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We know that testing is essential in identifying and slowing the transmission of COVID-19. At the start of the outbreak, tests were reserved for only the sickest patients with a history of travel or contact with other confirmed COVID-19 cases, and limited testing made it difficult to detect just how many people were infected through silent community spread.

The landscape of testing has significantly changed since February. From UW Medicine’s development of the COVID-19 test to the first drive-thru test clinic to free Seattle-wide tests, and now antibody testing, researchers and public health officials have a better scope of transmission.

From your nasal cavity to the lab

When a provider orders a COVID-19 test, often a nasopharyngeal swab, that test goes from your nose to the lab and the results are sent back to the provider. But one intermediate step that often gets overlooked is the transportation of specimens by medical couriers.

In March, UW Medicine’s Virology Lab ramped up its testing to over 1,000 tests per day. And both the medical couriers and lab technicians stepped up to meet these demands.

Jack Davis, Reference Lab Services (RLS) courier lead, says that the first step they took was setting up extra routes to the UW Medicine Virology Lab, the lab performing the majority of the COVID-19 testing for UW Medicine patients and staff among many others in the state and region.

“It seemed everyone wanted to get tested by UW Medicine,” says Davis. “As a result, courier workloads and how that work got done quickly became much more complicated.”

The couriers regularly cover territory from Olympia to Ferndale and as far east as Moses Lake using a route-based system. Some of those routes include 10-hour drives. As carrying volumes increased, some routes were adjusted with added stops to accommodate testing for first responders. Eventually, other employers and entities that needed time sensitive test results were also added into the mix.

The RLS courier team quickly adapted a more fluid approach to their driving routes as the test volumes rapidly increased.

Driven by service

Davis describes the beginning of March as a nervous time. They were having a lot of trouble acquiring personal protective equipment (PPE), and sanitizing wipes and hand sanitizer were nearly impossible to get. Everything was in a state of flux.

To complicate the changes to driving routes and the additional personal protection precautions, Davis says that the handling of the COVID-19 samples themselves was an added hurdle. The high-priority refrigerated swab kits are volumetrically large when compared to something like the antibody test, which is a blood sample that requires a smaller test tube. Now apply those volumetric considerations to the additional thousands of samples per day that require transport and the logistics quickly become quite challenging.

But the couriers did what they needed to do to get the job done.

“I was impressed by how everyone in the group stepped up to the plate, even when we were unsure how we would make this happen or how it would impact us on a personal level,” says Davis. “We are just one part of the system, but we’re a critical part that most people don’t even think about.”

UW Medical Center RLS couriers are on the road every day of the year. They weather rain, snow, wind and even pandemics, but it is the service aspect of their job that keeps them going.

“One thing we try to teach when we hire is that you aren’t transporting specimens, you are transporting people and lives,” says Davis. “What’s in that test kit means something to somebody.”

In King County, over 190,000 people have been tested since January. The medical couriers have increased the number of routes from nine in March to 16 in June. Their hours are long and their routes take some serious logistical planning, but our medical couriers are dedicated to UW Medicine’s mission to improve the health of the public.

Like many of his fellow couriers, before joining UW Medicine 13 years ago, Davis had a different career. He was a boat builder, who never imagined working in healthcare let alone during a pandemic.

“If anyone told me I would be working in a hospital and enjoying it, I would have laughed and thought they were crazy,” says Davis. “But over time I’ve come to appreciate that sense of service aspect of the job that people talk about. It really is meaningful, and although it may sound hokey, it carries its own sense of value. It feels good knowing that what you do makes a difference in the lives of others.”

 

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