CHARLESTON, S.C. (WCBD)- Take a peek inside the Medical University of South Carolina’s COVID-19 testing lab where lab leader, Julie Hirschhorn Ph.D., and her team are working around the clock to deliver results.
“It’s all about trying to get the results out as quickly as possible,” Hirschhorn said. “We’re here 24/7.”
She and her team offer a behind-the-scenes look at the testing process:
Heather Hill, supervisor for MUSC’s COVID pre-analytical process, checks swabs that have come in for testing to make sure their labels match the names on the list that came with them. (Sarah Pack) 
Hill prepares to pour samples taken from people worried they have COVID into tubes for testing. She chooses the type of tube based on which of MUSC’s testing machines is in use. (Sarah Pack) 
The testing team has streamlined its process during the pandemic. It’s now able to get results to patients through electronic health records as soon as a machine finishes testing them. (Sarah Pack) 
The lab team, including assistant Ajah White, switches roles frequently to ensure everyone can handle everything. (Sarah Pack) 
Lab associate Katlin Thompson, left, and technician Glenda Rebl prepare samples for testing in the Abbott Alinity machine, one of several options at MUSC that can handle COVID tests. (Sarah Pack) 
Liquid from a nasal swab is poured into a tube for testing. (Sarah Pack) 
A sample is processed through the GeneXpert Infinity machine to do a rapid test for COVID. (Sarah Pack) 
Betsy McLaughlin carries samples from a refrigerator, where they’ve been kept cool while waiting for testing, to a colleague. (Sarah Pack) 
A label on a test sample is scanned to get the patient’s name and information into the system before testing. (Sarah Pack)
The first stop for a swab that is ready to be tested for COVID-19 when it arrives at MUSC is to go through a pre-analytical process.
“What we’re doing here is called manifesting,” Supervisor Heather Hill said, as she checked labels on bags containing swabs. “We’re bringing in the samples. All the samples that come in from other locations, they put information on the manifest list that we then check to make sure that what comes in is actually what’s in the bag.”
Then, urgent cases go to the rapid testing area where results can come back in less than an hour. The rest are tested through a slower machine that can is capable of processing between 1,600 and 1,800 results in a day.
Hirschhorn said that right now the lab can get results to the people waiting for them in less than ten hours.
“If specimen travel is needed by a courier to get the samples from the collection site to the main laboratory, it can add upward of eight hours to the resulting time, due to the time spent in transit,” she explained. “When the laboratory has a lot of specimens to handle, that can also increase the turnaround to 24 to 48 hours because it takes more people and time to process all of those specimens.”
Once the samples have been checked by Hill and her team, they are transferred to tubes and put through one of three different machines that the lab has access to for testing: Panther System, the Abbott m2000, and the Abbott Alinity. Hirschhorn said they have been using all of those machines amid the recent surge, but can pivot to another if one type of machine has a problem.
“We can shift pretty quickly,” she said. “Once a specimen is received in the lab and prepared for testing, we try to run it as soon as possible.”
Once a sample is in one of Hirschhorn’s team’s machines, it goes through several steps.
“In the first step, it’s going to break up the SARS-CoV-2 virions where the virus is located. Then it’s going to isolate that virus. Once the virus is isolated, it’s going to go through a process called nucleic acid amplification. And basically, what that means is that it’s going to look for COVID-19 in particular. If COVID is there, it’s going to amplify it. And if it amplifies it, it’s going to detect it as positive. If COVID is not there, it has nothing to amplify, so it’s negative or not detected,” Hirschhorn said.
The machines are interfaced with MUSC’s electronic health records, so once the result is in, it automatically pops up in the patient’s health record.
With concerns mounting about the speed of results, Hirschhorn offers up one simple step that could help patients get their results faster:
“The most important thing that really plays into turnaround time issues is registration,” she said. “When people register for a COVID test, when you put your name on a label, the most important thing you can do is to use your full legal name.”
