Widespread COVID-19 testing is essential to safely easing shelter in place restrictions, and one Piedmont resident has been working overtime to expand testing capacity for the Bay Area. Ed Thornborrow, M.D., Ph.D., Senior Medical Director of Clinical Laboratories at UC San Francisco, oversees the operation of the medical center’s clinical laboratories which typically process 8 million tests of all kinds per year. When COVID-19 emerged as a threat to the U.S. in February, Thornborrow was tasked with getting testing for the virus up and running. UCSF now has six testing platforms operating in four locations, including a new diagnostic lab built out in eight days, and antibody testing is anticipated to roll out shortly. In addition, UCSF recently announced that it is offering free COVID-19 sample analysis indefinitely to all Departments of Public Health in California.
The Exedra talked to Thornborrow on April 18, who shared what it has been like to be working at the center of a global pandemic.
“I’m essentially a project manager making sure my teams are in sync across four high complexity labs across San Francisco,” said Thornborrow, who is also a board certified hematopathologist specializing in the diagnosis of leukemias and lymphomas. In response to the spread of COVID-19, he undertook supervising the rapid transformation of a former research lab into UCSF’s fifth clinical lab, diversifying testing platforms to address supply shortages and sourcing scarce materials from as far away as China.
Together with colleagues Steve Miller, Medical Director of Microbiology, Associate Director Charles Chiu, and Joe DeRisi, Ph.D., Co-President of the Chan Zuckerberg BioHub, and Emily Crawford, Ph.D., Project Lead for the Chan Zuckerberg BioHub, Thornborrow helped to lead the conversion of a research lab located in Mission Bay into an operating diagnostic lab in just over one week. Launched last month, it is known as the UCSF Clinical Labs – Biohub because of its location adjacent to the Chan Zuckerberg Biohub, a non-profit research association and UCSF partner which, along with the Chan Zuckerberg Initiative, supported the lab conversion.
In early March, Thornborrow temporarily relocated his office to the site where he spent 18-hour days, seven days a week, to ensure the new lab met strict clinical standards and to oversee a safe working environment for hundreds of volunteer staff and graduate students, who as researchers had never done clinical testing.
“It was a manually intensive process requiring a lot of people, a huge lift,” said Thornborrow, who is impressed by the commitment and willingness of the grad students to do whatever was asked of them. “These young folks could have chosen to stay at home playing Fortnite or whatever it is that 20-somethings do these days,” he said. “But you could see their excitement to generate clinical results … this wasn’t an experiment. These results have immediate impact with decisions made based on the results.”
The new lab is capable of processing more than 2,600 samples per day with results returned in as little as 24 hours, and effectively doubles UCSF’s overall testing capacity.
However, due to supply shortages, testing remains limited. According to Thornborrow, last Friday, April 17, was a record day with 350 tests run.
COVID-19 test samples are analyzed using high-tech automated equipment, each using its own specialized, brand-specific reagent, the chemical solution used to process the tests. Many of the necessary reagents are in short supply. As a result, Thornborrow moved to varied testing platforms. “I knew reagents were going to be an issue, so we started bringing in new instrumentation resulting in five different molecular-based tests, so that testing can always take place. If one reagent is not available for one instrument, another may be available for another,” said Thornborrow. “Yet, even with all these platforms we run into supply chain issues with multiple vendors.”
In addition, a dearth of swabs used to obtain nasal and throat samples is stalling testing, so Thornborrow unexpectedly found himself scouting swabs from abroad. Supporters of UCSF connected him with sales reps in China, and he has spent hours emailing, texting, and examining grainy photos sent to him to evaluate potential products. “Sometimes it’s like looking at a PDF of a cartoon character holding a swab and trying to determine if it would be safe and effective,” said Thornborrow. Last week the shortage of swabs was alleviated for the time being when Marc Benioff, chairman and CEO of Salesforce and a major UCSF benefactor, tweeted that 100,000 nasal swabs had just arrived in the Bay Area, intended for UCSF.
Antibody testing is one of the next hurdles to clear, and Thornborrow anticipates that it will be up and running this week or next.
However, he cautions that it is an open question as to how long antibodies persist. “The biggest misconception is that having antibodies means you are now immune to the virus,” he said. Researchers simply don’t have enough data to make a determination about immunity at this point in the pandemic.
While significant progress has been made in ramping up testing, according to Thornborrow, “population-wide screening will really be a challenge and will definitely put a strain on all equipment.”
Nevertheless, he is encouraged by the collaboration among Departments of Public Health, hospitals and laboratories in the Bay Area and across the country and universities including Stanford, UC Davis, UC San Diego, and the University of Washington.
The State of California and other agencies are working to quickly build out the infrastructure to offer stand-up, easily accessible screening to identify those with the virus. “We are all working together. It takes a village to get this done, and people are working their butts off to get this right.”