Henry Ford begins in-house, same-day COVID-19 testing

By: Nick Mordowanec | C&G Newspapers | Published March 20, 2020

File photo by Deb Jacques

METRO DETROIT — On March 16, Henry Ford Health System began in-house, same-day testing for COVID-19.

The molecular-based testing, done via nasopharyngeal swabs, are available to Henry Ford providers in two ways: those performed on current hospitalized patients, those being admitted through emergency means, and Henry Ford health care workers; and real-time tests performed on outpatients, and those screened at drive-through locations where results are determined by an outside lab four or five days later.

At press time, Henry Ford Allegiance Health was operating a drive-through screening center at its Jackson location, with additional sites “coming soon.” Those sites are intended for community members who have the symptoms of COVID-19, including fever, cough and shortness of breath.

Patient triage tents have been set up at all five Henry Ford hospitals, in Detroit, Clinton Township, West Bloomfield, Jackson and Wyandotte. On March 17, the health system said the tents were not yet in use but “staged should patient volumes require.”

All Henry Ford coffee shops and cafeterias remained open at press time, with seating limited to 50 or less persons due to social distancing in the cafeterias. All self-service food options have been eliminated.

Testing and results

Senior public relations specialist Michelle Fusco, of Henry Ford Macomb Hospital in Clinton Township, shared the system’s first report from March 13 that three patients had tested positive for coronavirus: one female and two males.

The female and one of the males were discharged by the time of that release, with instructions to stay home and quarantine. The other male patient was discharged that same day and said to be in “good condition.”

On March 18, Henry Ford Health System announced its first COVID-19 related death: an 81-year-old Wayne County resident who died Wednesday, at Henry Ford Hospital in Detroit.

The health system issued a string of daily advisories between March 17 and 19.

In a March 17 conference call, it was stated that more than four days of around-the-clock work was being conducted so COVID-19 could be sampled in-house.

Dr. Richard Zarbo, senior vice president and chair of pathology and laboratory medicine at Henry Ford, said the health system was first notified of Food and Drug Administration rule changes in February. However, it took until March 7 to create a template to entertain the Centers for Disease Control kit for validation.

Protocol was written March 8, primers and supplies were ordered March 9 and arrived March 12 for testing that evening by multiple molecular biologists. Testing went live March 16.

Dr. Linoj Samuel, division head of clinical microbiology at Henry Ford, said the FDA likely realized they could not manage data nationwide and delegated authority from state-based laboratories. Testing and recorded results that began March 16 were being reported to the Michigan Department of Health and Human Services.

The nasopharyngeal swabs are long, narrow tubes put up the nose and in the space behind, swishing the lining of cells for material from mucosa. They are able to locate any infectious agents, including influenza.

Health care employees at the hospital are also being tested.

Zarbo said test numbers are escalating to 100 tests per day, to 200 tests per day, to possibly 1,000 tests per day by mid-April. Drive-through tests help, but are not a long-term solution.

“The actual intent (of the drive-through) is great if the nation could do 5 million tests a day, but the nation can only do 36,000 tests a day for 300 million-plus citizens,” he said.

John Waugh, vice president of System Laboratories at Henry Ford, said drive-through sample collection or evaluation takes two-to-three hours to complete.

There is also a scarcity of resources, he noted, referring how he partook in a national conference with colleagues nationwide and was told how essentially every lab across the U.S. is backed up and over-subscribed to testing requests. It pushes the turnaround time longer.

“Some of (the resources) are perhaps used on patients who are not the sickest of the sick right now. … It’s a broad area of concern that we are trying to look at,” Waugh said.

Samuel said about 30 tests were conducted March 16, and another 50 by the afternoon of March 17. Approximately 10% of the test results came back positive, not for the general population but tests already sampled to sick inpatients.

Zarbo called it a “rapidly-changing field,” mentioning how there are a couple strains of the virus and mutations have occurred. Figuring out how to adapt the fluctuating cycle now consumes most of the physicians’ days.

“It’s important for academic sophisticated institutions to continue to grow our capacity,” Zarbo said. “These smaller hospitals just do not have the specialty depth to do what we just did. … This is a one-in-a-100-year phenomena we’re experiencing. We’re not used to this, shutting down a nation to stop a pandemic.”

Beds and supplies concerns

There are 360 total beds across the health system’s intensive care unit, as well as about 150 negative pressure isolation rooms.

Bed counts at each hospital, as of March 18, were as follows: 877 at Henry Ford Hospital; 475 at Henry Ford Allegiance; 361 at Henry Ford Macomb Hospital; 401 at Henry Ford Wyandotte Hospital; and 191 at Henry Ford West Bloomfield Hospital.

Staffed bed occupancy, as of March 13, was 83% at Henry Ford Hospital; 78% at Henry Ford Allegiance; 75% at Henry Ford Macomb Hospital; 62% at Henry Ford Wyandotte Hospital; and 81% at Henry Ford West Bloomfield Hospital.

On March 18, Henry Ford announced it had postponed non-time sensitive procedures and surgeries to protect the health and safety of patients, as well as to ensure the availability of medical equipment and resources in the event of a “patient surge.”

Procedures and surgeries are currently being performed at all five Henry Ford hospitals and six outpatient surgery locations.

On March 19, hospital officials stated that inventory — including masks, gowns, face shields, wipes and more — were being monitored. They are in “constant communication” with suppliers as the concern of increased positive cases rises, and are taking measures to extend the life of their supplies.