SPEAKER_00
For me, AB, I'm Matt Pelish, and this is Office Hours, the weekly podcast covering higher education. Back in March, as colleges and universities across the country were just beginning to get their heads wrapped around all the ways they needed to respond to COVID-19. A new phrase made its way into our common lexicon, testing and contact tracing.
Since then, schools have grappled with the many complexities related to testing, tracing, that are necessary to the reopening of campuses, but also for society. On this week's episode, EAB's Caitlin Eloni gets to the heart of the matter with Quest Diagnostics Senior Director of Marketing, Stacia Rovello. Quest shifted their focus this year from a range of common health concerns towards supporting COVID-19 testing, and Stacia will talk us through how testing has gone so far.
She'll also answer some important questions, like why testing varies so much from state to state, what tests we might start to expect to see in the near future, and maybe most importantly, what's the most important best practice colleges should adopt for successful testing protocol. Thanks for listening, and welcome to Office Hours with
SPEAKER_01
EAB. Hi everyone, welcome back to Office Hours with EAB. This is Caitlin Eloni joining you again from my home in Washington, DC.
It's mid-September now, so most of our college and university partners have already started the fall semester. Back when we hosted convenings in our offices, I always loved hearing partners' fall traditions surrounding their orientation and moving in a start of fall sports. It's something we often use as an icebreaker for in-person events.
But this year, of course, the new semester looks a little different on college campuses, and students, faculty, and staff at many schools are experiencing a new ritual of sorts, COVID-19 testing. So to give us a little more context around the testing circumstances on college campuses, I'm joined today by Stacia Rovello, Senior Director of Marketing at Quest Diagnostics. Hi, Stacia, thanks for being with us today.
SPEAKER_02
Hi, Caitlin. Thanks so much for having me.
SPEAKER_01
And where are you joining us from today?
SPEAKER_02
I am joining you from Cumberland, Rhode Island.
SPEAKER_01
Oh, wow. Okay. I think you're our first guest from Rhode Island. So welcome.
Glad to have you today. Thank you. Before we jump into hearing about the specifics of what's going on on campus, can you give us a little more context about how Quest is working with college and universities?
SPEAKER_02
Sure. So I think typically in the past, we would normally work with colleges and universities in supporting their student health center for more general health and wellness testing. So we would work with them a lot on testing such as tuberculosis testing, sexually transmitted infections, flu and other viral or respiratory illnesses.
But COVID has changed that a little bit. So now we're partnering with quite a few colleges and universities across the country to help partner with them in developing their pre-arrival, but also their on-campus testing
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strategy. Sure, that your organization has been just as disrupted by COVID as many of our College
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and University partners. But it's always been a very busy six months. Tell us what are you seeing
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and hearing from your College and University partners about how their testing programs are working so far? Maybe some of the challenges that they've faced as they've repopulated their
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campuses. I have to say, we've seen quite a bit of variability in the way that schools are approaching their testing plans. I think part of that is that they're having to take guidance from a lot of different sources.
And then let's face it, every college campus is unique. There's a lot of factors that are going to change what that testing strategy should look like. So I think one of the first things that we always want to understand when we're working with these schools is, number one, what are you trying to accomplish? So are you going to be testing symptomatic students or are you looking to do something that's broader where you're doing more of a screening or surveillance program? The next thing is around really that operational plan.
So how are we going to operationalize that? And that's really broader than just the testing component. There's a front end part of that with making sure requisitions are generated and getting all of the orders created. And then on the back end, it's managing all of that data that comes from the testing.
Yeah, that makes sense. I'm
SPEAKER_01
thinking about how my mother is a nursing faculty member at a small college in Pennsylvania. I think they're only doing symptomatic testing for students on campus. At the same time, I have a brother who's starting a master's program at Northeastern University in Boston.
I think they're required to show three positive, three negative tests, excuse me, before they can even arrive on campus and then maybe testing every two or three days from there. So obviously a lot of variability, like you mentioned. Are institutions, are there federal guidelines that they're expected to follow when developing their testing strategies or are they pretty much to their own devices when coming up with their plans?
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The CDC did put out some general guidance around what testing protocols could or should look like for the universities. But to be honest, in our experience, most colleges and universities are following guidance that's being put out by the State Department of Health. So the states have been very vocal in helping to shape what that testing strategy is.
And many of them have required testing for students even pre-arrival within a certain timeframe of the student arriving. And then again, once they're on campus, additional testing just to ensure that there's no risk of spread once the
SPEAKER_01
students are back. Got it. Beyond the state guidelines, does Quest recommend any factors that your institutional partners should consider when developing or modifying their testing programs?
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I think the key here is that there's really no one-size-fits-all approach. So our preference really is to partner with the colleges and universities on the unique dynamics of their college campus and then partner with them to define what that testing strategy should look like. I think that your testing strategy might be a lot different if you are in a more secluded campus where maybe you have a one-way in, one-way out, or you're able to create one of those bubble type atmospheres versus some of these universities who are in the middle of a large city and the students are frequently coming on and off campus, going out into the community on a daily basis.
I think those are important factors to consider in terms of how frequent you are testing the
SPEAKER_01
students. That makes sense. I know I've worked with some university leaders as they've been considering their repopulation plans, particularly in the earlier months of the summer.
And there was a lot of confusion. I actually admit there's a lot of different types of tests on the market at this point. There were some high-profiled incidents called into question some of the reliability.
I think different states and municipalities have released different data and metrics around their testing. It's very confusing just to the general public. Curious for your opinion on how accurate the coronavirus testing is today compared to a few months ago and have we reached any sort of consensus around which tests are the most reliable, which tests our institutions should be considering using?
SPEAKER_02
Well, I can't speak to some of the other tests on the market. I probably should only comment on the testing that Quest provides. I can say from the Quest perspective, we only work with reputable manufacturers that have extensive data packages that support the accuracy of their test.
We use tests that have received the FDA, EUA approvals. And then even after that, we do perform our own internal verification studies just to make sure that there's that additional level of quality
SPEAKER_01
check being performed. Got it. That makes sense. And for faculty, students, staff that are listening that may be subject to these testing protocols on campus, I know from them that there's a lot of confusion around what impacts the turnaround time and why maybe they're hearing some of their classmates getting results in 12 hours versus a week.
Could you share a little context for our listeners around what factors determine the turnaround time for obtaining their results back from the lab?
SPEAKER_02
There can be so many factors that impact turnaround time. And many of those things could be something that's out of the control of the faculty, the staff or the students. Things like testing capacity, supplies, logistics, even as we start moving into the winter months, weather can have an impact on turnaround time.
Here at Quest, we try to be as transparent as possible about both our turnaround time and capacity. And we do make all that information public on our website at newsroom.questdiagnostics.
com. So anytime anyone is interested in seeing that information, they can just log on there and pull it up.
SPEAKER_01
I'm glad that you mentioned all the factors outside of the control of the institution. That's one thing that we harped on with our partners when we were helping them through repopulation planning. It was not just thinking about the state of the PPE and the procurement supply chains, but also how we can't be thinking about testing and isolation.
It has to be orchestrated in relationship with a de-densification plan and also contact tracing, something that I think has entered the lingo of a lot of Americans that perhaps they'd never considered before. We know now how important contract tracing is to help contain the spread of the virus. What are some of the pros and cons to the various approaches to contact tracing that you've seen from low-tech interventions, just a contact tracer interviewing the student to ask them where they've been, who they've been with, all the way up to some of these more high-tech apps that we're seeing institutions develop for students to download on their phones that give them access to certain card swipe data and class attendance records and mobile contact tracing.
SPEAKER_02
Yeah, so I think first of all, contact tracing is incredibly important in terms of controlling spread across these college and university campuses. The earlier that you can identify positive cases, both symptomatic and asymptomatic, and then isolate those positive cases, that's where you're going to have the best chance of minimizing that spread. Now, with that being said, I think that it can be a double-edged sword because the contact tracing also can give you access to a lot of other data, especially if you're using some of those technology platforms to help inform your approach.
So I think that one element that colleges and universities have to consider is student privacy and any other ethical implications that could come from that contact tracing. But the pro is definitely around being able to identify positive cases and get them into
SPEAKER_01
isolation as soon as possible. Yeah, we've heard a lot of concerns about data privacy, particularly with regards to the app, but also just with regards to testing itself and who would have access to a student's testing records or any member of the institutional community. So our institutional partners need to make data-informed decisions about how they're approaching their testing strategy.
I'm curious for your take on how difficult it is for schools to harness and manage all of the data that they're collecting. What are the sorts of challenges, what sorts of roadblocks are you helping institutions through as they're managing the
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volumes of data that they're amassing? In the conversations that we've had with various colleges and universities across the country, I would say data management ranks up in one of the top three concerns because to your point, performing one of these broad-based testing programs is going to return a ton of data in itself. And then when you layer on any contact tracing, it just amplifies that level of data that you have access to. However, that data is critical in being able to take the data, have that consolidated view, and then being able to manipulate the data so that you can see any trends that are emerging in your student population and allowing that data to help you quickly identify any risk and then implement those preventative measures.
So the data is crucial. There are a lot of different ways that we try to work with the colleges and universities in that aspect. So many of them want to leverage their student health center, the EMR, that's already there.
We can work to develop an interface with them so that the results are flowing seamlessly into that platform that they're already using. We also have our own platforms that they can use to help consolidate and visualize the testing data, as well as we have partners of our own, if they're interested in a more broader scale data visualization tool. We have partners that we can also bring forward to them to help them, again, manage that data, manipulate it the way that they need to.
I think the last part of it is the government reporting, because all of these tests do need to be reported to the state so that the state can perform their own tracking and contact tracing. So we will also work with the universities on their strategy to report that data to the state to make sure that everyone's fulfilling those requirements. That's interesting.
It hadn't
SPEAKER_01
struck me that that would rise to the level of a top three challenge is the data management. I don't think it's something that comes to mind readily when we talk about testing, but I will say that I'm sure our chief information officers and chief data officers on the line, their ears are singing hearing you acknowledge that. So thank you for pointing that out.
I think that's a great point though that some of the behind the scenes elements going into testing are not just even the staff, the healthcare providers needed to actually perform the tests, but all of the people behind the scenes looking at that data, getting the tests from campus to the lab and back, but getting the results out to the students. How are schools operationalizing this? Are a lot of institutions hiring new staff or they getting support from the local community? What is that
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looking like on campus? Again, it's back to there's been a lot of variability and there's really no one size fits all approach. So I think that's where it's really important to have that conversation and understand what operational capabilities already exist and then design that testing program based on that. So we have some schools that we're working with where they just don't have that onsite staff to help execute a testing program.
So instead we might leverage our unobserved self collection kit where the student can collect the sample themselves and then get it back to us or it might be a more broad scale event where there's actually testing locations set up onsite at various different parts of university and where either assisting in providing staff or the university already has onsite staff where we work with them to help set up a testing schedule. We can help them with scheduling appointments for the students so that when the student walks up all of their information is already pre populated and then the staff that's at the event will supervise the student collecting their sample right and then there. So I've seen a little bit of everything.
SPEAKER_01
Yeah, well quite the enterprise. I'm thinking back to a previous episode of this podcast that I recorded with a research colleague where we were talking about some of the physical space changes that were being made to accommodate COVID-19 and we talked a lot about just all the custodial staff, the registrar, the people just working so much extra behind the scenes to pull off repopulating campus. You're just adding to the list of unsung heroes, staff that are stepping up and really going the extra mile to make this semester work.
Absolutely. I mean we're focusing on the
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testing aspect but in all honesty testing is just one component of a much larger repopulation plan that every single one of these colleges and universities have had to put together. So they have done a tremendous amount of work in a very short time in order to bring all of the students back for the fall semester. It's very impressive.
Yeah, you've done a great job painting
SPEAKER_01
a picture of what testing looks like on campus right now and I think for any listener that is joining in from a college campus one big takeaway is that what they're seeing and experiencing day to day probably looks a lot different than their their colleagues or fellow classmates on campuses in other parts of the country. But I think all of our listeners are probably curious about how the rest of the semester will play out and when it comes to testing if things will change will they just stay the course or will there be any sorts of new tests on the horizon or any conversely any shortages or constraints that they should anticipate or be aware of. Curious if you can offer any insights into the months ahead what some of our viewers might prepare for
SPEAKER_02
or might expect to see. That's a great question. So I would expect that if your school is already if your school is already implemented a testing program I would imagine that will likely continue throughout the course of the semester so I don't necessarily think that will change.
From from a quest diagnostics perspective you know I don't have any concerns about supplies and and things like that but I what I will say is that we're always reevaluating new testing methodologies and we have a very robust research and development pipeline so in the future what we're going to be bringing to the colleges and universities is number one a rapid antigen test to help them get results faster especially in a surveillance testing perspective and then also a combination flu COVID test because as you all know the symptoms overlap quite a bit between flu and COVID-19 so being able to differentiate between the two will be really important as we move
SPEAKER_01
into the winter months. That's really interesting. I remember back when the pandemic broke out in March hearing stories about people being tested for all the various viruses and and respiratory agents going around so that hopefully will give listeners comfort that they can be tested once for the multiple viruses that they might be subjected to.
Absolutely. Anything else is as you look ahead kind of advice for university partners around how to make this fall as successful and
SPEAKER_02
effective as possible at least from a testing perspective? From a testing perspective I would say you know there's there's a few things that I think are really important and we've touched on a lot of them. Number one is that operational aspect so understanding what you have the capabilities to do but also where you may have gaps and being honest with what those things are I think are helpful for whoever your testing partner is not just if it's Quest it's helpful to be able to have those conversations as early as possible so that we can have a successful testing program. Being prepared for the fact that you could have an outbreak on campus and having a plan on how to handle that whether it's moving people into isolation, expanding testing protocols, so having a really strong plan in place in case your situation changes and then again as we mentioned being able to use the data that you're collecting to quickly identify any risk and then act on that risk.
I think that those are
SPEAKER_01
some of the key factors there. As you mentioned earlier I think as of today we're recording on September 9th we are almost exactly to six months from the day that campus closures occurred back in March. Six months living with this pandemic.
Like I said I know it's been a crazy six month request diagnostics as well. Curious as you look back at what surprised you most about the past six months particularly when it comes to working with higher education institutions? The number one thing that
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surprised me I think was on how quickly things changed. So the conversations that I had with schools in May were drastically different than the conversations I had with schools in August. And I think that there are a lot of factors that play into that.
You know I think changing guidance from organizations like the CDC or even the American College Health Association. So I think that that was one aspect of it. But then you know we did see a surge again in some states which I think changed everyone's mindset on how they should be approaching testing especially as we were looking at pre-arrival testing.
So that I think would be the first thing. The second thing is maybe around the importance of having a strong communication plan when you're about to implement one of these testing programs. I would say that I saw the schools that I worked with that had a very direct and concise and almost over communicated what their plan was with their students.
In my perspective I think that they had that their testing programs went more smoothly and they saw greater student engagement. Whereas in some of the schools that I worked with where they gave their students a lot of options on how to get their testing done I think it limited our ability to work together to measure the success of that program. So we weren't able to say you wanted X number of students to get tested and of that number this percentage of students actually went through and got their tests done and here's their results.
We weren't able to have that transparent conversation and I think that that made it more difficult to manage that testing
SPEAKER_01
program overall. That makes total sense and I'm sure more difficult to just rally the campus community behind the data if you're the more cuts of the data that you make the less it feels like a uniform testing infrastructure. I want to go back really quick to the point you made about how you were surprised about how much the conversations changed between May and August.
Can you give a little more specifics about what changed and why in your opinion you think those changes happened?
SPEAKER_02
Sure. So I think one of the areas that I saw the change take place was around the shift of, it was a shift from what type of test the colleges and universities were looking for. So in the beginning there was a lot of interest around using antibody testing especially from a pre-arrival perspective but the market was flooded with a lot of tests and then I think that the sensitivity of those tests went into question.
So I think that that ended up changing the perspective of what tests made the most sense for these schools moving forward. So there was a definite shift from using an antibody test over to using a PCR test instead.
SPEAKER_01
Interesting. Do you get the sense was we're institutional leaders just kind of reacting to what they saw in the news media or were they being informed by different faculty on campus? What kind of prompted the change in their sentiments?
SPEAKER_02
It's probably both. There was quite a bit of media surrounding it but I think too a lot of schools involved various departments on campus to help them in making that decision. Some were more pro antibody testing, some were more pro PCR testing and the presidents had to make that decision based on you know what their committee felt was best for their student population.
SPEAKER_01
Yeah it goes back to the variability point. One thing we observed was a lot of our large research university partners do have world-class epidemiologists in their faculty who were able to provide a lot of consultation. Smaller schools perhaps who are more liberal art focused and have access to this faculty and were relying much more on you know their own web research and
SPEAKER_02
consulting with experts like you. That's a great point. The schools that have either an epidemiology department or a department of public health I found that they were much more interested in understanding the sero prevalence of their student population than some of the smaller schools that
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wouldn't typically have those departments. And what is sero prevalence? Just for listeners of
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the line without that back up. I'm sorry sero prevalence would be the percent of your population
SPEAKER_01
that tested positive for having antibodies. Got it. Did you give any specific recommendations then to your institutional partners that didn't have public health schools or epidemiologists on campus and kind of any advice tailored to some of our smaller institutions? I think it's more just
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don't be afraid to reach out and ask for help from the experts. We have a very large team of scientific and medical experts that are more than happy to work one-on-one with you to understand the needs of your student population and what an appropriate testing protocol would be. So don't feel like you have to design that all on your own.
Feel free to tap into our experts to
SPEAKER_01
help you do that. Encouraging advice for sure. I'm encouraged just hearing you say that.
Well Stacia we always love to end on a positive note and I know that this semester has already been chaotic and perhaps exhausting for students, faculty, and staff as they've been enduring these testing protocols. Wondering if you could leave our listeners with any glimpses of hope or optimism from the data or the institutions that you've worked with. Anything that's gone well that our
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listeners can cling to. Well again as I mentioned all of these colleges and universities had to put together a very broad comprehensive plan in a short amount of time. So I think first of all we should all be incredibly proud of these schools for what they were able to accomplish in such a short amount of time.
So in looking at higher education in general I think everyone deserves a round of applause for being able to do that and to be able to start repopulating their college campuses. From a quest perspective I think one of the things that I find encouraging is number one the level of partnership that we've seen in working with our customers. But number two in the pre-arrival testing that we've done we actually saw a very low positivity rate so under one percent.
So it's reassuring to know that as students are coming back to school the rate of infection is low. So you know hopefully we'll be able to help the schools in managing that positivity rate through the testing programs we're working with them on. Yeah that's really
SPEAKER_01
good to hear. I know that the testing depending on what type of test that you get it's not always the most pleasant experience so I'm sure that the listeners are happy to hear that at least it's been worth it. We're seeing good metrics so far.
We're very grateful for you having you on the podcast today to share some of your insights behind the scenes into the testing environment with our listeners. So perhaps we'll have you back once there are more testing developments. Thank you
SPEAKER_02
Caitlin I very much appreciate you all having me today and of course if you or anybody else would like more information on how Quest can help you can visit questbacktoschool.com. Questbacktoschool.com will do.
Thanks Tisha. Thank you.
SPEAKER_00
Thanks again for listening. Join us again next week when we welcome Broward College President Gregory Anemhael to talk about influence power that our networks have on our lives as well as steps Broward has taken to overcome the network gap. Until next week I'm Matt Pelish with Office Hours from EAB.