From Spit Tube to Results: Inside the Massive COVID-19 SHIELD Testing Operation

On a recent school day, students at Illinois Math and Science Academy in Aurora lined up for their weekly COVID-19 test.

But unlike the now familiar nasal swab routine, these students are taking a different kind of test.

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“It’s the simple matter of drooling into a tube, either funnel or straw. It’s very easy to do and patients are typically in and out in five minutes,” said Rhiannon Clifton, senior director of operations and client integration at SHIELD Illinois.

The unique saliva test was developed by University of Illinois scientists and SHIELD officials say it has become an essential tool in halting the spread of COVID-19.

“The beauty of the SHIELD test is we can catch the virus sooner, so we catch it before the patient is contagious,” Clifton said.

Evan Glazer, president of Illinois Math and Science Academy, says the school contracted with SHIELD last August when students returned to in-person learning.

“IMSA’s unique because we’re a residential campus, so students are in close quarters all the time,” Glazer said.

Not only has the school been able to stay open, Glazer says the test positivity rate has stayed below 1%, even throughout the delta and omicron surges.

“Out of 26,000 tests, we’ve had 56 cases … which is remarkable,” Glazer said. “We went five weeks without any cases at all.”

Although not every school has seen that level of success, Glazer says IMSA paired the testing with robust contact tracing.

“Once you’re informed of the results, you have a whole team behind the scenes making sure anyone you’ve had close contact with is also removed from the environment based on vaccination status and symptoms,” Glazer said.

IMSA is one of 1,800 locations currently employing the test — 1,700 of them are schools. A team of health care workers from, or contracted by, SHIELD comes in and runs the entire program. It’s a massive operation built by the university on the fly.

Shield Managing Director Ronald Watkins says the test costs one-third as much as the standard PCR test — and schools have the entire cost reimbursed with federal CARES Act money.

University of Illinois brought together business, engineering and supply chain specialists to come up with a system that would produce PCR results in less than a day, Watkins said.

“U. of I. put the money in, jumped out there, started building the labs, and it’s like, we’ll just figure this out as we go,” Watkins said.

There are 11 labs up and running that are either operated or contracted out by SHIELD Illinois. Once the test hits the lab, it’s an average of 10 hours from arrival to result.

Lab director Natalie Lubbers says the North Chicago facility came online in a month. Saliva samples are sorted either manually or by robotic machines built specifically for the process.

“We go through an extensive review process ... we keep a very clean lab — we go through a review of every sample so we’re releasing the best possible results,” Lubbers said.

Lubbers says a false positive is exceedingly rare because SHIELD is testing three different targets, and two of those three have to come up positive in order for the test to be conclusive. 

The results are sent electronically to the patient within minutes, Lubbers said. The process of testing samples has played out more than one million times since SHIELD began, but Watkins says the goal is to eventually dismantle the organization.

That will mean the pandemic has passed into endemic phase. But he says the saliva technology has limitless potential for other applications.

“Everything from being able to detect a person’s wellness, to whether or not they’ve had a concussion — all kinds of different uses for saliva,” Watkins said.

Follow Paris Schutz on Twitter: @paschutz

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