Answers from the Lab

William Morice, II, M.D., Ph.D., Chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and President of Mayo Clinic Laboratories, joins the Answers from the Lab podcast for his weekly leadership update. On this episode, Dr. Morice joins Dr. Bobbi Pritt to discuss the different forms of masking that are available and which type you should consider based on your state guidelines, in addition to the scientific studies performed.

TimestampsDr. Bobbi Pritt: (00:45) Can you share a little bit about yourself and how your role has changed since COVID-19? Dr. Bobbi Pritt: (02:10) Has there been any additional quality management practices that have been put into place since the start of COVID-19? Dr. Bobbi Pritt: (04:13) Do you feel like these practices will continue to be followed going forward? Or do you think that some are just specific to the COVID-19 pandemic? Dr. Bobbi Pritt: (06:55) What challenges have you encountered and how have you overcome them? Dr. Bobbi Pritt: (09:15) What is something inspiring that you've noticed during the pandemic? Dr. Bobbi Pritt: (10:49) What lessons have you learned that other laboratory professionals would benefit from the COVID-19 pandemic? Dr. Bobbi Pritt: (11:38) Is there anything else that you'd like to share with our audience today, Jill?

William Morice, II, M.D., Ph.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and president of Mayo Clinic Laboratories, joins the Answers from the Lab podcast for his weekly leadership update. On this episode, Dr. Morice discusses how we can approach the upcoming flu season, and Bobbi Pritt, M.D., shares the differences between screening and surveillance approaches to testing for COVID-19.

William Morice, II, M.D., Ph.D., Chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and President of Mayo Clinic Laboratories, joins the Answers from the Lab podcast for his weekly leadership update. On this episode, Dr. Morice discusses how we can prepare for the upcoming influenza season and take necessary precautions as we approach Labor Day weekend.

Resources:https://news.mayocliniclabs.com/covid19/

William Morice, II, M.D., Ph.D., Chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and President of Mayo Clinic Laboratories, joins the Answers from the Lab podcast for his weekly leadership update. On this episode, Dr. Morice discusses how leadership practices have shifted since the onset of COVID-19, the creation of our command center, and how the team has made significant changes to ensure there is an increase in open communication with staff.

Resources:COVID-19 Resource Center

Timestamps:Speaker 1: (01:03) Do you want to tell us a little bit for the listeners, what herd immunity is? Speaker 1: (02:49) With your immunology background, if you have any thoughts on what would be the ideal way in your mind?Speaker 1: (06:21) So it does show the power of the immune response, but it is that question of, is it going to be antibodies? Is it going to be T cells? Is it going to be a mixture of both and can a vaccine elicit a protective response from those different branches of the immune system: cellular and humoral?Speaker 1: (08:37) What do you think about other tests as far as detecting T cell responses? What do you see on the horizon? Resources:COVID-19 Resource Center

Timestamps:Speaker 2: (01:12) Where does it all start? Speaker 2: (04:32) How many followers have you? Speaker 2: (05:59) So what would your advice be to someone who might listen to this and want to follow in your footsteps? Speaker 2: (10:41) So you've been doing this now for a long time, 600 cases on your blog, do you have a few favorites? Resources:Creepy Dreadful Wonderful Parasite Blog Twitter: @parasitegalFacebook: https://www.facebook.com/ParasiteGal/

01:21 Could you give us the updates on what you see the state of testing to be today? 01:53 What are some of the new things on the horizon? You know, we're hearing about pooling and antigen testing. 08:34 What are your thoughts on that?

Timestamps:Speaker 1: (01:14) Can you tell our listeners about the state of testing today? Speaker 1: (05:14) You've been posting on Twitter, some really interesting statistics, do you want to share some of those?Speaker 1: (09:46) Do you have designer masks, Bill, and do you match your outfit for the day? Resources:https://news.mayocliniclabs.com/covid19/

00:44 So can you tell me a little bit about what your normal role was at Mayo Clinic before COVID happened? Then how has that changed as the COVID pandemic started and progressed? 02:06 So, what are some of the current challenges facing the supply chain and what have been some of Mayo Clinic’s strategies to successfully navigate through these evolving supply chain shortages and demands for supplies during the COVID-19 pandemic? 05:51 What are some of the innovative ways that Mayo Clinic has adjusted to overcome some supply chain shortages during the COVID-19 pandemic?10:01 So, Dr. Jannetto, is there anything else that you think would be of interest to our group?Resources:https://news.mayocliniclabs.com/covid19/

(01:01) Can you tell us how lab testing capacity is in general at Mayo Clinic and across the United States? (03:34) We’re trying to balance how we test for the routine stuff, in addition to meeting COVID demands? (04:40) How should we be using testing to manage this COVID-19 outbreak? (06:36) So the partnership you mentioned, do you want to tell us a little bit more about that? Because it was recently announced and not everyone may have seen those announcements with what we're doing with Delta. Resources:https://news.mayocliniclabs.com/covid19/

Timestamps:Speaker 1: (01:00) Perhaps you could start off by just telling us how is this test different than the other antibody tests? What is a neutralizing antibody to begin with? Speaker 1: (02:40) Can you tell us about the new neutralizing antibody test then and how it came about? Speaker 1: (03:39) What did you do specifically to make it a clinical test? Speaker 1: (04:50) How many tests then can be completed each day? Speaker 1: (05:11) How would you incorporate this test into the clinical workflow then? Would there first be a screen to make sure the patient has antibodies to begin with? Speaker 1: (06:12) Can you tell us a little bit about the science about how that works and how this live virus comes into play? Speaker 1: (08:10) How will this assay be used now that we have it and should everyone be tested? Speaker 1: (09:53) Do you have any idea of how many people that have antibodies, actually have neutralizing antibodies specifically? Speaker 1: (11:19) Are there other laboratories that can offer this type of testing?Speaker 1: (13:07) Are there any other ways that this test could be used at this time? Resources:https://news.mayocliniclabs.com/covid19/

01:16 What are you thinking when you look to the future for laboratory testing for COVID-19? 03:05 What are your thoughts on that? What would be some ways that we could predict who would be at risk for severe disease and really might go downhill quickly? 04:47 So should we be testing for T-cells? Are there any T-cell marker tests in the future? 05:41 Can you tell us a little bit about that from your view as our chair? Resources:https://news.mayocliniclabs.com/covid19/

Timestamps:Speaker 1: (00:39) So let's start by talking about the new neutralizing antibody test. Can you tell us a little bit about this test and how it came about? Speaker 1: (04:55) So we are screening all of the employees throughout the Mayo Clinic enterprise. Can you tell us about this and the scope and the purpose behind this program? Speaker 1: (07:26) So a lot of things to consider, I'm sure our listeners are now saying, so how did you roll it out? Or what are the plans? Resources: https://news.mayocliniclabs.com/covid19/

Full Show Notes (Timestamps)Speaker 1: (00:56) So there continues to be a lot of interest in antibody testing for COVID-19. Can you refresh our memories on what antibody testing is? Speaker 1: (02:12) Now that we are actually six months into this outbreak, what is our understanding about using serologic testing? Will it be the magic bullet that will allow us to go back to work?Speaker 1: (05:26) Can you explain that to everyone in ways that we could all understand? What does this mean exactly? How does this impact serologic testing and interpretation of results? Speaker 1: (09:29) So given this information on the positive predictive value and how it's influenced by both the prevalence and specificity of a test, have government agencies provided guidance on how to select and interpret serologic results for COVID-19? Resources:https://news.mayocliniclabs.com/covid19/

Full Show Notes (Timestamps)Speaker 1: (00:50) So this is now our six months in a world with COVID-19, which is just amazing. What is new in terms of testing at Mayo Clinic Laboratories for COVID-19? Speaker 1: (02:23) It has the potential to really help a lot of patients, if you can show that giving convalescent plasma is going to be helpful to our patients struggling with COVID-19. Speaker 1: (04:04) So as chair for our department, what are some of your considerations now when balancing the huge volumes of COVID testing we're doing with all these other necessary laboratory tests? Speaker 1: (08:16) How has that impacted our laboratory operations and being able to provide that critical testing for our patients? Speaker 2: (09:37) COVID-19 is still clearly ravaging the globe. I think there'll be a renewed focus to make sure that access to both the diagnostics and the care is equitable across this country and across the world and on the heels of that, to really address some of the health care disparity issues that need to be addressed. So as painful as it is, the only way we can make meaning out of that pain is to actually understand the source and to really drive and make meaningful changes.

01:23 How do you envision that we could use these two types of tests to help restart our economy? 07:04When you test one day, what does that mean?08:59What can the laboratory do to help guide how our tests are used for clinical decision making public policy and even help guide how future tests are created so that they can best serve our patients? Resources:https://news.mayocliniclabs.com/covid19/https://news.mayocliniclabs.com/2020/05/18/client-virtual-town-hall/

00:53 So you were the division chair of clinical microbiology at the time that the COVID-19 pandemic began. How did COVID-19 affect you in that? 05:49 So how did COVID-19 impact this society that we call ASM?10:32 Our department chair, Dr. Bill Morice, asked you to lead a COVID-19 biospecimens group for Mayo Clinic. What does this group do?

01:46 So Dr. Morice, how have you seen the laboratory response evolve along with the pandemic? 04:01 Do you feel that Mayo Clinic is in a unique position to contribute to testing and the dialogue around testing given that we have our local practice as well as our international reference laboratory practice?

Dr. Pritt: (02:13) Could you tell us a little bit more about your podcast and what people can expect when they tune in?Dr. Kreuter: (06:02) What can listeners to Answers from the Lab podcast expect to hear in the coming weeks and months? Dr. Pritt: (07:24) Since you've been doing this for a while, do you have any lessons that you'd like to share from your podcasting experience? Resources:Lab Medicine Rounds Podcast: https://news.mayocliniclabs.com/podcast/lab-medicine-rounds/

(00:49) Things continue to move really quickly on the COVID-19 testing front, and now the big news is really the government is transitioning to push testing coordination out to the states. We'd love to get your input on this and what advantages you see to this approach.(03:36) Let's talk about some of those concerns you may have about this approach. (07:39) Seems like we're optimistic that things are working well, but still some challenges to face here. (08:22) So in reflecting on this scenario and how it's unfolded, are there any things that you would do differently or any lessons that you would take from this approach? Resources:https://news.mayocliniclabs.com/covid19/

TimestampsSpeaker 1: (01:17) Can you tell us why that decision was made and how you went about bringing up this new test? Speaker 1: (04:27) We went with our laboratory developed test, which was essential to get us up and running, but had a limited throughput. Then you've basically tripled our capacity by adding these additional platforms and tests.Speaker 1: (05:27) Now I also know when you verified this, you really turned it around amazingly fast. Can you tell us a bit about that? Speaker 1: (06:46) That is amazing. Now you mentioned the assay has received EUA—emergency use authorization—from the Food and Drug Administration or FDA. Now what specimens does this assay have EUA for? Speaker 1: (07:31) Are you adding additional specimen types to what you're accepting for this assay? Speaker 1: (09:23) How are you using this assay today and what is your total capacity for testing? Speaker 1: (11:41) Now you've also brought in another test. How was that decision made and do you want to tell us a little bit about that? Speaker 1: (14:34) Now, I don't believe before this that you were working 24/7, is that correct? Resources:https://news.mayocliniclabs.com/covid19/

(01:19) I think really of interest is this new partnership with Minnesota and state leadership to provide COVID-19 testing for all Minnesotans as needed. One of the first partnerships in nation of this sort. Could you just touch on that and tell us where are we right now in making this happen? Resources:https://news.mayocliniclabs.com/covid19/

(00:50) Can you explain for our listeners what a drive up phlebotomy site is and how this process works for patients and staff? (02:46) Can you tell our listeners what the drivers were for having this nontraditional suboptimal system? (03:47) So what were some of the challenges you faced when setting this service up and how were you able to overcome them? (04:47) So how is it going so far then? Is it working as expected and do you think the patients and staff like the new process? Resources:https://news.mayocliniclabs.com/covid19/

(00:57) Can you tell us more about this partnership and how it evolved? (05:10) So can you tell us a little bit about what are those goals? What are the desired outcomes from this new partnership? (06:22) What is Mayo clinic doing and Mayo clinic laboratories in ramping up to be able to provide this. Resources:https://news.mayocliniclabs.com/covid19/

(00:47) So there are a lot of tests on the market now for detecting COVID-19 can you tell us what the main categories of these tests are? (01:30) Let's delve into those a little bit more. Let's start with the molecular test. Can you explain to our audience how that works? (03:32) Because there's so many different types of PCR tests out there right now, can you tell us a little bit about the differences and specifically how these different types of tests may compare to one another in terms of accuracy and turnaround time? (06:12) Dr. Binnicker, can you tell us when and how physicians can use PCR to diagnose patients with COVID-19?(08:00) So it sounds like, again, just to confirm, the PCR test is really for diagnosing that patient during that early stage when they have symptoms?(08:55) Can you tell us more about serologic testing and how that works? (09:53) So when would you use serology? (10:57) So can you just summarize just for our audience again, how these two tests work together?

(01:24) When did you first realize that the virus was likely to be a problem in the United States? And how did you respond at that time? (03:44) How did you progress then when you realized that we did need to step up our efforts and start putting a team together? What were your plans for that and who did you pick to represent the individuals for that team? (05:47) So how did your efforts change as the pandemic progressed and what steps did you take as a leader? (09:23) So what do operations look like today? How has this been running? (12:00) Reflecting back now with all of these challenges, do you have any lessons you'd like to share with our audience about being a leader during an emergency, such as the COVID-19 pandemic? Resources: https://news.mayocliniclabs.com/covid19/

A discussion with Dr. Elli Theel, the Laboratory Director of the Infectious Diseases Serology Laboratory at Mayo Clinic, who led the efforts to evaluate and implement the antibody test for COVID-19. Topics covered include an overview of antibody testing, why Mayo is testing for IgG only, ordering scenarios, sensitivity and specificity of the Mayo test, a comparison with other serology test offerings, and what will be included with the test result.

Coming Soon: Answers from the Lab, a podcast sharing Mayo Clinic knowledge and advancements on the state of testing, science, and people who are making it happen behind the scenes.