When molecular diagnostics expert Karen Kaul ’84 MD, PhD, ’88 GME ordered reagents and other supplies for her lab at NorthShore University HealthSystem’s Evanston Hospital in early February, she and her team had been following the coronavirus outbreak overseas for weeks. They figured they’d better be prepared, just in case.
“We hoped we were wasting a couple hundred dollars and that we would never need these supplies,” says Kaul, who chairs the health system’s pathology department. “Obviously, that turned out not to be the case, but we were fortunate to be ready to go.”
And go they did, rapidly developing a COVID-19 test that is now pending approval by the Food and Drug Administration. On March 12, Kaul’s lab became the first in Illinois to offer large-scale clinical testing beyond the Illinois Department of Public Health. Within a week, they were testing 100 patients a day, and now they’re testing about 1,000 patients daily.
“We want to do more,” Kaul says, explaining that her lab tests not only patients coming to NorthShore but also patients at other hospitals and nursing homes across Illinois. “We’ve also taken on testing for one of the state-run drive-through testing sites for front-line responders. We’re working to fill and expand our testing capacity every day.”
Informed by 2009
Kaul’s experience during the 2009 swine flu pandemic has helped guide her approach to coronavirus.
“The H1N1 virus was one of the reasons we started watching this outbreak and thinking we needed to be ready to respond,” Kaul says. “Back in 2009, we found ourselves in a situation where there was testing available through the state labs and the CDC, but results were slow, staff were limited, and the testing capacity just wasn’t there.”
And so, then as now, Kaul’s lab pitched in in a major way, helping ease the burden on the Centers for Disease Control and Prevention and other labs by testing hundreds of people per day.
Today, Kaul’s COVID-19 test generates results in as little as 24 hours, compared with seven days or more elsewhere.
“Speed and breadth of testing are hugely important,” Kaul says. “We need to provide results quickly so that patients can be appropriately managed and isolated if need be. And having testing available in hospitals all over is really critical for managing acutely ill patients.”
Staying safe, rallying together
Kaul’s lab is used to working with infectious disease samples and taking every possible precaution. But the unpredictable nature of COVID-19 and the dynamics of a busy, fast-paced clinical lab demand additional safety measures.
“The lab is crowded. We have lots of people working here,” Kaul says. “So, if someone contracts the disease and they unknowingly infect or expose their co-workers, we could have a whole lab shift go down.”
Kaul’s team has been working around the clock for weeks, adapting to increasing national anxiety and ever-changing circumstances.
“We’re learning as we go because this all came on so quickly,” Kaul says. “This is a disease that wasn’t on our minds half a year ago, and now things are changing fast in terms of needs and issues and treatments. We all feel a sense of purpose and pride in what we're doing, and it’s been amazing to see this work come together, but people are definitely tired, and this is tremendously challenging.”
Erin McElvania, NorthShore’s director of clinical microbiology, says Kaul is uniquely suited to leadership during these chaotic days.
“Karen is calm under pressure and the consummate professional even during times of high stress,” McElvania says. “She has been very hands-on with laboratory testing during this pandemic. On top of that, she is always checking in on staff to make sure they are doing well and have the support they need during this difficult time.”
Looking forward with hope
Kaul remains optimistic that shortages of personal protective equipment, nasal swabs and other critical supplies will ease in the near future, as manufacturers and others adjust to the needs of the health care community. And while she expects the virus “to be with us for a while,” Kaul is buoyed by her state’s proactive response and hopes for an effective treatment and vaccine.
In addition to testing for active COVID-19, Kaul’s department is also helping evaluate antibody testing, which would indicate if a person has been previously exposed to the virus. The hope is that these tests would help determine who could safely come out of quarantine and social isolation, but Kaul says right now, too much is unknown.
“An accurate, clinically validated antibody test would certainly indicate exposure, but we don’t know if COVID-19 antibodies will really confer immunity and, if they do, how long-lasting that immunity will be,” Kaul says. “There are still so many questions that we need to answer.”
One thing’s for sure: Kaul and her team will be a part of that effort.