In the very early stages of the pandemic, one team at UNC Health developed deployable tests for COVID-19 at a time when there were extreme limitations on testing availability.

Thanks to their work, as of two weeks ago, UNC’s Medical Center hit its 100,000 test.

Dr. Melissa Miller is a Professor of Pathology and Laboratory Medicine at UNC’s School of Medicine. She is also the Director of the Clinical Microbiology and Molecular Microbiology Laboratories for UNC Health Care – UNC’s main COVID-19 testing hub.

These clinical microbiology labs are responsible for all the testing done at UNC’s Medical Center, Respiratory Diagnostic Center and all of UNC’s affiliate hospitals. UNC Health introduced its first in-house COVID-19 test on March 16. Since then, Miller said the medical center tends to use the more commercial-based FDA tests in order to test more people per day.

“When we started we could do a maximum of between 120 to 300 a day using our test alone,” Miller said. “Very quickly we built capacity. About two to three weeks after that we had some commercial tests that we brought in house, which brought us up to the 300 to 500 range. Today we have the capacity to do 2,500 tests per day with the capacity that we built here at the medical center.”

While UNC has the capacity to test 2,500 people per day, they aren’t actually testing that many. Miller said it’s important to have more than enough testing as we head into flu season. While our test positivity rate has been slowly but steadily decreasing, with a five percent positivity rate in North Carolina, Miller said the positivity rate during flu season may look very different.

“So you’ve heard about these twin epidemics and it has caused a lot of concern for us in the laboratory, for providers and for the community,” Miller said. “How do you manage a respiratory virus pandemic in the middle of another respiratory virus potential epidemic?”

Miller said she and her team are working on algorithms right now on how to co-test both flu and COVID-19. She said building duplicity with tests for these different viruses will be beneficial down the line if there continues to be supply shortages. She said the supply chain continues to be a major issue – not just for COVID tests, but for all laboratory testing – particularly as it relates to microbiology labs like Miller’s.

“As we continue to have supply chain problems, we can switch from one test to another test without interrupting patient care,” Miller said. “So there’s a lot of behind-the-scenes action that I think is not readily apparent to most of the community that will be very important as we are now heading into our traditional respiratory season.”

Within the UNC Health system, going forward, Miller said anyone who is symptomatic will be tested for both COVID-19 and the flu at the minimum. Asymptomatic patients will only be tested for COVID-19.

While supply chain concerns are expected to continue, Miller said she thinks UNC Health is as prepared as they can be going into the flu season amid a pandemic – especially considering what their laboratories have accomplished thus far.

Miller said the fact that UNC Medical Center has tested over 100,000 people since it first introduced COVID-19 testing back in March is no small feat.

“We’re often behind-the-scenes and no one really knows what happens after their specimen is collected and it goes to the lab,” Miller said. “To be able to build this capacity and to reach that milestone in terms of numbers of tests, we’ve had to not only buy instruments, we’ve had to hire new employees, get them trained and find space for all of the testing that’s being done. So it’s really been quite a massive effort to get to where we are today.”

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