After a University-wide initiative to gather the needed funds, technology and reagents, University Health System researchers have independently developed a COVID-19 test that is now being used throughout the University Health System and at hospitals across the Commonwealth. When Amy Mathers, associate professor of medicine and researcher in infectious disease and international health, first started responding to the COVID-19 pandemic, her goal was to use tests with the most rapid turnaround times possible so researchers could understand more about how to contain the virus. At the time, the University Health System had been relying solely on tests from public health departments — many of which had only enough tests for the sickest or highest risk patients — and private companies like LabCorp, which could have turnaround times of up to nine days. Mathers — along with Mendy Poulter, associate professor of pathology and director of clinical microbiology — quickly began gathering testing supplies and bringing up molecular assays, diagnostic tools used in biological analysis, for the creation of the University’s own COVID-19 test. Researchers from all over the University donated their technology and supplies, while others at the Health System gathered funding for the development of the test. Soon after, Mathers, Poulter and team quickly finished developing the test — which currently has a less than 24-hour turnaround, though the group hopes to reach a two-hour turnaround for in-house patients and 12-hour turnaround for tests from outside hospitals. Patrick Jackson, University physician in infectious disease and international health, explained how the test works. “The test that we have at U.Va. is a RT-PCR test,” Jackson said. “You take a swab from someone’s nose or mouth, get RNA, probe the RNA with short primers that are complementary to [the virus’s] genome, and if they pair up, you get an increasing signal with PCR, [which is] when you know someone could have the virus.” Jackson recognized what this faster turnaround time means. “U.Va. is one of the foremost places in the country to turn over these tests so rapidly to investigate potential cases,” Jackson said. Testing in the University Health System began last week at a volume of 100 tests per day with the expectation to reach 500 tests per day after the receipt of a one million dollar grant from the Quantitative Foundation, a Charlottesville-based organization that provides funding for research projects. The additional tests will continue to be used for inpatients throughout Virginia hospitals, as well as for patients in surrounding states and clinical providers and first responders who have symptoms. As of Tuesday evening, the Health System is now offering 50 of these tests per day to five additional hospitals across Virginia and one in North Carolina for inpatients that meet clinical guidelines for testing. These hospitals have received information about how to request testing for their patients through a Virginia Hospital and Healthcare Association memo. “Our hope is that providing these tests will assist hospitals across the Commonwealth in caring for their patients and responding to this pandemic,” said K. Craig Kent, executive vice president for health affairs at the University, in a University Health System press release. “We also hope this will help to save protective personal equipment and other critical resources for Virginia’s public health needs.” Jackson confirmed the importance of testing and emphasizes its importance in reducing the virus’s spread. As of March 26, Virginia has 460 reported COVID-19 cases, with 23 of those in the Thomas Jefferson Health District, which includes the City of Charlottesville and Albemarle, Fluvanna, Greene, Louisa and Nelson counties. The University Health System is currently treating four COVID-19 patients who are in isolation and following Virginia Department of Health Guidelines. “If you are in the mode of having an outbreak of any sort of pathogen, figuring out which people have it, isolating them and reducing the spread is very important,” Jackson said. Testing is also key for identifying and treating those most vulnerable to COVID-19, according to Jackson. As described by the Centers for Disease Control and Prevention, these are people with serious underlying conditions like heart and lung disease, those older than 65 and pregnant women. The outpouring of University support through technology, supplies and funding was essential for the test’s rapid development as the tools Mathers and Poulter needed to develop the test were not readily available, most notably reagents and testing swabs. Reagents are chemical mixtures used to determine if a testing sample matches COVID-19’s genome sequence, and so far, they have been supplied to labs by private companies. However, these companies have been reportedly canceling orders to research institutions and the Centers for Disease Control and Prevention. “The reagent supply itself looks a lot like the toilet paper shelf at Walmart,” Mathers said. “You can’t get the machines and supplies, and there's a shortage on the swabs.” According to Mathers, COVID-19 test swabs are not the traditional cotton swabs one might see in a doctor’s office, but instead require a special material called Rayon that does not degrade the virus’s RNA like cotton does. These types of swab are difficult to find and difficult to create, according to Mathers. Because testing supplies and medical resources are generally low across the United States, it is key to maintain the supply chain and ensure limited resources are not used on those who are not very sick or at high risk, according to Mathers. “We [in the United States] don't have enough testing kits to test the sickest people,” Mathers said. “We don't have enough supply chain, and it feels like resources have been funneled into drive-through lines for healthy people, which may be more politically palatable.” For those with COVID-19 symptoms like fever, cough and shortness of breath, contact your primary care physician to determine if testing is needed. For specific information on testing through the University Health System, see their website’s COVID-19 page.