Hospitals and clinics in cities across the U.S. have recently established drive-through testing for COVID-19. It’s the strategy that enabled countries like South Korea and Japan to test as many as one out of every 142 people for SARS-CoV-2, the virus that causes the infectious disease, thus helping to track and slow the virus’ spread.
But a tiny clinic in central Pennsylvania, tucked in amongst neat farmsteads covering the anthracite hills, is setting up drive-through testing that’s meant to accommodate a horse and buggy as well as cars. The Central Pennsylvania Clinic caters to the local Amish and Mennonite communities, and its founder, D. Holmes Morton, wants to ensure that rapid COVID-19 testing isn’t limited to those with motorized vehicles.
“We already have a relationship with this community, and testing is an opportunity to raise awareness about the need for isolation of vulnerable individuals,” Morton told Motherboard.
Together with Regina Lamendella, a professor of biology at nearby Juniata College and co-founder of Contamination Source Identification (CSI), an infectious disease diagnostics startup, Morton has created one of the rural area’s only Covid-19 testing facilities. The test, which is based on similar methods already approved by the FDA, detects the virus’s genetic material in an infected person’s nose and throat. The pair hope to have the test up and running by the first week of April. They say they’re equipped to perform 300 tests per day, and Lamendella intends to return test results within 24 hours—five times faster than the current timeframe from many large commercial labs.
“It doesn’t do clinicians any good knowing seven days after that their patient is Covid positive or negative. It helps to know as quickly as possible so you can quarantine the right individuals,” Lamendella said.
Morton’s clinic is a mélange of tradition and cutting-edge technology. Many of the parking spots have hitching posts and the clinic was built in a traditional barn-raising by the local Plain community (as the Amish and Mennonites refer to themselves). Semi-annual auctions of handmade quilts allow Morton to treat their Plain patients free of charge. In the clinic’s lab, however, are cutting-edge DNA sequencers that would be at home in any university lab or biotech startup. That Morton and his colleagues are analyzing the genes of people who wear bonnets and drive a plow rather than a tractor is beside the point.
At first, the arrival of COVID-19 in late December 2019 was just another respiratory ailment for Morton to caution his patients about. Many of his patients are medically fragile under the best of circumstances, Morton says. Even an otherwise uncomplicated flu season can be deadly. Add in other respiratory infections, such as Hemophilus influenza b, Pneumococcus, and respiratory syncytial virus (RSV), not to mention the novel coronavirus, and what might be a minor cold to a healthy person could easily kill many of Morton’s patients.
Morton wanted to test the staff at the Central Pennsylvania Clinic for COVID-19, but they weren’t eligible under CDC testing guidelines. Healthcare providers don’t qualify unless they are symptomatic and have been exposed to someone who tested positive. With the high number of asymptomatic COVID-19 cases, Morton knew it was all too possible that clinic workers could show up and spread the virus without even knowing it.
He also knew it was imperative that his patients be tested so that they could isolate themselves from the community to avoid spreading the disease even further. Like many Americans, those in the Plain community have been loath to postpone weddings and other large gatherings that can draw families from as far away as Ohio and Indiana. “That’s a nightmare scenario in terms of epidemiology,” Morton said.
Morton had met Lamendella when he rented lab space next to hers at a Juniata College biotech incubator. Lamendella was starting CSI to develop better diagnostics for infections like Lyme disease, and Morton needed a place to run his genetic analysis while waiting for the clinic to be built. Their pairing on COVID-19 tests seemed perfect, as Morton could provide the necessary medical oversight while Lamendella could develop and run the actual testing operation.
“She’s the real genius behind this,” Morton said of Lamendella. “She’s a real dynamo.”
This kind of forward thinking is key to stopping virus transmission, said Rick Nolte, the chair of infectious disease at the Association of Molecular Pathologists and the Clinical Director of laboratory medicine at the Medical University of South Carolina. Without testing, scientists have no way of knowing how far and wide the virus is spreading. A series of errors and equipment shortages that began with the assumption that the coronavirus was going to remain a problem only for China, continued with manufacturing errors with the initial test kits designed by the U.S. Centers for Disease Control and Prevention, means ongoing backorders of vital testing supplies, Nolte says.
“It was the perfect storm to complicate the whole diagnostic issue,” he said. And small, innovative testing facilities are helping to get tests where they need to go.
After three weeks of non-stop work to train staff and ensure they could run the tests properly, Lamendella and Morton submitted the necessary paperwork to the FDA over the weekend and are hoping that they can start ushering horses and buggies into their drive-through testing later this week.