Arizona State University's Biodesign Institute hopes to dramatically increase available coronavirus testing by using robots that can process a high volume of samples simultaneously, with a goal of opening a drive-thru testing site for the general public as early as Monday.

By using robots to process the samples, Biodesign Institute executive director Joshua LaBaer said, ASU can offer testing at a faster rate than state and hospital labs.

Faced with a testing kit bottleneck, health care officials and the state have lacked the ability to conduct widespread testing to screen for the virus, even among those who may be exhibiting symptoms or who are at risk already. If successful, ASU believes it could provide a crucial service that could start to turn the tide in fighting this outbreak.

"This is critical because if we’re going to be able to separate those with the infection from those that don’t have the infection we need to know who's infected," LaBaer said. "If we don't, then this thing is going to multiply exponentially, and then that's when the hospital systems will become overwhelmed and physicians will have to be making decisions as to who goes on ventilators and who doesn't. We don't want that to happen."

Currently the testing capabilities of the state of Arizona are relatively limited, with only 265 people tested by the state lab to date as of Wednesday afternoon. This is because much of the sample processing has to be done by hand, with individuals transferring liquids from one tube to another, meaning that only one or a few samples can be handled at a time.

As a research institute, ASU has unique resources that could enable the university to dramatically ramp up testing, such as the robots that can automate the processing of samples and devices that can read results for many samples at the same time.

"The goal will be to automate as much of this as we can to expedite it," LaBaer said.

The university is hoping to test 400 samples a day to start, and build up to running over 1,000 samples a day.

ASU has not yet decided how many samples per person the institute would test, but LaBaer said the university is prepared to work with only one sample per patient depending on the pace of the epidemic spread and the demand for testing. That would allow more people to be tested.

'We need to be thinking big'

One of the biggest challenges currently is getting materials needed such as swabs, tubes, and ingredients that stabilize the virus until samples can be tested. Those materials have been in short supply.

"Hospitals can't find them," LaBaer said. "But we're a university, we can make them."

This is an option that ASU is investigating while they actively hunt for testing kit supplies. The university would prefer to use pre-made kits because they go through careful manufacturing and quality assurance analysis, LaBaer said, but will work with the Arizona Department of Health Services on the possibility of having the university produce kitsif possible and if needed.

"We'll have to worry about the regulatory part later because it won't be approved and sealed and signed," he said. "But if they get the job done and if they save lives, that's what matters to me."

If the university isn't able to get or produce enough testing kits, the drive-thru testing could be limited to just members of ASU's community, such as students and faculty. But LaBaer said they would rather be aggressive with the ambition to test as many people as possible, because early interventions are crucial to saving lives.

"We need to be thinking big and we need to be thinking bold," he said. "I'd like to go live Monday. That's my goal."

Currently the only places offering drive-thru testing in Arizona are Mayo Clinic and Coconino County in northern Arizona. Mayo's testing is reserved for Mayo patients who have a doctor's order and Coconino County's tests, which are being processed by the Translational Genomics Research Institute, are only administered to people with a doctor's orders.

LaBaer said it's still unclear how ASU's drive-thru testing site would work if it is open to the general public and whether a doctor's order or appointment would be needed to get tested.

"There's a lot to think about in not much time to think about it," he said.

However, university employees are currently working around the clock to set everything up. In thinking through logistics, they're modeling their approach after what has worked successfully in other countries such as South Korea, where widespread testing has helped curb the spread of the disease and number of infections.

The advantages of drive-thru sites

The drive-thru testing model offers several advantages, according to LaBaer, which include speed of testing, sites where people could potentially come in and out in 10 minutes to get their sample collected, and limiting the spread of infections that could occur in clinics.

In addition to testing kit supplies, LaBaer said ASU would need tents, tables, people to collect and process the samples, personal protective equipment for those people, and an informatics system that can code and track each patients' sample to match results to individual patients.

What's unclear is how the university would fund the process.

"ASU doesn’t have any way to bill insurance. We don’t know how to pay for this, but our primary concern is acting before it is too late. Hopefully the government will help us eventually," LaBaer said. "Obviously, you know, ASU has a foundation and there's always a need for support because none of this is easy or cheap."

The tests will rely on a well-known technique known as reverse transcription polymerase chain reaction, otherwise shortened to RT-PCR. This is the same type of testing used by the Centers for Disease Control, but tweaked to fit the university's needs.

The clinical-grade substances, or reagents, needed to cause a reaction for this type of testing only became available to order last week, according to LaBaer, and ASU finally received the order of the substances they needed on Tuesday.

'We don't have a lot of time'

The university already had the expertise and facilities to immediately start using the materials and set up testing. A lab that was approved for a separate research project to test people for radiation exposure had the necessary biosafety measure in place — such as specialized safety hoods, negative room pressure and machinery that met strict regulations — to test samples of the new coronavirus.

"It occurred to us that we could repurpose those exact facilities to specifically focus on testing for this virus, and that's what we're doing right now," LaBaer said. “We’re basically just swapping out the genes for radiation testing for this new coronavirus.”

A lot is still unsettled at the moment, but the university is working out details and collaborating with other health care organizations around the state and expects to have more information in the coming week.

"If the state of Arizona collapses under not being able to test people because we don't have kits available, that's just crazy," LaBaer said. "We don't have a lot of time here. And so we have to do what we can do with what we have available."

Amanda Morris covers all things bioscience, which includes health care, technology, new research and the environment. Send her tips, story ideas, or dog memes at amorris@gannett.com and follow her on Twitter @amandamomorris for the latest bioscience updates.

Independent coverage of bioscience in Arizona is supported by a grant from the Flinn Foundation.

Support local journalism. Subscribe to azcentral.com today.