JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas (June 8, 2020)- Fort Sam Houston is home to the busiest military hospital in the United States, known as Brooke Army Medical Center, where the lab technicians have processed over 10,000 COVID-19 tests.
As one can imagine with a hospital this large, COVID-19 has spurred an alteration in the normal mission of the hospital in various areas. Nurses and doctors all over the world are doing a phenomenal job day in and day out, but lab technicians are often overlooked and are a huge part of the discovery.
The lab techs at BAMC are unsung heroes. They aren’t on the frontline swabbing patients and they aren’t caring for patients face to face. They have been working diligently in recent months, aiding the fight against the novel coronavirus.
The Original Mission to Now
U.S. Army Capt. Eric Coate, chief of Molecular Diagnostics and Immunology at BAMC explained that prior to COVID-19 the lab’s day to day work consisted of screening for sexually transmitted infections (STI)/HPV, carrier screening for Cystic Fibrosis, and viral load for patient disease status (HIV and Hepatitis B/C). “Since COVID started we have added additional personnel to help with the large mission requirements that COVID has presented us,” said Coate.
“Routine tests have decreased in number, while COVID testing has become the main focus,” said Leslie Contreras, medical technologist. “Some tests have been put on a hold and are being sent to a reference lab to accommodate the priority of COVID.”
Coate said although the hours of the lab are from 5 a.m. to 10 p.m., the lab often runs testing for 24 hours depending on the amount of testing samples collected. The workers wear the proper mandated personal protective equipment when working, which consists of a lab coat and gloves in their Biosafety Level 2 lab environment.
The section that tests for COVID is led by U.S. Army Lt. Col. Robert Cybulski, Jr. and supervised by Marisa Fernandez.
Cybulski recognizes the help the lab has received in their efforts to combat the virus. “Those with whom (the lab) has the closest relationship - aside from our teammates within the Department of Pathology, we collaborate with the staff that is running the BAMC testing and screening operations, the staff of the Infectious Disease Service, and the staff of the Preventive Medicine Department,” he said. “We have benefited from support provided by separate commands located on Fort Sam Houston (Public Health Laboratory) and retired Army officers who have been reactivated to support the COVID-19 response.”
Along with these departments, the Wilford Hall Ambulatory Surgical Center and Food Analysis and Diagnostics Laboratory technicians have volunteered their time and resources to assist the ongoing COVID-19 mission at BAMC. All of this assistance has aided the lab in conducting so many COVID tests while still maintaining focus on their regular mission.
So what happens when a test comes back positive? “Immediately after a positive result is generated in the lab and reviewed at the appropriate level, the results are reported to senior leadership in the hospital,” said Cybulski. “Immediately after that, they are passed to a group of infectious disease physicians for appropriate clinical follow up.
“On a daily basis (once every 24 hours), the total list of positives generated during that time period is sent to infectious disease, as well as the Public Health personnel on Fort Sam Houston and Lackland Air Force Base, and select physicians within BAMC Family Medicine, to ensure that patient follow-up is completed and documented appropriately, and to facilitate additional reporting on the Public Health side,” he said.
This chain of events allows for safe and proper acknowledgement for those infected to seek treatment and be able to quarantine, along with an effective follow-up of patients.
Are Tensions Settling?
U.S. Air Force Lt. Col. Carolann Miller, laboratory manager, believes in the beginning of the pandemic there was increased anxiety due to “fear of the unknown” as this is a novel virus. However, over time and with proper guidance like wearing face masks, social distancing, and the adjustment of work schedules, the anxiety has somewhat subsided,” she said, while stressing the importance of ongoing vigilance.
“The lab’s biggest impact on COVID-19 is laboratory leadership and the molecular section leadership being 100 percent engaged from the beginning and getting the testing for this virus in house as soon as possible to serve our beneficiary population in the JBSA area,” said Miller.
US. Air Force Col. Samantha Butler-Garcia, chief of the Department of Pathology and Area Laboratory Services, revealed that her favorite part about coming to work is providing safe and high quality healthcare for active duty and veteran personnel. “They have made sacrifices for their country in ways that are often unimaginable so they deserve the best healthcare,” said Butler-Garcia.
U.S. Army Master Sgt. Jeffrey Thomas, Department of Pathology and Area Laboratory Services noncommissioned officer in charge, noted, “The laboratory has not only shown amazing resiliency as it has adapted to the evolutionary changes that have come from the CDC, DoD, and other agencies regarding the understanding of COVID-19, but the staff has shown a level of teamwork and camaraderie that (he) only experienced under the most high stress environments.”