As of March 16, there were 4,200 confirmed cases of COVID-19 in the United States and more than 179,000 cases globally. More than 7,000 people worldwide have died from the disease, which causes mild to severe respiratory illness. The disease is particularly dangerous for elderly people and those with pre-existing health conditions, including heart disease, diabetes and lung disease.

The Clinical Virology Laboratory is providing testing services not just to Stanford Health Care, but also to several hospitals in the Bay Area. A drive-through testing site also has been established at Stanford Health Care’s same-day primary care clinic in Palo Alto.

More testing needed

More testing is needed to identify people infected with the coronavirus and their close contacts who may be infected but are not yet experiencing symptoms. Quarantining exposed people before they infect others is an important way to slow the spread of the disease, which is transmitted through the air via respiratory secretions when infected people cough or sneeze. 

On Feb. 29, the Food and Drug Administration announced that it was relaxing the restrictions on the use of diagnostic tests developed by laboratories in the United States for COVID-19. Prior to the announcement, doctors had to rely on public health laboratories or the Centers for Disease Control and Prevention to test samples from patients — a process that could mean several days before learning the results. 

Pinsky’s team in the clinical virology laboratory began providing Stanford’s in-house diagnostic test earlier this month for clinical use after working through January and February to ensure it met United States’ testing guidelines for clinical use. The team has spent the past 10 days rapidly increasing Stanford’s testing capacity to meet the growing need for testing by health care providers around the Bay Area and beyond. 

Aid in scaling up the Stanford test has come in the form of donated equipment from other Stanford laboratories and the reassignment of staff to help perform the testing, as well as the production at Stanford of some test components in short supply, such as the primers and probes used to amplify viral genetic material in patient samples.

“The coordinated response by researchers and administrators throughout the hospital and across the university to help us increase capacity and reduce our reliance on outside suppliers has been remarkable,” Pinsky said. In addition, the team is working to implement and validate another testing platform and to work directly with companies to obtain reagents that can’t be made at Stanford.

Support of clinical trial

The Stanford virology lab will also provide support for a recently launched clinical trial to test the efficacy of the antiviral drug remdesivir in treating people with the virus. Remdesivir, which inhibits the replication of viral RNA, was recently shown to block the ability of the novel coronavirus to infect monkey cells grown in the laboratory. It is currently under clinical development as a possible treatment for infection by the Ebola virus. 

“Very few other places in the country are capable of providing this scale of COVID-19 testing at this point,” Pinsky said. “Fortunately, we had the foresight in January to imagine that the ability to provide testing for COVID-19 would be important, and we worked hard to make that happen.”