‘It was our moral obligation’

On February 11—just two weeks after the World Health Organization declared a global public health emergency, and with just a dozen COVID-19 diagnoses in the country—Mayo Clinic decided they needed to develop their own test for SARS-CoV-2, the virus that causes COVID-19.

Developing a test like this would normally take six months to a year.

Three months, they hoped, was a best-case scenario.

But the Mayo team realized early on that this virus was different. That maybe they’d never seen anything like this.

“We felt like it was our moral obligation to offer testing to as many people as we can,” says Dr. Matthew Binnicker, Mayo Clinic’s Director of Clinical Virology, who oversees the clinic’s lab response to COVID-19.

So Binnicker put together a 15-member team—including the seven clinical microbiologists that run the clinical labs at Mayo Clinic—who worked late hours and long shifts.

Three weeks later, Mayo Clinic unveiled its new test.

“It was a heroic effort and a team effort,” says Binnicker.

We talked—virtually, social distanced—to a member of that team, Dr. Bobbi Pritt, one of those seven clinical microbiologists.

Rochester Magazine: OK. Have you ever seen anything like this?

Dr. Bobbi Pritt: No. I haven’t. I’ve been involved in a number of pandemics. Since I took my role, we had the H1N1 back in 2009, and then we’ve seen a few smaller outbreaks of things like MERS and Ebola and Zika virus, but I’ve never had anything to this extent. So it’s tested all of our plans—and we’ve had to adapt—but, thankfully, we had pandemic plans in place that have really served us well.

RM: At what moment for you did you realize that teams needed to be shifted or ramped up to combat COVID-19?

BP: Well, of course, we were all keeping our eye on the news earlier this year when we started hearing reports coming out of China. We got together on February 11. The whole effort was led by my colleague, Dr. Matt Binnicker. He pooled together a team of 15 people and, in three weeks, created, designed, validated, and implemented real-time PCR assay [polymerase chain reaction; a technique used to copy small segments of DNA for testing] for SARS-CoV-2, which was incredible. I mean that’s just unheard of. Usually it takes three to six months to design and implement a real time PCR assay that’s actually developed in the laboratory. But we knew that we were under a deadline, that the virus was spreading ...

RM: Did you have to bring in people from other departments when you were putting these teams together?

BP: Essentially, our teams started working around the clock. We created three shifts. Some of these testing laboratories didn’t previously work a night shift, but they do now. And so initially, we started by ramping up within our existing team. But we are now at that point where we’ve brought in about 25 people from other areas of the laboratory to help with testing and to form additional teams so that we have backups in case someone in one of the teams gets sick and we need to substitute people.

RM: What kind of response have you seen from the team?

BP: There’s definitely a lot of energy. Everyone’s pitched in. It’s really been an incredible team effort, but that’s not to say that it hasn’t been hard. Many of our employees have young children. They have family responsibilities, and some of them are experiencing dramatic changes in their hours. Now they’re working an evening or even an overnight shift, so you can imagine that has a profound impact on their home life. There’s also just a real sense of urgency for them to test as many patients as possible. There’s a real sense of purpose, and our staff has just really come together in this time of crisis. There’s a lot of pride in being able to contribute.

RM: Was there a specific point where you said, wow, this is really going to be what we feared it might be?

BP: The very first day that we went live with our new test, we received several hundred samples. And that was, at that time, about the maximum we could test. That was an eye-opener, that day we went live with testing.

RM: That was March 12?

BR: Yes. So, based on that high number of samples we received, it was very clear in our minds that we were going to need a second test. So that was on March 12, and that evening, Roche Diagnostics received clearance for their own test. So we decided that we were also going to purchase and bring in the Roche test for SARS-CoV-2 and so that was a little easier because we could purchase the kit commercially. We did that testing in 111 hours. Again, which was just unprecedented. Shortly after that, we brought in a third test by Abbott Labs, another diagnostic company. So we are now currently running three different tests to be able to meet the volume for testing for SARS-CoV-2. Right now, our capacity is about 8,000 tests per day.

RM: And where were those first samples coming from? All over the U.S.? All over the world?

BP: Initially, we were testing Rochester Mayo Clinic patients, and that was another reason why we wanted to bring national testing. We wanted to be able to support the State of Minnesota, not just Rochester. And we also wanted to be able to support the areas of our country that were particularly hard hit. At that point, we were starting to see some hot spots popping up in the United States, and so we wanted to be able to reach out to the laboratories in those areas and offer our assistance.

RM: And these tests are specifically focused on whether someone has COVID-19 or not right now.

BP: Right. So that’s a very important point. These tests that we’re talking about right now, these are the real-time tests that are really just detecting when a patient is sick. But just two weeks ago [in early April] we started our serology test—it’s also known as antibody testing—and that is a test to show that a patient has been exposed and that their immune response kicked in and has started fighting the virus by forming antibodies. So that’s a completely different test that we think is going to really help guide us to see who has been exposed and who has not. Both tests together will probably play a key role in restarting our economy in getting people back to work. We have a capacity of 10,000 antibody tests a day right now.

RM: I know you had plans in place for this sort of thing. But those plans must have just been guidelines for what you’ve actually experienced.

BP: We had to make changes to our plans almost immediately. I think, initially, we had a special ward in the hospital where we planned on putting people, and it very quickly became apparent that we were going to exceed the capabilities of just that single unit and that we would probably have patients throughout our hospital that had COVID-19. So we had to be flexible and just adjust on the fly. We were changing plans every day, sometimes multiple times a day. But then, we also have to become very creative along the way because we realized that there were significant shortages, and still are to this day, in the supplies and equipment we need to collect specimens from patients, and then to perform the testing. So we learned to draw upon our existing skills and also to kind of learn some new ones to start doing things so that we could keep up and running. For example, we started looking at our own swabs that we could use to collect patient specimens if we ran out of test swabs. Thankfully, we have not run out yet. But we actually use 3D-printing technology to make our own swabs. The swabs go into a liquid in a tube, and we’ve put together little kits that can be sent to the laboratory. Because very quickly, that liquid was short supply. We couldn’t buy it in the United States. Everyone was out. We’ve been using vaporized hydrogen peroxide to sterilize and to reuse our surgical masks and N95 masks. Again, it’s a back-up plan. We haven’t run out of masks yet. We’re in OK supply, but we need to come up with a back-up plan for almost everything.

RM: That’s amazing stuff. What positives can we take from what we’ve learned from this?

BP: Well, I think that, first of all, relying on our plans and structures is essential. We’ve put them into place, and so that’s the basis for moving forward. But we’ve learned the key is being flexible and being innovative. And this whole team—this whole place—has come together to do that.