A New Approach to COVID Testing
Scan Delaware Health’s plan could help Delawareans return to their lives
A new nonprofit called Scan Delaware Health has approached state officials with a plan that could help Delaware take another big step toward offering statewide testing for COVID-19 and return residents to work safely.
Scan Delaware Health says it can quickly add testing of 120,000 residents per month — starting with front-line health care workers, first responders and high-risk populations like assisted care employees, their families and residents, populations at risk, critical infrastructure personnel and public works employees.
That would double the number of tests the state is now conducting after buying 200,000 saliva tests from Curative Inc. in May in an effort to add 80,000 tests per month.
Scan Delaware Health plans to conduct rapid antigen and antibody testing of all state residents, and is working with providers to expand PCR testing, going beyond those who have had signs or symptoms of COVID-19 to identify people who have previously recovered from the coronavirus and may have some level of protection from subsequent infections.
Victor Cushman of Wilmington is leading the project. He’s lived in Delaware on and off for more than 50 years, having attended A.I. duPont High School and the University of Delaware. Cushman’s resume includes 18 years at IBM prioritizing and managing R&D projects. He has also served on several federal task-force working groups for critical infrastructure protection, pandemic planning (2003/SARS) and cybersecurity.
Cushman says his team wants to take the pressure off Delaware hospitals, the Division of Public Health and commercial labs for high-volume scaling and testing, adding that the test methods that will be used by Scan Delaware Health are not a “diagnostic test.” Rather, the purpose is to “improve our understanding of the proportion of the overall popula-tion who have previously been infected with COVID-19 as part of ongoing surveillance.”
Under Scan Delaware Health’s proposal to put people back to work in Delaware — including potentially residents of bedroom communities in Pennsylvania and Maryland — the initial screen would find the people who have the virus, then test them later for antibodies, with some verification at the end before they go back to work.
“In Europe, they call it an ‘immunity passport,’ and a combination of testing approaches would cost about $150 per person, which equates to what others charge for a single diagnostic test,” Cushman says. “And you may be able to get that cost down further if you order in volume. By comparison, businesses in Delaware are losing billions of dollars per day by not being open.”
Cushman believes that state govern-ment can’t solve this challenge on its own, adding that plans created for previous pandemics, like the 2003 SARS playbook, are applicable to today’s crisis.
“Businesses need a coordinating hub,” Cushman says.
The Delaware Way: innovation through connections
As is so often the case in Delaware, project momentum was built after a few connections, starting with the state’s public-private economic development agency, Delaware Prosperity Partnership (DPP).
“People come to us with these kinds of innovative ways of thinking,” says Ariel Gruswitz, DPP’s director of innovation. “We are exploring several collaborative Delaware-based innovation projects that could deliver solutions for the pandemic’s challenges. Despite the negative impacts of the pandemic, I see an opportunity for the state’s unique strengths in life sciences, digital technologies and data analytics to deliver solutions locally and globally.”
Helen Stimson, who recently left her role as president and CEO of the Delaware BioScience Association to become chief operating officer at Incyte, connected Cushman with scientific and technology resources that are providing different pieces of the puzzle, including:
ANP Technologies, which was spun off from the U.S. Army Research Laboratory in 2002, has developed two tests that don’t require reagents: a nasal swab test for antigens and a serological (blood) test for antibodies that can be compared to a pregnancy test, says Dr. Ray Yin, founder and president of ANP, which is conducting clinical trials in California and continues to work with the Department of Defense.
- QPS, a global contract research organization located in the Delaware Technology Park, specializes in building novel laboratory tests which are then used by clients to support new drug submissions to the FDA, says John Kolman, the company’s vice president. QPS has developed additional capacity for hospital-grade PCR testing, adding 15,000 tests per month and working around supply constraints.
- Delaware Health Information Network (DHIN) will provide central coordination of records through an electronic network used by hospitals, physicians, labs and other clinical entities to quickly and securely exchange clinical results and reports. DHIN is currently working to obtain approval to support the Apple/Google contact-tracing application in Delaware.
Jennifer Horney, a University of Delaware professor and founding director of UD’s epidemiology program, has trained rapid-response teams in the United States and around the world to respond to outbreaks of novel and re-emerging diseases. The university’s Disaster Research Center, where Horney is a core faculty member, is leading efforts to collect information about community impacts and adaptation.
- CompassRed will provide analytics and predictive analysis that will be crucial to informing the testing and communicating the progress, says founder Patrick Callahan, adding “whether it be machine learning that alerts to higher levels of immediate risk, analytics to support the facilitation of interventions, or simple analytics to inform all parties of current rates of infection, data and analytics will need to be at the core of the solution.”
Cushman says ANP’s tests are critical to quickly identifying the infected, along with those who have immunities. He adds that QPS can deliver scale and additional capacity to testing in Delaware with an approach that does not rely on material shortages currently hampering testing across the country. And finally, Cushman says, Horney’s experience in moving from testing to scale and evaluating the data from an epidemiological viewpoint is a “rare find to have in Delaware.”
Building a better mousetrap
Cushman and Yin came together on the project in a particularly “Delaware way.” After Cushman approached Stimson with his idea, she suggested he reach out to Yin.
The two were already friends whose children were classmates at Tower Hill School, but they had never discussed the projects they were working on.
“Victor has tremendous energy and enthusiasm, entrepreneurial experience, and experience with SARS,” says Yin, who has been working on rapid biothreat detection for nearly 25 years. “Our role is to put our best technical effort behind doing this. We all live in Delaware and we do not want our neighbors getting sick. I’m a test developer and I want my home state to get tested. We’re basically ready to launch.”
The same rapid tests developed by ANP are also being extensively tested by the U.S. Department of Defense right now, after which a production contract will follow. Yin says the group’s test is far more accurate than the temperature tests that people get at airports and their workplaces.
“We can’t afford to wait for a 100 percent solution to reopen Delaware,” Yin says. “Instead, we need to start testing Delawareans immediately with a combination of PCR, as well as rapid antigen and antibody tests so that we will know where the current and past infected people are, and the rate of spread.”
Ensuring test accuracy, data security
“We do a lot of work with clinical testing, which is heavily regulated by the FDA, and we work a lot with antibody-based drugs like Humira,” QPS’s Kolman says. “We’ve built out our facility to enable us to run the needed clinical testing for pharmaceutical companies who are developing vaccines. We have also worked hard to get the necessary processes and approvals in place to allow us to test COVID patients. The pieces are in place.”
Achieving the scale that Scan Delaware Health hopes to achieve is “difficult but not impossible,” Kolman says. “This is in our wheelhouse. The raw materials for these tests can be difficult to get your hands on. But, since we are a service provider and built our own tests, we don’t depend on the same supply chains as others.”
Data from the tests would be secured and delivered by DHIN, which maintains lab, medical and test records for all Delaware residents.
DHIN shares data with the state Department of Health and provides reporting out to doctors, hospitals and the greater medical-care community. DHIN also offers an online portal to patients so they can have access to their medical results and messages in the community health record.
“The initiative is ambitious. It’s inspiring as well as daunting in its scope and scale,” says DHIN Chief Operating Officer Randy Farmer. “We have to help support and explore these ambitious initiatives if we are going to get things back to normal.”
Farmer says that while nine out of 10 ideas like this don’t happen, he’s more optimistic about the Scan Delaware Health initiative. “This is clearly a full-court press and a full-team effort. But coordination and engagement with the Division of Public Health is central to everything that is done in this space.”
“This is a time when you leave no stone unturned,” says Bob Perkins, executive director of the Delaware Business Roundtable, a consortium of state business leaders. “Testing will drive consumer confidence, and you can see all the things that will change if we can figure out testing.”