WAYNE, NJ – Before the sun begins to rise over the horizon and as the sky slowly brightens, the Passaic County COVID-19 testing facility at William Paterson University comes to life. County staff and volunteers emerge from their cars and make their way down to the staging site where the preparation for the day’s testing begins.
Anxious, sick patients are early too, sitting in a line of cars that inevitably elongates and snakes through looping curves of orange cones within the parking lots of the university campus.
Volunteers from the Passaic County Sheriff’s Community Emergency Response Team staff the first check point where the patients enter the facility. They provide direction, make sure each patient has the proper paperwork and keep careful count of each car as well as the number of patients in each car.
When the patient count nears five hundred, the decision is discussed to close the line. On Tuesday, the line was cut-off at 9:30am, only thirty-minutes after the first collections began. The patients in the last car could then wait four, five or even six hours before their sample is collected.
The next point of contact for these patients is the registration team who are covered from head to toe in Personal Protective Equipment (PPE) which consists of booties, a hazmat paper/plastic suit with cuffs at ankles and wrists and a hood that covers the head, disposable gloves and a plastic face shield.
Before the pandemic, Ana Maroldi worked as a research technician at Memorial Sloan Kettering Center in Manhattan. She currently lives in Kinnelon and has been volunteering at the Passaic County COVID-19 screening facility since the second day of its operation. “My team is in charge of registration. We’re the first faces that the people see,” she said in a muffled voice from behind her face shield. She checks IDs and prescriptions, answers questions, does her best to calm worries and marks each car’s windshield with a number indicating how many people will be tested in each car.
The next step is where the registration team collects personal contact and geographical data. “It’s really a critical part because that’s where we get the info for contact tracing,” said Jason DeAlessio, who manages the registration team. He wears a simple surgical mask and scrubs because he isn’t interacting directly with the patients, yet. “So, of the patients who come back positive, the municipal health departments then contact everyone that the patient has come in contact with, so we can get those people quarantined and isolated to keep them from infecting others.”
DeAlessi has an undergraduate degree in public health and is working on a Master’s in Epidemiology and Public Health from Rutgers. His calm, professional demeanor reflects his team’s attitude as they interact with the patients. Their 'car-side manor' is critical and can provide a sense of calm and reassurance to the frightened folks who don’t know what the future will hold for them.
Once through registration, each car is directed down to the “Hot Zone” and then split into two lines where two teams are ready to begin the careful process of collecting samples that will be sent to the lab for testing.
This area is where the volunteer medical professionals are assigned. Experienced doctors, nurses and technicians, who have been previously trained to safely interact with patients, answer questions while collecting potentially infected samples from each patient.
A long nasopharyngeal swab, which looks like a long Q-Tip, is carefully, but uncomfortably, inserted into the patient’s nostril to collect an upper respiratory mucous sample. The swab is then placed in a long vial and sealed. Handlers make sure each vial is properly marked with the patient’s identifiers and placed in coolers to wait for shipment to the lab at the end of the day.
The patients then drive home to wait for a call from their doctor with the results which takes anywhere from one to three days.
With every interaction, the volunteers must observe and make an informal assessment of each patient’s health. Coronavirus is a deadly disease for some, and no one knows what stage the patients may be in the disease process.
“Last Wednesday, we had a woman die,” said Anthony De Nova, the Passaic County Administrator, and the person in charge of the entire operation. “The person who tested her saw that she was in distress and her lips were blue. We have an ambulance that sits right there,” he said, pointing past the collection area.
“We got her in the ambulance and heading over to St. Joe’s in Wayne, which is three-minutes down the road. By the time they got her there, she was dead,” he said with a sad shake of his head. “For me, I read numbers all day, but then you start putting faces to those numbers and…,” he choked up. “It’s just devastating.”
Collected samples are tested at BioReference Labs. The lab charges Passaic County $50 for each test kit, the processing of the sample and the distribution of the results.
Results go to the County, into the online State registry and are also faxed to the doctors who prescribed the test to the individual patient. The patients are notified of the results by their doctor.
The State notifies each municipal health department of residents who test positive. The municipalities then reach out to the patients to begin a contact investigation. Every patient who tests positive will be interviewed to find out where they have been and who they have been in contact with. Those who may have been in close contact with someone who tested positive will be called and told to quarantine themselves for two weeks just in case they are carrying the virus.
The Genesis of the Testing Facility
Dr. Charlene Gungil is the Passaic County Public Health Officer. She was part of the team that created a plan in 2010 that was the genesis for the COVID testing facility. “Part of our responsibility as the Emergency Preparedness Team was to create plans for mass vaccinations, mass testing – such as this case, and mass distribution of prophylactics to people. So, we can always be prepared to respond to various situations very quickly,” said Gungil.
“What allowed us to open quickly was having that plan in place,” said the County Administrator Anthony De Nova.
“Now, executing the plan,” he said, and began to laugh. “I lost a lot of sleep over that. I woke up many nights in a cold sweat not knowing whether or not it would work. A plan on paper is a lot different from what you see here.”
“I’ll never forget this,” said Gungil with a small smile toward her boss De Nova. “This started on a Sunday night [March 15]. All the counties were told that we each had to set up a testing facility within a week.”
That night De Nova created a County COVID Task Force and put Dr. Gungil in charge.
“We began to meet immediately,” said Gungil. “We talked about: What’s this going to cost? Where is it going to happen? What’s going to happen? Who is going to be in charge of what? How are we going to use computers and technology to make it more efficient? Who is going to run it? How are we going to do this?”
“All of this without even knowing if we were going to have test kits,” said De Nova.
“Build it, and they will come,” said Gungil with a smile. “So, we set it up and we did it. We were ready by Friday.”
The state sent us everything we asked for,” said De Nova. “In retrospect, I wish we had asked for more,” he added with a laugh. “We thought we were asking for a lot, but honestly nobody knew how much testing we would do and how much we would really need.”
An integral piece wasn’t in place until the night before the County’s deadline: testing kits and a lab to process the samples collected. “It was that Thursday that we were on a Governor’s conference call when we found out that certain labs would work with certain counties and Mr. De Nova was able to get an agreement with BioReference Labs to procure test kits.”
“They could only guarantee us 1,000 test kits initially,” said De Nova.
“I had a good feeling that we would get more than 1,000 testing kits, but I couldn’t say I was confident at the time,” said De Nova. The County Administrator is no longer concerned about the availability of test kits.
“Pretty much, we’re getting whatever we ask for. They are picking up anywhere from 250 to 500 samples per day,” he said. “My concern is more about availability of PPE and keeping the volunteers willing to keep coming back.”
The volunteers are the lifeblood of the testing facility. “They are critical to our operations,” said Dr. Gungil. See story.
Without volunteers, the County testing site would have to close, so more volunteers are needed. If you want to volunteer email: email@example.com
As of the end of day on Saturday, the facility had tested 4,663 residents, and about 57% of these tests come back positive.
The testing facility is serving its purpose and operating efficiently. “I’m proud of this operation and all the volunteers who come here every day,” said De Nova. “They are incredible.”
Regarding the job that the County Public Health Officer Dr. Gungil is doing, De Nova said: “She has a PhD in Epidemiology and teaches both Epidemiology and Global Health at William Paterson University. What she has been training for her whole life is happening right now and all I can say is that Passaic County couldn’t be in better hands with Dr. Gungil leading this whole operation.”
The testing site hours of operation are Monday, Tuesday, Thursday, Friday and Saturday from 9:00am - 12:00pm, based on test kit availability. They are closed Wednesdays, Sundays and when the weather does not cooperate.