Wearing blue lab coats and rubber gloves, microbiologists bustled through a lab at Henry Ford Hospital in Detroit on Tuesday morning, charged with a new mission: To test as many patients as possible for COVID-19, the disease caused by novel coronavirus.

Henry Ford Health System became the first hospital system in Michigan to adapt the U.S. Centers for Disease Control and Prevention's test kits, and develop a way to test samples collected from its patients in its own lab — and deliver results on the same day.

It now has the capacity to run 100 tests a day — with priority given to patients who are already hospitalized, those in the emergency room and health care workers — and hopes to be able to ramp up testing so it can handle as many as 1,000 samples a day. Results of its in-house tests are available in three to four hours, if working at optimal speed.

"They've been working around the clock," said Dr. Richard Zarbo, chairman of pathology and laboratory medicine for Henry Ford Health System.

Of the first batch of patients it tested Monday, about 10% came back positive for COVID-19, Zarbo said, noting that the tests were run on hospitalized patients who were already symptomatic, and at high risk for COVID-19.

Other hospital systems are fast on Henry Ford's heels.

Beaumont Health announced Tuesday afternoon that it, too, now can do limited same-day testing of COVID-19 samples in its Royal Oak lab using a commercial vendor that has gotten emergency authorization from the Food and Drug Administration.

It began running tests Tuesday, and can perform a few hundred tests a day, said Mark Geary, a spokesman for the health system, adding, "the number will likely change dependent on access to supplies."

Because there is a national shortage of reagent materials, compounds used in the testing process to create a chemical reaction, it limits Beaumont's capacity to use that commercial test.

Geary said Beaumont is working to adapt the CDC test for use in its labs as well.

“We’re proud to have developed a mechanism to process tests within our health system," said Dr. Barbara Ducatman, chief of pathology and laboratory medicine for Beaumont Health, in a news release. "It typically takes months to do this and we did it in several days. Our lab team’s expertise has allowed us to serve our patients better during this pandemic."

Lansing-based Sparrow Hospital launched processing of the CDC test for COVID-19 in its labs on Sunday — a day ahead of Henry Ford, said Dr. James Richard, medical director for Sparrow Laboratories. While its labs can't run tests in a few hours, as Henry Ford and Beaumont can, Sparrow now has a capacity to run about 60 tests in 24-48 hours time.

The process is precise and complex, and the risk is high for DNA contamination, Richard said. It requires highly-trained staff to do the work.

"We've been training staff, doing the testing, doing the preliminary testing the validation and verification necessary before we could even produce our first result," he said. "The intensity the techs have to have in order to do this on the preparation side, ... you have to be exact with things. It's It is very challenging."

People who weren't trained to do that kind of work pitched in by emptying trash cans, refilling lab supplies and offering support to those who were racing to get a test up and running, he said.

"Everybody knew that it was important to get it done. We had full staff working overtime over that whole weekend trying to get it done and up because we knew we were close," he said. "... I can't be more proud and humbled by the staff that took care of it."

Michigan Medicine also is working to adapt the CDC test kit for COVID-19 at its lab in Ann Arbor.

"It's a complicated process. It's been complicated from the beginning," said Duane Newton, director of the clinical microbiology lab at Michigan Medicine, which is affiliated with the University of Michigan, in an interview March 13. "... The exact time frame is not entirely clear. Tomorrow is dependent upon what happens today. ... We know more each day. We are moving forward and progressing very well.

"We will have a capacity that will meet our short-term needs when we go live and we expect that to increase over time."

The race to test

At Henry Ford's Detroit hospital on West Grand Boulevard, dozens of red-capped vials were lined up in a rack on a counter top in the lab — all new samples ready for COVID-19 testing. More specimens were stored in pink buckets in a refrigerator. One was labeled in-patient, another emergency room and a third outpatient.

The hope is that Henry Ford's lab can help reduce the strain on the public health system, and give a boost to a nation that has lagged in surveillance and testing for the virus amid an outbreak that has reached pandemic proportions.

"The testing capacity as of yesterday across the United States was 36,800 tests per day," Zarbo said. "That's 36,800 and we've got a population of more than 300 million.

"So we contributed another hundred to that. The entire state laboratory systems across the U.S. do 3,100 tests a day. That's 3,100 tests for 300 million people.

"If we don't have more laboratories, academic laboratories, sophisticated laboratories like Henry Ford doing this, and contributing, we're not going to be able to keep up with the testing requirement.

"If we don't know what we're dealing with, then everybody gets the disease. How do you understand who you have to isolate?"

In Michigan, 65 people had tested positive as of Tuesday afternoon for the virus. Nationally, there were about 6,330 cases and 106 deaths, according to the Johns Hopkins COVID-19 Global Case Tracker.

"It is well-known that across the country there are challenges with people being able to get a test for COVID-19," said Dr. Joneigh Khaldun, chief medical officer for the Michigan Department of Health and Human Services in a video message posted Tuesday to YouTube.

"We recognize this and because of that, we are working with our hospitals, our private labs and our medical providers to expand testing capacity across the state. We are working hard every day to make sure you get the information that you need as quickly as possible."

The MDHHS changed its coronavirus website earlier this week so it no longer includes details about how many COVID-19 samples have been tested at the state labs.

The MDHHS did not respond to a Free Press message seeking updated information Tuesday about how many Michiganders have been tested or what the backlog now is of samples that have yet to be tested.

As of Sunday, before the website was changed, it reported 389 people in Michigan had been approved for novel coronavirus testing. At that time, it said 30 test results were pending.

Zarbo applauded Gov. Gretchen Whitmer for taking fast action to restrict large public gatherings and closing schools, bars and restaurants, especially knowing that Tuesday was St. Patrick's Day, which usually draws out hoards of revelers.

"That would be the worst thing that we could do is to continue to spread it unknowingly," Zarbo said. "So we basically try now to treat everybody like they have COVID-19."

Testing is slowly making gains

Linoj Samuel, Ph.D., and division head of the Henry Ford microbiology department of pathology, said the testing situation in Michigan and nationally is slowly catching up to demand, but it's been a struggle.

"I know that the state lab has a backlog of samples," he said. "They've tried their best to help us in terms of providing samples for validation ... and that's been a very good collaboration and we talk to them almost every day."

The United States simply does not have the capacity yet to broadly test people who are asymptomatic, Samuel said, though it's trying to get there.

But Americans should prepare for COVID-19 to be around and spreading in the community for quite some time, he said.

"If you look at the history of other pandemics, this will put us into the summer, most likely," Zarbo said. "Look at the 1918 influenza pandemic. That one unfortunately came back gangbusters into a second year. We don't know the nature of this one.

"This is a once in a 100-year problem — so 1918 to 2020, and this is our opportunity to step up and do the right thing."

Robert Tibbetts, Ph.D., the associate director of microbiology at Henry Ford Health System, explained that the plan is to run the samples of the sickest patients first.

"We're prioritizing the in-house testing for the inpatients and the emergency department patients because they're the most critically ill," said Tibbetts. "Your patients are coming in and they have a flu-like symptoms. They would send those people home and say quarantine for four or five days until we get your results back."

The people whose symptoms are not severe enough for hospitalization are now being sent to outside labs for testing, and results come back in days rather than hours.

Tests for health care workers also get fast-tracked, Tibbetts said.

"It's crucial that we get their results quickly because of the potential for spread," he said.

Right now, the process is very time-consuming, labor intensive, and requires highly specialized microbiologists who are trained in molecular virology. But the hope is to automate the process so it can move much more quickly, and deliver results for up to 1,000 patients a day.

"The second we realized that we could pull the trigger on this, that's when we did it," Tibbetts said. "That's when we got volunteers. ... and mobilized everything. They stayed late, worked overtime, came in on the weekend to make sure the test was done right."

For now, he said, there are enough supplies to continue running tests and collecting samples.

"There are reports of potential decrease in the supply quantities," he said. "I know that a lot of the vendors are ramping up production. I think the caveat is that we need to really focus our testing on the right people, because if we don't, we will run out.

"And when we run out, the people that suffer are the ones who really, really need the testing, and that's the most vulnerable population. So we can't we over-test. We need to know what's in the community, but we can't overdo it because we will run out."

Samuel he said it's vital for people to understand that as hospital systems, including Henry Ford, launch drive-up clinics where people can have samples taken for COVID-19 testing, they still can't test everybody who wants to be tested right now.

"It doesn't mean you can just drive up and get it," he said. "A lot of perfectly healthy people I've heard have shown up in the drive-through and been turned away, which is the correct thing to do.

"We have to focus on the sicker patients," Samuel said, which means it can be three or four days for others to get test results. "I hope people understand that that's the timeline that they're going to be looking at."

While they're waiting for a result, however, Samuel said, "they still need to quarantine themselves."

And rather than just showing up at a drive-thru screening center, Samuel said people who have COVID-19 symptoms such as fever and cough should stay home and contact their health care provider to get instructions about what to do next.

Contact health reporter Kristen Shamus: kshamus@freepress.com or 313-222-5997. She can also be reached by encrypted email at kristenshamus@protonmail.com.

EDITOR'S NOTE: This story has been updated to include details about testing now also being done at Sparrow Hospital's labs.