUSC Health chief operating officer Tom Crawford, Ph.D.

The most important feature of the pods had to be that it was safe for health care workers. The design team accomplished this by creating positive pressure within the pod. Because the air pressure within the pod is higher than the air pressure outside, germs floating about in the air outside won’t be sucked into the pod.

To allow for interaction with patients, the team replaced one wall of the pod with clear plastic. Built-in gloves allow the health care worker to reach outside the pod, swab the patient’s nose and deposit the sample into a drop box.

The pods are also more comfortable for workers. The teams working at the drive-through site and pop-up testing sites have to wear full-body personal protective equipment. Even with cooling vests, PPE quickly becomes unbearably hot in a South Carolina summer. Modrzynski said they recorded temperatures radiating off the blacktop of 151 degrees this summer. At times, they’ve had to rotate teams every 20 to 30 minutes to give them breaks from the PPE.

“They’ve been absolute soldiers out there. They just get it done because it needs to be done,” he said of the nurses and technicians who have worked in the heat and rain.

a portable testing unit sits in the street on the College of Charleston campus 
Nurse Yasmin Graham waits for the next patient within the prototype pod at a testing event at the College of Charleston in September.

There are other benefits to the pods. They’re light enough that two people can lift one unit, so they can easily be moved from one location to another.

Crawford said this will give the testing team flexibility to redeploy if they realize that a particular testing location isn’t attracting as many people as expected. The design team has so far used the prototype pod at scheduled mobile testing days at The Citadel and the College of Charleston and, in conjunction with the S.C. Department of Health and Environmental Control, at an unannounced testing day at a Sam’s Club outside Columbia.

“Instead of thinking people are going to drive to a centralized location, we decided to take the testing to where the patients are, and I think it was received very warmly,” he said.

Modrzynski envisions use for these pods even beyond the COVID-19 pandemic. Situated at doctors’ offices and clinics, they could be used for flu tests and other tests for airborne diseases, he said.

Crawford said the pods are another example of how MUSC has responded to the pandemic with ingenuity.

“I am thrilled we continue to innovate in the midst of the pandemic. A lot of people are reacting, and yet, we’re trying to find a way to be innovative, and I think that really underscores the spirit of MUSC and MUSC Health,” he said.

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