Montgomery County has ultrafast COVID-19 test results thanks to an emerging nutritional fad

Mako Medical Laboratories, a six-year-old diagnostic company based in Raleigh, N.C., decided in 2020 to enter the nascent field of nutritional DNA.

The idea: Studying a person’s genome could suggest the person’s optimal diet, with recommendations including how much vitamins and minerals to consume. Then COVID-19 struck.

“We had to make a decision whether we were going to retreat as a business and weather the storm,” said Josh Arant, the company’s chief operating officer.

Fortunately, the equipment and tools used to test DNA for nutritional recommendations are used to test for the coronavirus, too. As other large diagnostic companies like Quest and LabCorp struggle to process an enormous number of samples for testing, Mako suddenly finds itself with capacity to spare.

This week, Montgomery County began sending samples to Mako, which promises people who visit one of the county’s six testing sites will get their results within 36 hours. The company has been averaging a 12-hour turnaround.

That could be a major asset in Montgomery County’s ability to conduct contact tracing and prevent asymptomatic people from spreading the virus, said Valerie Arkoosh, a county commissioner and physician.

“This is why we went with them,” she said. “They indicated to us their intention was to get us results the next morning.”

The company has met the regulatory requirements for testing federally and in Pennsylvania, Arkoosh said.

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County commissioners approved a contract of a year for up to $16 million this month, an overestimate, she said, based on the assumption that no one tested would have health insurance. The contract piggybacks on an April agreement between Mako and the Physicians Integrated Network, a cooperative of hundreds of Pennsylvania physicians from 52 medical practices to process as many as 5,000 test samples a day, said Scott Shapiro, a Lower Gwynedd cardiologist and chief strategic officer for the network.

The speedy results will make it easier to schedule elective surgeries, said Shapiro, who helped connect the North Carolina company with county officials. One of his patients this week, he said, “got swabbed at 3:30 in the afternoon and got results at 4 in the morning. Record time.”

Because there is no comprehensive, federally operated testing program in the United States, local and state governments have struggled to meet the need, Arkoosh said. Pennsylvania health officials said earlier this month that a lack of supplies and delayed results have kept them from meeting a goal of testing 5% of Pennsylvanians a month.

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Montgomery County was one of the first places COVID-19 appeared in Southeastern Pennsylvania, prompting the county to embrace testing early, she said. In the first months of the pandemic, results from the county-run testing sites were coming back within two to three days. Since July, though, as the pandemic has spread widely in the United States, the national labs have become overburdened and waits extended up to two weeks.

A July study published in the medical journal the Lancet reported that test results needed to be available within three days for contact tracing to be effective in containing the virus.

People infected but without symptoms make long delays in test results particularly dangerous. Health officials need to be able to convince people who feel well that they are infected and could be a risk to others.

“It’s very hard to keep people in quarantine who think they’re not sick,” Arkoosh said.

» READ MORE: U.S. bungles coronavirus testing again, this time with delayed results due to hotspots, lack of federal coordination

Mako Medical Laboratories has 11 polymerase chain reaction testing machines and 22 machines to purify RNA, which combined are capable of processing 384 samples at a time, and hired 600 lab techs since April. Once a sample is at the company’s lab outside Raleigh, it takes only six to eight hours for a lab tech to purify it through RNA extraction and run it through one of the machines, which seeks to identify the presence of three genes that in combination indicate a COVID-19 infection. Arant said the company could process 25,000 to 30,000 samples a day, and is committed to quick turnaround.

An average of about 742,000 tests are being taken each day nationally, according to the COVID Tracking Project.

Mako, which before the pandemic primarily operated as a molecular diagnostic test resource for East Coast hospitals, is currently managing seven government contracts for COVID-19 testing from around the country.

Montgomery County has reported 10,395 COVID-19 cases since March 7, and 824 deaths. The county’s six testing sites are collecting about 180 samples for testing a day, Arkoosh said, but she would like to see that number rise to 600.

» READ MORE: Are antigen tests the silver bullet to Pa.’s coronavirus testing delays? Not so fast.

People don’t need a doctor’s note or symptoms to be tested at one of the county sites, she said, and can walk or drive to them. There’s no cost at the site for a test. If a person has insurance, the county collects that information and bills the insurer, and the test is free for people without coverage.

The county sites are accessible only to people who live or work in Montgomery County, Arkoosh said, but there have been discussions about Mako taking on testing for neighboring counties as well.

The implications for rapid test results are significant, Arkoosh said. It would allow people to safely plan visits with relatives who might be particularly susceptible to serious consequences from COVID-19 infection, those who need to travel internationally for work, or for people who just want fast information if they think they have been exposed.

“You can’t get that anywhere in the Philadelphia area now,” Shapiro said. “It’s tremendous.”