Meeting the COVID Challenge

As testing for COVID-19 continued into the summer at Rosalind Franklin University Health Clinics (RFUHC), Angie Santillan, PMAC, clinical practice manager, performed nasal swabs on 42 people in a single hour one day at the clinics’ drive-thru testing site in North Chicago. The mother of three exemplifies the selflessness of health professionals at the frontlines of care during the pandemic.

We’re responding to the need, in the foreseeable future, for increased testing capacity, especially for our most vulnerable populations

“Yes, I had some fear early on,” Ms. Santillan said. “But it’s my job to help people. I have the training, the education and the duty to serve this community. COVID is so much bigger than me or any one of us. That’s why it has to be a team effort.”

Both RFUHC and the university continue to answer the state of Illinois’ call to increase testing capacity. As COVID-19 surged across Lake County and the nation, RFUHC began offering testing for campus community members and registered clinic patients on April 17, and expanded access to the general public began on May 1. Meanwhile, the university’s Clinical Immunology Lab adapted to conduct diagnostic tests for the virus — on samples taken from both RFUHC and state-run sites.

“We’re responding to the need, in the foreseeable future, for increased testing capacity, especially for our most vulnerable populations,” said Ronald Kaplan, PhD, RFU’s executive vice president for research. “We believe we can make a significant difference in our university community, our neighboring communities and in our northeastern Illinois region.”

John Nylen, MBA, president of RFUHC and RFU executive vice president for finance and administration, said the quick investment in and expansion of COVID-19 testing capabilities for the general public sends a strong message: “We’re committed to the health and wellness of our region and to containing the spread of the coronavirus.”

Widespread testing is key to slowing the spread of the pandemic. New cases can be isolated while still infectious, and lifesaving treatment can be offered before it’s too late.

The Clinical Immunology Lab typically performs more than 1.3 million diagnostic tests per year for national and international clinics and physicians, many related to reproductive immunology. The university added dedicated staff, space and equipment for the three-step processing of COVID-19 patient samples: extraction, preparation and detection. The test for SARS-CoV-2 is based on the Real-Time RT-PCR Diagnostic Panel.

“It’s the kind of test we do a lot of — though typically not for diseases that cause pandemics,” said Kenneth D. Beaman, PhD, founder and director of the lab. “But we’re comfortable doing these tests. We have the hoods, PPE and other equipment we need. Most importantly, we have highly trained and qualified staff.”

The lab began serological testing for COVID-19 antibodies in June. While a positive test for antibodies indicates exposure to the virus, scientists are still trying to learn if that affords protection from infection and for how long, and whether those with antibodies can still spread the virus.

“It’s a very interesting virus,” said Svetlana Dambaeva, MD, PhD, associate director of the Clinical Immunology Lab. “We need another six months or more to understand how immunity works; meanwhile, social distancing is key to prevention.”

While the lab began to see a dramatic decline in positive COVID-19 tests in June, Dr. Dambaeva emphasizes the importance of antibody tests in controlling the spread of the disease.

“It’s important to do more of those, especially for people tested who experienced symptoms 10 or more days earlier,” Dr. Dambaeva said. “When the viral load drops, the molecular test can’t detect the virus. That’s when the serology test is really important, because it can detect a false negative from a molecular test.”

The lab is working to produce a COVID-19 package that, in addition to diagnostic tests for the virus and antibodies, includes a test to detect a cytokine storm, a potentially deadly inflammatory response to the virus.

“We hope to put out a test to physicians that in conjunction with early clinical observations detects inflammatory syndrome — telling us what is going on in the blood of the patient,” said Mahmood Bilal, PhD, Clinical Immunology Lab assistant director. Dr. Bilal is researching cytokine interleukin-6 (IL-6) as a biomarker of inflammation. Early evidence suggests a low level of the protein can predict a cytokine storm.

We often get testing results within the same day

“We can draw serum and see if the storm is beginning,” Dr. Beaman said. “The healthcare team can prepare and do something before it arrives.”

Meanwhile, the Clinical Immunology Lab continues to report every test result, as required, to the Lake County Health Department and Community Center, the state of Illinois and the CDC.

“We often get testing results within the same day,” said Valerie Riehl, MS, a research assistant who returned to campus after the stay-at-home order was relaxed to allow clinical testing. Every day, she dons layers of PPE to process patient samples inside the new extraction room, a space she cannot leave during the duration of her work hours.

“It’s nice to have a purpose again,” she said.

“I feel blessed to have such a supportive team at RFU — clinical research staff, administrators, facilities,” Dr. Bilal said. “It feels good as a team to provide the community the testing and other resources it needs.”