A Behind the Scenes COVID-19 Battle

On March 10, 2020 Southeast Georgia Health System received notification from the Georgia Department of Public Health (GDPH) that a patient treated at the Health System’s Camden Campus preliminarily tested positive for Coronavirus (COVID-19). Due to the novelty of the virus, initial testing had to be outsourced which caused delays in receiving the exceedingly necessary results.

Health System Vice President DelRia T. Baisden, FACHE, recalls those tense early days. “There were so many unknowns about this highly contagious virus in the beginning. But one of the things we did know was how important it was to identify and isolate positive COVID-19 patients to reduce the risk of additional infections.”

“We needed to know if patients had COVID-19, and we needed to know fast,” says Patrick Godbey, M.D., FCAP. “If a patient tests positive, they require one-on-one care in an isolation room and use of what was then very limited PPE [personal protective equipment]. Each positive COVID test represents a huge financial decision and commitment of resources. When the pandemic first began in Southeast Georgia, we had to send COVID tests to the state laboratory first, and then large reference laboratories as commercial testing products were not yet available.”

In addition to serving as the Health System’s Department of Pathology Chief and Laboratory Services director, Godbey is the current president of the College of American Pathologists (CAP).

Three weeks after Southeast Georgia Health System admitted its first COVID-19 patient, the Laboratory Services department achieved “the Easter Sunday breakthrough,” says Godbey. “By Easter Sunday, we brought testing in-house. That’s a testament to Brendon and our lab staff.”

Godbey is referring to Brendon Winstead, MT (ASCP), FACHE, and his team of medical technologists who worked nights and weekends to get testing up to speed. Winstead is the Director of Laboratory Services, which includes Phlebotomy, Chemistry, Hematology/Urines/Coag, Microbiology and the Blood Bank.

Overcoming Hurdles
To imagine the challenges the lab faced, picture a team of runners racing against the clock while jumping hurdles, on a race track full of potholes. “It took time for manufacturers to develop in-house tests. Companies who had never produced tests began selling them, but we had to evaluate the testing equipment instrumentation, the test quality and the companies’ track records,” Winstead says. As Godbey points out, “Inaccurate test results are worse than no results. It takes tremendous effort to validate and obtain accurate test results, and the majority of diagnosis and treatment decisions begin in the lab. We kept the bad tests out of our lab!”

The hurdles included supply shortages and shipping delays. “We had to search for reagents, pipettes and swabs. Areas not even related to COVID testing were impacted by COVID related shortages, for instance, the agar plates used for growing bacteria. It was terribly time consuming,” explains Godbey. “We added a third shift in Microbiology to help with the increasing COVID testing, hired agency medical technologists and worked overtime making sure that everything was processed and supplies were ordered. We did whatever needed to be done,” Winstead recalls. “It was truly a team effort and I’m so grateful to have such a wonderful group of people working with me in the lab.”

Leading the Charge
For Winstead, that meant rolling up his sleeves and sitting down at the bench. Although he had not processed and tested samples in years, he worked alongside his team to expedite the process. Though he believes that any good leader should demonstrate their willingness to do whatever the job takes, Godbey says, “Not many lab directors would do that. The pandemic required tremendous effort from the entire microbiology team and no one deserves accolades more than Brendon.” Baisden concurs, “Brendon was key in determining how to diversify our testing platforms to counteract supply shortages, while constantly focusing on quality. Additionally, his leadership led to in-house testing very early in the pandemic. At one point, facilities were waiting several days for COVID test results from reference laboratories. Providing faster results for our most critically ill patients was extremely important to patient care.”

Innovating around Obstacles
For every obstacle the lab encountered, they found a solution. For example, they kept up with the increasing COVID-19 testing demands by sending less time sensitive tests to off-site labs, freeing up vital supplies and instrument capacity. Winstead worked with the Health System Supply Chain Services department to source hard to find testing supplies, which Godbey says will pay dividends into the future. The lab leaders and staff educated Health System leadership and medical staff about which procedures worked, and which didn’t. “We educated them about certain antigen methods that should and should not be used, and they listened,” Godbey says. He is grateful hospital leaders didn’t ask the lab to take short cuts.

World Class Care
As president of CAP, Godbey inspects labs around the U.S. and the world. He holds the Health System labs to high standards, and they have not fallen short. “Our lab measures up against any I have ever visited. Our lab and blood bank are the most regulated square footage in the hospital.”

Speaking of the blood bank, coronavirus impacted those services, too. “We experienced huge shortages because churches and employers were closed, and that’s where donations happen. We got by because elective surgeries were cancelled. Thankfully our supply is good now, but we typically experience shortages every summer,” Godbey says. The blood bank also played a pivotal role in treating patients with COVID-19. “We were one of the first places to get convalescent plasma. We had to rewrite the treatment procedure three times to comply with ever-changing FDA guidelines.”

The Laboratory Services team has always worked behind the scenes, but the pandemic underscored their contribution to a global health crisis. Baisden says the lab was pivotal in helping the Health System handle the situation. “Our patients will likely never meet most of our laboratory team members but they are an essential part of the health care team here and committed to providing the best possible patient care.” Today, all COVID-19 testing is done in-house. Combined, the Brunswick and Camden Campus labs run about 200 coronavirus tests a day, which includes Emergency Care Center and pre-surgical patients as well as staff and residents at the Senior Care Centers. Fortunately, Winstead says that positivity rates are down.

Reflecting on the labs’ performance during a historic health crisis, Godbey reiterates his belief that, “There is no lab better than ours, and I have visited labs all over the world.”