UIHC Now Has In-House COVID-19 Testing, But Officials Warn It's Still 'Limited'

Mar 24, 2020

The University of Iowa Hospitals and Clinics can now run its own COVID-19 testing in-house. Hospital officials say the step will help free up other testing resources across the state, which are integral to responding to the disease. Public health officials say testing is critically needed in order to gauge the disease’s spread and respond to it, and the development comes as the country faces a nationwide shortage of testing supplies.

As of now, the state’s largest hospital has the ability to meet the testing needs of all of its own COVID-19 patients, which a lab staffer says is “encouraging," though hospital officials caution the scale of the testing is still “limited."

Currently, the UIHC testing will only be available for the hospital’s qualifying patients and not the general public.

“Importantly, just because testing is available, it doesn’t become, anyone who wants a test can get one, as much as we’d like that to be the case,” said Bradley Ford, Director of Clinical Microbiology at UIHC. “That’s not where the nation is as a whole with respect to testing.”

Importantly, just because testing is available, it doesn't become anyone who wants a test can get one, as much as we'd like that to be the case. That's not where the nation is as a whole with respect to testing. -Bradley Ford, Director of Clinical Microbiology, UIHC

According to a spokesperson for UI Health Care, testing is currently limited to patients who have had a video visit with the hospital and are directed to a specific clinic for testing, or those who are inpatients.

Still, the development will help expand the state’s overall capacity, said Jennifer Brown of UIHC Marketing and Communications.

“Bringing UI Hospitals & Clinics testing online improves statewide testing capacity, which until now has relied almost exclusively on the State Hygienic Lab,” Brown said in an email.

Some national private labs have also been conducting COVID-19 testing for Iowa patients.

Having in-house testing capability will allow UIHC providers to be more flexible in their testing criteria for patients than the Iowa Department of Public Health is, according to Ford.

“I would say it is slightly more flexible,” Ford said. “But we are still trying to test the sickest patients and stick more or less to IDPH recommendations, which are good ones.”

The State Hygienic Lab and IDPH currently adhere to recommendations informed by guidance from the Centers for Disease Control and Prevention. Those standards limit testing to hospitalized patients with fever and respiratory failure; adults over the age of 60 with fever and respiratory symptoms and chronic medical conditions; people with symptoms who live in group settings such as a nursing home or correctional facility; and essential services personnel with symptoms, such as police officers or health care providers.

If a UIHC patient does not meet the criteria outlined above, providers can still request the patient be tested if they have “clinical suspicion for COVID-19."  Still, a notice to providers explains, testing will be prioritized for those patients “for whom test results will have a clear impact on clinical management."

Those [State Hygienic Lab criteria] are for tests of public health significance and so that's why the criteria is in place. That has expanded over time. To the extent that additionally testing capacity exists at the State Hygienic Lab, we might see that continue to expand further. -Sarah Reisetter, Deputy Director, Iowa Department of Public Health

And the scale of testing may be limited by demand, by key supplies such as swabs, and by the availability of laboratory staffers.

Ford said he has drafted a plan to scale up lab staffing from a single shift to seven days a week, early mornings, second shifts and potentially a night shift to get testing to full capacity.

IDPH Deputy Director Sarah Reiseter told reporters Tuesday that even with the UIHC’s expanded capabilities, the state does not currently have plans to adjust its own testing criteria at the State Hygienic Lab to be more flexible. But she said the criteria have been loosened in the past, and it’s possible that could happen again.

“Those [SHL criteria] are for tests of public health significance and so that’s why the criteria is in place,” she said. “That has expanded over time. To the extent that additionally testing capacity exists at the State Hygienic Lab, we might see that continue to expand further.”

Still, Ford said testing is a key factor in helping providers diagnose and treat hospitalized patients, those who are sickest with the disease caused by the highly contagious novel coronavirus.

As providers brace for a potential surge in COVID-19 patients, this testing capability is expected to help them better manage the influx. Accurately gauging which patients are infected can help providers limit the spread of the virus, and protect themselves and other patients, while conserving critical supplies of personal protective equipment or PPE.