Mar 14, 2020 4 min read

Implementation of a test for diagnosing suspected cases of COVID-19 is scheduled to begin Tuesday on a limited basis.

The University of Pittsburgh Medical Center, which developed the test for the novel coronavirus SARS-CoV-2, the virus that causes COVID-19, has established a collection site at UPMC Mercy South Side Outpatient Center, 2000 Mary St.

“We will be using this test initially for select symptomatic cases as we work to rapidly increase capacity at our central lab,” Dr. Alan Wells, medical director for UPMC Clinical Laboratories, said Saturday during a live-streamed coronavirus update. “We will be able to diagnose patients within 24 hours, rather than days or even weeks that we currently face with outside labs and strained capacity.”

Patients must have a physician referral approved by UPMC’s infection prevention team and an appointment to have specimens collected for testing.

“If you show up without an appointment to our South Side location, we won’t be able to obtain your sample, and you may actually hinder the ability for people who want the test under a physician’s order,” Dr. Donald Yealy, chairman of emergency medicine at UPMC, explained.

According to information provided by the health system, trained UPMC providers will collect specimens, doing so safely while wearing personal protective equipment. Collection will occur in negative-pressure conditions, assuring that air does not leave the room until it flows through a high-efficiency particulate air filter that removes pathogens.

“We expect to initially to test over 20 patients a day, quickly ramping up to over a hundred by the end of the week, and continue rapidly increasing that capacity, filling a critical need not filled by state and commercial labs,” Wells said.

Also speaking at the update was Dr. John Williams, chief of the Division of Pediatric Infectious Diseases at UPMC Children’s Hospital of Pittsburgh, who said researchers there have developed a test “to screen samples from pools of de-identified specimens from UPMC patients with cold symptoms.”

“This allows us to kind of take a pulse on when the virus might be present in the region,” he explained, reporting that more than 300 samples of children and adults have been tested.

None so far has registered positive for SARS-CoV-2.

“This does not mean that we should let down our guard and does not mean the virus is not here. The world is small. People travel all the time,” Williams said. “I think what this data tell us is, it strongly suggests that the virus is not widely circulating yet in our region. But COVID-19 remains a critical public health threat.”

Yealy discussed what occurs in the case of positive SARS-CoV-2 tests.

“Our experts will obviously be notified, and we will notify the patient who is positive. Also notify the appropriate governmental health officials, who will have the ultimate responsibility to maintain surveillance,” he said, plus the patient’s personal physician or one who is will be provided.

“The next step is to decide what’s the most appropriate care path, and that really depends on what symptoms they’re having and their independent-living situation,” Yealy continued. “Our job is, together with all of those people, to put together the best individual plan. Sometimes that will mean care at home, with very specific instructions. Other times, that will mean care at a hospital facility.”

Testing takes place with a swab that Williams described as looking “like a long, thin Q-Tip.”

“It has a little sort of brush on it that you put through the nose, kind of into the back of the throat,” he said. “It collects both the mucus secretions and some cells from the airway, and that’s where the virus is.”

Regarding the possibility of drive-through testing, as implemented elsewhere, Yealy said:

“We’re actively exploring that option right now, because it is a very good idea, particularly for people who are not terribly symptomatic. Our priority was to get a collection process up safe as possible and do the safety side of this right the first time. The building in the South Side had negative-pressure capabilities already, and we were able to design a very efficient process.”

Yealy also spoke about considerations with regard to age and demographics.

“Older people don’t get the infection more frequently, but they may have complications from the infection more frequently. So that’s a reasonable concern, no matter where you live,” he said.

“Rural settings may have less transmission person-to-person because of the natural social isolation, or they might have more intense pockets of it because of collections of people who, otherwise widely disparate, come to one area.

“The truth is, we have no way to know whether a rural setting is better or worse.”