Intermountain Healthcare has sped up from 14 COVID-19 tests a day to thousands

One of the first Utahns to get tested by Intermountain looks back, as the system passes 1 million tests.

(Rick Egan | The Salt Lake Tribune) Cassidy Murphy and Taylor Woodrow test for COVID-19 at Intermountain Healthcare Cottonwood InstaCare, on Friday, Dec. 11, 2020.

When Intermountain Healthcare’s central lab started processing COVID-19 tests last March, “we did 14 tests that first day,” said Dr. Sterling Bennett, the lab’s medical director.

“Within a few days, we were running 200 tests a day. We went to 2,000 a day by late March,” Bennett said Tuesday. Now, Intermountain can run 7,000 tests a day, Bennett said.

“It’s been satisfying, but extremely difficult,” Bennett said during a media teleconference, convened to mark the hospital system hitting the 1 million mark for tests processed. The milestone was reached last Thursday, the company said; as of 8 a.m. Tuesday, the lab has processed 1,017,640 tests.

Most of the tests the lab runs, said Dr. Bert Lopansri, medical director for Intermountain’s microbiology lab, are molecular tests — like the PCR test, which sometimes involves a swab put well up a person’s nose.

“That’s our workhorse test,” Lopansri said, adding that the lab runs between 2,000 and 5,000 of those a day.

Those tests could take days to process in the early days. Now, Bennett said, the lab has results back in 90% to 95% of the tests within 24 hours.

And the new race, Lopansri said, is keeping up with COVID-19 variants that are now circulating. “We’re currently in a foot race between vaccine administration and the emergence of variants,” he said.

The molecular tests are more sensitive, and therefore more accurate, than the rapid antigen tests that are being used more and more in recent months, Lopansri said.

The antigen test has the advantage of producing faster results, he said, and is easier to get out into the community. (There are rapid molecular tests, Lopansri said, but supplies for those are limited.)

None of the tests, though, can detect the new variants of the coronavirus that have been detected in the United States, Lopansri said. The B.1.1.7 variant, called the “U.K. variant,” has been found in three cases in Utah, health officials have reported.

The molecular test, Lopansri said, looks for evidence of three genes, one of them a spike protein that is mutated in the U.K. variant — so if that spike protein doesn’t show up in the test, it may indicate the presence of the variant. In those cases, he said, samples are sent to the Utah Public Health Lab for more detailed testing.

Testing Utahns

The expense for most tests, Bennett said, is covered through the patient’s health insurance. In those instances where insurance won’t cover the cost, those cases are documented and sent to the federal government for reimbursement.

When a patient doesn’t have insurance, Intermountain covers the cost as part of its charity program, company spokesman Jess Gomez said.

Gomez said the company did not have figures for how much revenue it gets for processing COVID-19 tests, because the accounting hasn’t kept up with the lab’s output. It’s believed, he said, that Intermountain’s revenue is less than its expense at providing and processing tests.

Gomez said 85% of those million tests were given to Utah residents. The lab has processed tests for all 50 states, and five U.S. territories.

Julian Romero was one of the first people Intermountain tested for COVID-19. The former Utahn, who now lives in California, was 26 last year when he returned from a music festival in San Diego — held just before the pandemic forced promoters to cancel such shows. He came back to Utah on Monday, March 2, and wasn’t feeling well.

“That night, I started to get a migraine,” said Romero, who works for a health technology company. “I progressively got worse and worse.”

Two days later, on Wednesday, he went to an Intermountain urgent care clinic in West Valley City. “They weren’t really giving out COVID tests,” Romero said, so the doctor gave him a flu test and a respiratory panel, and both came back negative.

On Thursday, Romero went to the emergency room, and was given a COVID-19 test. Within a day or two, the results came back positive. He said he immediately isolated in his room, to keep his family from getting sick.

Romero’s was the fifth COVID-19 test the lab processed. According to Tara Hall, Intermountain’s molecular pathology manager, a team of experts had been developing the lab’s testing procedures for just over a week.

“We pushed through and did that in record time, without compromising any of our standards or cutting any corners,” Hall said.

As the lab was getting up to speed, Hall said, “the earthquake hit.”

A ‘long road’ still ahead

The quake on March 18, a 5.7 temblor with the epicenter near Magna, “hit at a time when we were running samples,” Hall said. “It knocked our robotics machine out of alignment and caused quite a bit of contamination.” The lab was out of service for a day, while the machine was realigned, and back up the next day.

Intermountain officials praised the Utah Public Health Lab and ARUP Laboratories for their partnerships. They also singled out the Salt Lake City Mosquito Abatement District, which loaned a key piece of equipment in the pandemic’s early days, that allowed the lab to extract virus samples faster — as many as 96 samples in 50 minutes, Lopansri said.

Romero’s case is an example of how hard COVID-19 can hit even the healthiest person.

For a month after getting tested for COVID-19, Romero said, he suffered flu symptoms that came and went. By the second week, he had trouble breathing, and coughed up blood along with the mucus in his lungs. In the third week, his arms and legs went numb, and he experienced a flashing black-and-white pattern in his vision. In the fourth week, his symptoms included a rapid heartbeat.

In week five, his symptoms started to subside. An avid runner, Romero tried getting out on the track, but “I could barely run half a lap without getting winded and having to take a break,” he said.

Overall, Romero said, it took about a month and a half to feel better — and even then, he felt “just a lot of brain fog” for two or three months.

Lopansri reminded Utahns that, though testing has improved, the best weapon against fighting the pandemic is good public health practices: Wearing a mask, washing one’s hands, keeping physically distant from other people, and staying home if one is sick.

“We have a long road ahead of us,” Lopansri said.