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Embracing Change

The pivot into COVID testing and the start of Rize Laboratory

A new beginning

What looked like it might be the end of Willamette Valley Toxicology (now Rize Lab) turned out to be a critical turning point. It’s March 2020 — shutdowns looming, the gravity of the pandemic weighing more heavily every day. Manny Cruz, owner of then WVT Laboratory, had just been forced to furlough almost all of the lab staff. Down to a team of just four, they were looking at continued slowing in toxicology testing due to the pandemic. Shutting the lab’s doors for good became a serious possibility.

Known to pivot instead of throwing in the towel, Manny had a vision for helping the community through the pandemic. COVID testing early on was taking 7-10 days for results which was just not acceptable. The spread was too fast, and we needed faster results to help contain it and protect the public. We have a lab after all; what would it take to offer COVID testing? We don’t have the right equipment, but we do have plenty of experience and the necessary federal accreditations. What can we do?

At the same time just across town, Mark Ackermann, DVM, Ph.D, then director of the Oregon Veterinary Diagnostic Lab (OVDL) at Oregon State University, and Justin Sanders, Ph.D, Assistant Professor of Research and Section Head of Molecular Diagnostics at the OVDL, have a similar vision for increasing access to testing. The veterinary laboratory has tons of equipment designed for high-volume outbreak testing and research. However, due to regulatory limitations and strict protocols, they also have one major problem — they can’t test humans. What can we do?

We knew we had the pieces and we could run these tests with the infrastructure and instrumentation at the OSU lab. We just needed to work through a lot of red tape in order to run human samples with our equipment.

Justin Sanders, Ph. D

Frustrations mounted as calls come in from hospitals and public health directors asking for help. The toxicology lab wasn’t outfitted for it. The OVDL wasn’t allowed to test.

One key ingredient the Oregon State lab did have is the ability to make some of their own supplies from scratch. Clinical labs typically buy their supplies, and labs immediately started to run out of viral transport medium (VTM). The team at the OVDL was making their own. This caught the attention of Bruce Thompson, MD, Benton County Health Officer at the time.

Bruce introduced the teams from WVT and OVDL, helping the collective vision start to become reality. It didn’t take long for this small, dedicated crew to start conceptualizing how to join forces. This unlikely pairing of labs — veterinary diagnostics and clinical toxicology — allowed everyone to see the very real potential to offer this much-needed public health service. Seeing the potential was all they needed to say yes and hit the ground running.  

“We can do this”

No small feat, even for a team with their combined expertise, the transition from clinical toxicology into molecular diagnostics involved much more than simply putting the right equipment into the right space. The instrumentation for molecular diagnostics is very different from what WVT was used to. In addition to leasing the equipment from the OSU lab, WVT also needed more staff and to train that staff on this new equipment. Justin Sanders dug in alongside the WVT crew to share expertise, provide training, and help with setup of all the equipment.

In addition to instrumentation, COVID testing also requires specific equipment and tight protocols to avoid cross-contamination. That equipment included a borrowed bio-safety cabinet to ensure staff safety while opening infectious samples and a huge freezer that can keep samples well below freezing.

This may be a good time to mention the lab space we’re working with. These are not small pieces of equipment. The Rize lab space today is almost 3x bigger than what we had in those early days. That bio-safety cabinet (which we now have four of) takes up about 12 square feet of floor space and is a little over seven feet tall. In the renovated office space that is now Rize Lab, that cabinet needed to be moved up the stairs as it was too big for the elevator. That huge freezer? It had to be partially disassembled just to fit through the doorways, with some pieces coming up the stairs and some luckily fitting in the elevator.

And that’s all just to be able to start testing. Now the real challenges begin. This all happened in early April of 2020. You’ll likely recall the supply chain issues — maybe you couldn’t seem to find masks and gloves or perhaps your local store sold out of toilet paper? The Rize crew ran into these supply issues constantly. This is high-volume testing at a very high-demand time. You name it, they probably ran out of it at some point, often needing to drive to a state lab in Hillsboro to pick up supplies and even ordering what they could find in stock on eBay.

You know Manny, he’s a ‘we can do this’ guy.

Justin Sanders, Ph. D

Of course, where there’s a will, there’s a way. And between these two lab crews, there was always a will.

Now we had the equipment, the knowledge, and the capacity; we just needed samples. With all of the confusion around testing at the time, people didn’t know where to begin. We started to get periodic samples from some area hospitals. Justin was also part of TRACE, a community testing and research team at Oregon State University. The TRACE collection efforts brought in more samples but again, not the volumes we had outfitted the lab to handle. We were ready for more.

Don’t get me wrong, it was a dark time, but it was also really special meeting that group of people and being able to move so quickly.

Justin Sanders, Ph. D

There’s one more piece of this puzzle that’s been coming together in parallel: building partnerships with long-term care communities. Knowing that these populations could potentially see some of the most devastating impact from the pandemic, we built our process with them in mind and reached out to offer ongoing testing support. This was a huge turning point. The bulk of our early samples came in from long-term care all around the state. Now with nearly one million tests completed at Rize Lab, more than half have come from long-term care partners.

Onward and upward

It likely goes without saying that a lot has happened since those early, overwhelming days scrambling to figure out what the pandemic would mean and where things would go next. We’ve tripled our lab space, more than doubled our equipment, added almost 100 staff, and can run as many as 15,000 COVID samples a day in addition to our toxicology testing, which has also bounced back since those early declines.

What’s exciting is the amount we’ve learned and the potential we see ahead. We now have team members who are experts in COVID testing programs for schools and organizations, logistics, and long-term care to name a few. We have robust software for managing COVID test result data and for tracking our courier network. We’re able to partner effectively with county and state agencies, other labs, and care providers across the country.

Perhaps most exciting is that we’re now starting to apply what we’ve learned in other areas, providing research as a service, continuing to develop new tests, and exploring emerging pathogens. We’re also expanding our toxicology offerings and are currently adding to that side of the operation.

We’re also looking at all types of molecular-based diagnostics. There’s a lot of potential to leverage the equipment and expertise we’ve gained through the pandemic to expand into more specialized testing. Our region represents something of a desert in the molecular diagnostics space. Specialized genetics testing, as one example, is typically sent to bigger labs outside our region. We’re looking to change that.

The future looks bright.

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