Pictured above, row by row, top to bottom are Brad Sandberg, Jessie Schuman and Brandon Rich. In row 2, Caleb Reinking, Joanna McNulty, Liz Rulli and Zulema Reyes '23. In row 3 are Kiara Gallagher '21, Katelyn Steenvoorden '21 and Haley Rague '21. Not pictured are Melanie DeFord, Sue Ryan, Carol Mullaney, Carolina Avendano and John Lloyd.
If you haven’t received an email saying you’ve been selected to be tested for COVID-19, you will. Any member of the Notre Dame campus community can be selected for surveillance testing and some are tested frequently.
Amber Weems, who works in Building Services, has been tested three times. “My experience with testing has always been great. You’re in and out. And the people running it are as happy as the workers at Chick-fil-A,” Weems said.If you haven’t received an email saying you’ve been selected to be tested for COVID-19, you will. Any member of the Notre Dame campus community can be selected for surveillance testing and some are tested frequently.
Because of the nature of her work cleaning the busy Joyce Center, Weems is tested often. She has a short commute to do so. The COVID-19 Response Unit (CRU) testing site was recently relocated to the north dome.
“I am glad they have expanded testing at the University to include surveillance. No one is immune to this virus,” she said.
“It’s vitally important that we all cooperate fully with surveillance testing to keep our community safe and healthy.” (Source: ND COVID-19 Update, Oct. 15, 2020)
Understanding surveillance testing
Surveillance testing collects saliva or nasal mucus from people who are not experiencing COVID-19 symptoms such as a sore throat, headache, body aches, a fever, shortness of breath or loss of sense of taste or smell.
Why test people who appear to be well?
“Surveillance helps us identify those in our community who are asymptomatic but have COVID-19 and could unknowingly spread the virus. Identifying those cases can help us mitigate the spread by isolating those people. It also helps us understand how prevalent COVID is here,” explained Liz Rulli, associate vice president for research. She’s leading the surveillance testing strategy and program at Notre Dame.
Rulli has spent her career on the administrative side of supporting research, but nothing has been as fulfilling as leading the team that not only launched large scale surveillance testing on campus, but implemented a system to collect and analyze specimens here, she said.
“We’ve had epidemiologists, biologists and chemists, research programmers, data scientists, statisticians and computer scientists helping us with the sampling strategy and various people from all these different sort of research perspectives helping with this huge administrative project of testing and keeping the University open. I just have really appreciated how the research community and the University operations have come together with this effort,” she said.
Rulli started at the end of July when Vice President for Research Bob Bernhard launched a team of 14 people, with different expertise, to lead surveillance testing at Notre Dame.
“People have come and gone as the project has had different needs. The last time I counted, there were probably over 100 different people that have contributed in big or small but important ways to get this off the ground,” Rulli said.
She added, “This team goes above and beyond on a daily basis to keep campus safe. A great example of that is Melanie DeFord going to the Notre Dame Police Department at 10 p.m. the other night to collect saliva samples for those who work the overnight shift.”
"Saliva-based testing has increased the University’s capacity for surveillance testing. Since Sept. 28, the University Testing Center has averaged over 1,100 surveillance tests per day. The average turnaround time for saliva surveillance testing is one day, while the average turnaround time for nasal surveillance testing is 1-2 days." (Source: ND COVID-19 Update, Oct. 15, 2020)
Two kinds of tests: nasal and saliva
Surveillance testing began with the prematriculation testing of the student body before they returned and the testing of athletes who came back early for practice. The wider surveillance of the campus community, including faculty and staff, started in August with the use of a commercial nasal swab test analyzed at LabCorp in South Bend. In late September, the University added saliva surveillance tests, which are processed at the Notre Dame Saliva Surveillance Lab in McCourtney Hall.
Mike Pfrender, a professor in the Department of Biological Sciences and the director of the Genomics and Bioinformatics Core Facility, helped plan and coordinate how saliva samples would be collected and analyzed.
While the nasal swab tests and the saliva tests are different in obvious ways, both are molecular tests that detect genetic material of COVID-19 using a lab technique called polymerase chain reaction (PCR). So when considering the results of nasal swab and saliva tests, it’s not like comparing apples to oranges.
“The guts of the test are the same. Both are a PCR-based test and that’s the gold standard for COVID testing right now,” Pfrender said.
Student workers manage saliva collection
Joanna McNulty is the director of finance and administration for Notre Dame Research. This fall her administrative duties have included establishing and managing saliva collection operations.
“That has meant hiring about 50 students to work various shifts in different roles, overseeing them, getting them scheduled and teaching them the protocols and tweaks to processes,” McNulty said, adding that most of the student workers are science majors.
The student workers receive safety training and they never come in direct contact with the saliva samples. “The students never touch the collection tube itself after there is saliva in it. All of the student workers wear gloves and the tubes go right into the biohazard bag, which students hold out to the person depositing their sample. It’s a relatively safe work environment,” McNulty said.
But as much as many of them would like to work in the lab, the closest they can get is to drive the samples to McCourtney by golf cart, which happens every two hours.
“Because of COVID physical distance restrictions, it’s not possible for them to be in the lab,” McNulty said.
Getting a jumpstart on surveillance testing
Melissa Stephens, assistant director of the Genomics and Bioinformatics Core Facility, established the saliva testing lab, and has overseen the lab’s renovation, stocking, hiring and training of staff to process the samples from collection to data reporting.
That takes time, but fortunately, “We have all this expertise on campus, which enabled us to get this lab up and running quickly,” Pfrender said. “Melissa recruited the temporary help of some postdocs and technicians working in similar high-tech molecular biology labs. Without that help, it would have been another month before we could be in operation.”
Another crucial jumpstart to the process came through the generosity of an alumnus and researcher at the University of Illinois whose daughter is a student here. “He shared with us, under a non-disclosure agreement, the chemistry they’re using at Illinois for surveillance testing. That’s how we were able to move very quickly to say we want to do this kind of lab with this kind of equipment. We were able to jump ahead through the generosity of people at the University of Illinois, and they continue to help us and field our questions,” Rulli said.
Processes at the collection site and in the lab are always being improved. Last Wednesday, a robotic liquid handling machine was added to the lab. Stephens says it’s like adding another lab technician to the team. “There are so many samples, it can become a management problem, so robotics really helps with that. It can do some of the liquid handling and do some of the chemistry and keep everything in order,” she said.
Analyzing saliva samples
When the bins of samples arrive at the lab, a technician removes the racks holding the tubes and then places the tubes in a 95 C degree thermal bath.
“It’s a big water bath and we leave the tubes there for half an hour to inactivate the virus. So this is a really safe procedure because nobody’s handling any of the samples,” Pfrender said. “Then we take those tubes out and start moving them into the chemistry part of it by taking a sample out of each tube and logging them into the system. We scan the barcodes that are on the tube. The barcode is ultimately tied to the person who gave the sample.”
No one in the lab can see names associated with the barcodes. That’s because when a person checks in at the testing site using an NDID, a student worker scans the barcode on a specimen tube, linking the person’s identity to the barcode.
“We just have the tube and the barcode, and that’s all we need to keep it all organized. The results from the test are linked to the identity of the person at the computer level,” Pfrender said.
Getting test results
Ultimately, the person tied to the barcode receives the result of his or her surveillance test via email and/or a phone call.
If there are no indications of COVID detected in a saliva test, the individual receives an email that says diagnostic testing will not be required on the basis of this surveillance test.
If there are indicators of the virus, the individual’s daily pass turns red and the person receives an email and a phone call with the instruction to go immediately to the CRU testing site for a diagnostic test.
The process is similar for receiving the results of a nasal swab test.
When asked whether the surveillance testing team has heard of any success stories, McNulty said, “Someone was asymptomatic when he came in for a saliva test, learned he needed to be tested diagnostically, tested positive for COVID-19, and went into isolation before his symptoms started. He said ‘Saliva saved the day,’ because he could have infected many more people if not for the test.”
Natalie Davis Miller, Managing Editor of NDWorks, contributed to this report.
Originally published by ndworks.nd.edu on October 19, 2020.at