Being both on the frontlines and behind the scenes, the work done in the UT Health San Antonio pathology labs has been and continues to be crucial in the response to COVID-19 in the community.

With 20,145 samples processed to date, the technologists in the pathology labs are “truly in the trenches” in the fight against COVID-19, said Marjorie David, MD, MS, director of the molecular diagnostic laboratory in the Department of Pathology and Laboratory Medicine. The technologists directly handle test samples as they meticulously prepare vials and analyze the data, often working late hours and on weekends. “They have really gone above and beyond.”

Pathology lab technologists (from left to right) David Montes, Guillermo Nunez and Kumari Vadlamudi in front of the Hologic Panther instrument. Pictured above: Bethany Landry preparing reagents for testing.

The test samples are predominately collected from UT Health Physicians clinics, the School of Nursing’s Wellness 360 clinic and the School of Dentistry, which has an increasing need for pre-procedural testing. Currently, the pathology lab is processing an average of 217 test samples every day. In most cases, test results are ready within 24 hours.

“I’m very proud that we are able to provide a quick turnaround time for any patient posted within our system,” Dr. David said. “That has a huge impact on patients being able to quarantine themselves and alert individuals that they’ve been in contact with, which, of course, prevents further spread of the virus in the community.”

But a lot of preliminary work was required in order to quickly process and test so many samples.

In the early months of the pandemic, important resources were hard to come by. Swabs and PPE were notoriously difficult for labs and health care facilities to obtain, as was viral transport media, or VTM, another crucial component for testing that was not commercially available during the initial surge of COVID-19 in the US, said Nathan Wiederhold, PharmD, professor in the Department of Pathology and Laboratory Medicine and Department of Medicine/Infectious Diseases. To solve this issue, Dr. Wiederhold and his team made their own.

“It was really a combined effort between the University Hospital pharmacy, the virology lab and then us over here in pathology to make a lot of VTM and have it ready to go when needed for testing.”

VTM is the liquid that keeps test samples viable from the time the sample is collected to the time it is analyzed in the lab. Dr. Wiederhold and his team found recipes for VTM in some older journal papers and, after some experimenting with the formula, made a perfect VTM for coronavirus testing.

In order to ensure the VTM was created in a perfectly sterile environment, Dr. Wiederhold collaborated with the pharmaceutical labs at University Hospital and Mays Cancer Center, which offered their “clean rooms” for VTM production. Working together, the teams made 55,000 vials of VTM, which can also be used for testing the flu and other respiratory viruses, Dr. Wiederhold said.

To boost testing capacity, the creation of a new lab was in order. There was “a lot of scurrying around and a lot of late days” to convert an available research lab into a diagnostic lab, Dr. Wiederhold said.

Working closely with Facilities Management, Dr. Wiederhold secured a space on the fourth floor of the Medical School Building. After some renovating, the lab now features two spaces connected by a window. One side is dedicated to preparing the test samples, which are then handed off to the other side where they are put into machines for analysis.

The purchase of one of these machines, the Panther Fusion System, was made possible by a gift from USAA. This sophisticated piece of equipment allows for increased testing capacity and ensures much less human error, Dr. Wiederhold said. With the addition of the new Panther Fusion System, the COVID-19 diagnostic lab now has the capability of processing up to 2,000 tests per day.

“It’s been a lot of long hours and some very stressful days, but you do get a sense of reward that you’re actually helping,” Dr. Wiederhold said. And the experience of the pandemic has also helped to foster communication and collaboration between colleagues, departments and partners, he said.

“We couldn’t be doing what we’re doing without the School of Nursing going out collecting the samples,” he said. “Then of course there’s the departments of infectious disease and facilities management, as well as University Hospital. All of these folks have been playing a huge role. We’re just part of a larger team.”