Indiana Regional Medical Center on Monday will begin on-site, same-day COVID-19 virus testing in a partnership with Indiana University of Pennsylvania.
In a program spearheaded by the university’s Narayanaswamy Bharathan, chairman of the Department of Biology, the hospital could potentially complete as many as 200 coronavirus tests daily.
Bharathan developed the testing procedure at the IUP campus, which has been absent of students since March as part of statewide shutdown orders during the coronavirus outbreak. He moved the needed equipment to IRMC from his laboratory in the John J. and Char Kopchick College of Natural Sciences and Mathematics on Monday and has spent the week conducting trial runs of the testing process.
When the program begins, testing would be done on symptomatic patients already under care for suspected COVID-19 infection, a hospital leader said.
Officials of the university and the hospital unveiled the partnership Friday in much the same way that IUP has conducted classes for the past month — using audio/video/chat technology in an online meeting app.
“We’re all being affected by the coronavirus pandemic. Many of these effects are very unpleasant; people are sick, some people are dying and it’s very challenging for all of us,” IUP President Michael Driscoll said. “Something I’ve observed in the middle of this challenge to our county and to our state and to our country is the ability for people to come together to help each other — perhaps come together virtually on occasion — but certainly … to do the right thing. IUP is certainly part of the Indiana community, a place where people do step up to help each other in very many ways, and bring our expertise to bear.
“We all have heard that testing is a critical step in controlling the disease and helping people as they become ill.”
Driscoll praised Bharathan, “whose expertise is known nationally and internationally,” for designing the testing program.
IRMC President and CEO Stephen Wolfe expressed gratitude to IUP for developing the COVID-19 testing program.
“We’re blessed for all that you do and this is just a special blessing here with Dr. Bharathan,” Wolfe said. “This coronavirus has been an incredible challenge to the world, and certainly our nation and our state and our county here. … Testing is a vital part of what’s going on, and it’s hard to articulate all the different aspects that this testing advancement for us through IUP and Dr. Bharathan will mean.
“I will tell you that right now we have patients laying in isolation for five, seven days, just waiting on a COVID test result. So you can imagine what that means to the patient and the family, especially with no visitation privileges at the hospital currently, to have to wait for that result. To be able to give peace of mind to the family and the patient, and just a quick four-hour or same-day turnaround is going to be huge in that aspect alone.
“As is well-documented around the world, there is a real shortage of protective equipment for patients and healthcare providers — things as basic as masks and gowns and face shields — so when we have someone in isolation under COVID suspicion, we really use a lot of those vital resources … when you’re trying to prepare for what potential surges may come down the road,” Wolfe added. “So getting an answer quicker is able to take somebody who is negative from a COVID test and getting them out of isolation, opening that for another patient, and really trying to preserve that (personal protective equipment).
“We wanted to be able to do a lot more in terms of community testing, to find out what’s going on in the community, identify some cases, try to see what community spread percentages are. So this is really huge in so many different ways.”
Bharathan hailed the work of many on the staff of both IUP and IRMC who teamed up in recent weeks to assure the integrity of the testing procedure and the compliance with industry and regulatory standards.
“I want you all to know that the real time PCR (polymerase chain reaction) is a technique that is so powerful that allows us to detect a single sample in less than 35 to 40 minutes,” Bharathan said. “But if you are going to have at a given time close to about 75 to 90 samples, then it takes approximately 3ﾽ to 4 hours to give you a complete result.
“So testing is going to be the key. It is the bedrock, the heart of the entire process of moving forward. This has got tremendous significance in terms of the perpetration of the virus within a population, within a community. And I want you all to know that as a scientist, I can tell you that we are learning a lot from this virus.”
Bharathan cited a published report that holds that the coronavirus is most infectious in the first 48 to 72 hours when a person shows no symptoms.
“There was nothing known about COVID before. We do not know anything about the SARS behavior. We never knew anything about MERS behavior,” Bharathan said. “So for community transmission, even if an individual is asymptomatic ... that individual becomes a primary source of infection to the entire population of the community. So testing becomes very critical, even in individuals who are asymptomatic.”
“We are very proud at IUP to put forward a teacher-scholar model, and certainly Bharathan is a key example of that. Dr. Bharathan has worked with students and others with the technology and techniques in wonderful ways, and now we’re going to put this together with our partners at IRMC to help keep people safe and well right now,” Driscoll said.
Bharathan will be working in a laboratory at IRMC under the Pennsylvania Department of Health; the IUP equipment can do specialized COVID-19 RT-PCR clinical diagnostic testing. The equipment, which includes a microfuge 22R Beckman Coulter Table-top refrigerated centrifuge and Eppendorf AG DNA thermal cycler, is used by Bharathan in his classes and for his own research work.
Bharathan will work closely with the physicians at IRMC to determine the presumptive positive cases and negative tests that need to be reported to state agencies. He also will train IRMC personnel to maintain the RNase-free environment in the laboratory, to do RNA purification, how to use the Eppendorf Thermal Cycler and will work with these staff members to efficiently process patient sample following protocols approved by the Centers for Disease Control and other public health agencies.
IRMC will provide personal protective equipment for his work and will purchase supplies needed for the ongoing testing.
Bharathan’s expertise includes work with RNA viruses and protocols for testing and identifying these viruses, which includes COVID-19.
His work with IRMC will be practical research as well, he said.
“Testing allows us to develop data, data in terms of epidemiology, as to how the virus is transmitted from asymptomatic individuals to healthy individuals and how the transmission takes place among infected individuals,” he said. “So the real time PCR is a valuable tool to give you a very specific … and a type of result that has very less false positives and false negatives.”
Jackie Sansig, director of Laboratory and Respiratory Services at IRMC, said the partnership would close a gap in service for the hospital.
“One of the things we have been struggling with to help the community of Indiana is making sure we have enough testing,” Sansig said. “Sometimes we were having a turnaround time of greater than a week. As Steve Wolfe said, that’s not great for our community and our patients, who need an answer and they need an answer now, and they need treatment.
“Working with Dr. Bharathan, we can be able to get answers to whether a patient has the COVID virus in less than five hours. This will greatly impact the patients and the providers in the community of Indiana.
IUP’s School of Graduate Studies and Research facilitated the collaboration, which was initiated by Driscoll. Dr. Hilliary Creely, associate dean for research in the IUP School of Graduate Studies and Research, was the lead on developing the logistics and legalities of the agreement.
“We are very enthusiastic and excited to be collaborating with Indiana Regional Medical Center in this way,” Creely said. “Not only is this work critical to the health and safety of our community, it opens the door for future research collaborations. IUP is very fortunate to have a researcher like Dr. Bharathan, who maintains a very robust research agenda while being a great educator. His work as a professor is an important part of this project, as he will be training professionals at IRMC on the testing processes.”
Dr. Randy Martin, dean of IUP’s School of Graduate Studies and Research, noted that the collaboration is a perfect fit for the School of Graduate Studies and Research.
“Our mission is twofold: service and support to our community, and to further our research and knowledge base,” Martin said. “Providing local COVID-19 testing to our community through the expertise of our faculty certainly meets these goals.”