Monday, March 23, 2020

The COVID-19 pandemic has impacted testing not just for COVID-19 but for other tests that use the same materials. 

Because there is a national shortage of certain supplies, University of Iowa Health Care is seeking assistance identifying resources that might be re-purposed for clinical testing. 

If you have any of these SPECIFIC supplies, please contact Bradley Ford, medical director of the Department of Clinical Microbiology and clinical associate professor of pathology, at bradley-ford@uiowa.edu:

1.   SWABS

SWAB FORMATS

Swabs come in two formats.  UI Health Care needs both, but especially nasopharyngeal swabs.

  • nasopharyngeal swabs: flexible, mini tip, snap-off ends
  • oropharyngeal swabs: essentially all others, with variably sized heads and a thicker straight shaft

SWAB CONSTRUCTION

FDA believes that sample collection with a flocked swab is preferred. When options are limited, collection with certain other swabs may be necessary but may not be sufficient enough to rule out COVID-19 infection.  Therefore:

  • "flocked swabs" are strongly preferred (e.g. Copan, Puritan, BD)
  • synthetic non-flocked swabs may be acceptable, and can be evaluated by the laboratory on an individual basis

These may come alone, with viral transport media, or with liquid Amies (ESwab) or other media.  Any of these mixtures are acceptable.

NOT NEEDED

  • calcium alginate swabs
  • swabs with wooden shafts
  • cotton swabs
  • sponge-on-a-stick paddles/swabs

These are either inadequate for specimen recovery or may contain substances that inactivate/degrade viruses and inhibit PCR testing.

2.   DNA/RNA EXTRACTION

The laboratory has Qiagen EZ-1 and Thermo Fisher KingFisher instruments.  Lack of reagents for these has impacted both COVID-19 and other clinical testing.  Our preference is to find stock of reagents for instruments in hand, then identify alternate automated extraction instruments with large stocks of reagents available (in the thousands to tens of thousands of extractions), then resort to manual DNA/RNA extraction (materials for which are not in short supply but see below under "labor").

PREFERRED REAGENTS:

Qiagen EZ-1

  • Kit: QIAGEN EZ1 DSP Virus Kit and Buffer AVL (supplied separately) for offboard lysis
  • Card: EZ1 Advanced XL DSP Virus Card
  • Kit: QIAGEN EZ1 Virus Mini Kit v2.0 and Buffer AVL (supplied separately) for offboard lysis
  • Card: EZ1 Advanced XL Virus Card v2.0

Thermo Fisher KingFisher (duo or flex format)

ALTERNATE EQUIPMENT:

The laboratory is adequately equipped with hardware for the above reagents.  Acceptable extraction hardware (with large stocks of listed reagents, which are also in short supply for all platforms) would be:

Roche MagNA Pure LC

  • Kit: Roche MagNA Pure Total Nucleic Acid Kit
  • Kit: Roche MagNA Pure Nucleic Acid Isolation Kit I
  • Kit: Roche MagNA Pure 96 DNA and Viral NA Small Volume Kit

QIAGEN QIAcube

  • Kit: QIAGEN QIAamp® DSP Viral RNA Mini Kit or QIAamp® Viral
  • Kit: QIAGEN QIAamp® DSP Viral RNA Mini Kit or QIAamp® Viral RNA Mini Kit

bioMérieux NucliSENS easyMAG

bioMérieux EMAG Instrument

3. LAB PERSONNEL/VOLUNTEERS:

To respond to the COVID19 outbreak, UI Health Care is aiming to bring in expanded clinical lab testing for COVID19 into the clinical microbiology section of the UIHC Pathology laboratory. UI Health Care is in the process of validating this additional testing and its goal is to quickly flex its availability to 24/7.

For this, UI Health Care needs a volunteer workforce that can join its clinical laboratory workforce in various capacities while still meeting regulatory standards. It's welcoming volunteers from its biomedical research laboratories across campus to potentially serve in this capacity. Of course, appropriate training would be provided.

You can consider volunteering if you:

1. Have a doctoral degree (PhD, MD or equivalent) and research lab experience as a postdoc; OR

2. Are a PhD or masters student in a biomedical field with at least 1 year lab experience; OR

3. Are a research tech in a biomedical lab with at least 1 year lab experience.

AND

4. Have a meticulous approach to protocols and record keeping. (Training will be provided in specific skills).

5. Have the ability to volunteer for 4-hour shifts, either during working hours or in the evenings/nights. (Please clear this possibility with your supervisor/PI)

Volunteers with the following skills will be considered first:

  • Knowledge of the differences between RNA, DNA and TNA specimen extractions and methodologies.
  • Knowledge of storage conditions for and reasoning to include; RNA, DNA, TNA.
  • Understand the science of Polymerase Chain Reaction.
  • Understand the science design, principle and interpretation qPCR (Real-time).
  • Understand the difference between RNA, DNA – based qPCR (real-time).
  • Understand the role and use of Reverse Transcriptase in qPCR.
  • Familiar with 96 well format qPCR set-up.
  • Familiar with and proficient at pipetting small volumes (<10ul).
  • Understand the cycle threshold interpretation of qPCR.
  • Be familiar with the use of and need for assay controls (QC) for Clinical Assay.
  • Be familiar with the importance of QC methods for Clinical assay. CAP – requirements and Checklist items.
  • Be familiar with the importance of QC for Clinical reporting.

If you don’t have these specific skill sets, UI Health Care would still welcome you to send your CV for consideration as there will likely be future opportunities to assist with its clinical laboratory needs in the ongoing response to the COVID-19 Outbreak.

UI Health Care is also in the process of determining a payment structure for this, particularly if the activity falls outside of your normal work hours. If you would be interested in participating, please send an email to jonathan-pruessner@uiowa.edu along with your CV.  He will review and will be in touch with you as needed.