Behind the Tests at Temple; How the Enormous COVID Testing Program Works

Now, at this point in the semester, students know what a Covid test looks like: You show up, take your test, wait a few days and get your results. But at the Medical Research Building on Temples Health Sciences campus, there’s quite a lot going on behind the scenes.

The Process

After getting collected from the various sites, your test will join thousands of others on its way to the lab. Two shipments of tests arrive during the day, once in the morning and another in the afternoon. These tests head into the lab in massive batches. Then they are decontaminated and fed into a scanner to match the barcodes. These barcodes don’t provide any information about patients. Instead, they get the results back to you once they’re finished.

After being decontaminated on-site, another machine automates removing the lids. Strangely, this is one step that Dr. Glenn Gerhard, the Director of the Covid testing lab, explained as a major hassle during the early days of the testing. Beyond technical issues like the machine moving incorrectly, or the tubes being off by even a millimeter, here is where the supply chain comes into play.

Due to limited supply during the earlier days of the pandemic, Temple had to quickly figure out how to get enough tubes for the amount of testing they planned on doing. They had to figure out the best tube size to work with for the machines they had. They had to figure out which new devices they would need moving forward. The lab spent hours on the phone with companies across the globe, trying to find any resources, any options that might work in a pinch. But eventually, they realized there had to be a better way.

Dr. Gerhard put it best, “We had to figure out ways of doing it, sort of faster, better, cheaper.” 

Faster, better, and cheaper. And that’s what the Temple Covid Lab did. They put in the work and found a way to get these lids off without working away on it by hand. Instead of a dedicated worker sitting in the lab, unscrewing tiny, orange caps in batches of eight for ten hours a day, they automated it. Now the lab can check thousands of tests in a single day.

And your test is barely halfway done.

Once the lab finished these first steps, your test goes to the back half of the lab. Here, team members watch over an army of machines, all working to extract and test the tubes.

These tests are brought down to a different floor to check for positive reactions. Dr. Gerhard explained, while they may have room for testing in the same lab, the possibility of cross-contamination meant it was safer to test on a different floor entirely. In a process that requires the utmost care, this certainly feels like the right choice.

 Once it arrives at the auxiliary lab, these tests are put into two machines, in batches of around a few dozen at a time. Finally, they can read whether the results are positive or not. Unfortunately, this isn’t a perfect system, and that became increasingly clear to the lab staff. They check every test against a group of controls. These are tests that are absolute positives and absolute negatives, the platonic ideal of a COVID-19 test result. If your test comes out looking like the positive control group, there’s a pretty solid chance you’re getting a positive response. If your test stays flat against the line, the odds are your test is negative. But those aren’t the only options, and tests will show up in any varying array of shapes and looks. That’s where some of the trust in automation tests its limits. 

Every test result is double and triple checked, both by the computers and by the staff, making sure there are as few false results as possible. Dr. Gerhard stressed the odds of a false negative are relatively low. Of course, it’s not a perfect science, and accidents do happen. Often, these minor hiccups can be the reason your test takes longer than expected to return or why you receive an inconclusive result. The lab is being incredibly cautious with its decisions and taking every precaution to get your results back to you quickly and accurately. 

 From this final step, those barcodes we used back at the beginning – if you can remember that far back in the process – Are tied to results and sent out to another source to make their way back to you, the student. 

The Results

Immediately this begs the question, “Alright, so if that’s the process, why is it that sometimes my results are back the next day, and sometimes I have to wait two or three days just to find out I still don’t have Covid?” And the short answer is this: If you want your results back faster, get tested earlier in the day. Now, this is not a hard and fast rule, nor will it always yield perfect results, but if your test arrives in the morning batch, you’ll likely get processed on the same day. And so long as your grouping of tests contains no positives among them, then the odds are you can have a result later that day or the next.

If your test arrives before that first cut-off, around 12:30 pm, then your chances are going to be better; not perfect, but pretty good. The longer answer is, if a single part of this process is off, the lab will check again and again. The number one concern of the university is doing this carefully and accurately. They’re not going to jeopardize that to get tests back in under twelve hours. 

The Difference

So that’s the journey your tests take, from the testing site, all the way back to your Student Health Portal. But Temple’s testing facility runs a bit differently than most in Philadelphia, and we asked Dr. Gerhard about why exactly that is.

You know, for example, the Broad Institute, which does a whole lot more testing than we do – but they started with a hundred plus people, they repurposed them, then added another two hundred! I mean, we hired ten.”

Lucky for us, The Broad institute put their work online, and even without the massive building and staff, Temple was able to rework their strategy: Faster, better, cheaper. This work culminates in a testing process that services thousands of students, faculty, and staff out of a single lab room barely the size of a Morgan Hall dormitory. So, hat’s off to a process that truly is Temple Made.

Temple will continue testing students at sites across campus, and you can schedule a test on the Student Health Portal.

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