Finding the Enemy
Anthony Geronimo and his team at the Tropical Disease Foundation convert a tuberculosis research lab into a COVID-19 testing facility for Ayala employees
Words by ALYA B. HONASAN
“Nandoon yung pressure,” says Anthony Geronimo, laboratory administrator of the Tropical Disease Foundation (TDF) in Makati. “There was no room for error kasi umabot na sa taas, eh—sa taas ng company namin, sa taas ng Ayala, so pangalan namin yun nakataya, at parang pangalan ko na rin yun nakataya. Siyempre, ayaw din namin mag-fail talaga, because this was an opportunity to get involved in COVID-19 and to help.”
Anthony is remembering the Zoom meeting last April 16 where the partnership was first established between Ayala Corporation and TDF—the 36-year-old private, non-stock, non-profit organization providing research, training, and laboratory services to fight infectious diseases—to conduct COVID testing of Ayala employees.
Virtually present were Ayala Corporation chairman and chief executive officer (CEO) Jaime Zobel de Ayala and his team, including AC Health chairman and CEO Paolo Borromeo and Ayala Corporation chief human resource officer JP Orbeta. TDF was represented by president Dr. Roberta Romero, vice president for programs Lani Naval, and chairman of the board Dr. Ruben Encarnacion.
Anthony learned more about the two entities’ shared history, which started when Ayala donated the land that TDF stands on in Pio del Pilar, Makati. “It was like a meet-and-greet, but I felt that the top management of Ayala Corporation really wanted to get this done,” he says.
Groundwork
The groundwork had actually been laid weeks earlier, when, anticipating a return to work after the lockdown and quarantine in the National Capital Region, Ayala Corporation decided that its employees needed to be tested, at their own testing center. A rapid test would be administered, and a positive result would lead to a reverse transcription polymerase chain reaction (RT-PCR) test, considered the definitive indicator of infection. Earlier this year, no institutions other than the Research Institute for Tropical Medicine (RITM) were conducting such tests.
Instead of setting up laboratories from scratch, AC Health opted to tap TDF, originally a tuberculosis (TB) research lab that had been built with funding from international donors. Less than a month after that meeting, Ayala had provided for additional machines and people, as TDF could not use their TB equipment. In short, a dedicated COVID laboratory of sorts was established within the building, with Anthony and other senior staff undergoing special training at RITM to handle the new virus.
Trusted Lab. Founded in 1984, the Tropical Disease Foundation is one the Philippine’s research leaders on infectious diseases, such as tuberculosis, hepatitis B, HIV and drug-resistant typhoid fever.
Five people in the laboratory handle the samples. “You need a minimum of three people working inside to complete the process,” Anthony says. “So now, we receive approximately 10 to 15 samples per day.” TDF also works with Healthway, the network of mall-based clinics also owned by AC Health, which takes care of swabbing patients and sending over the samples.
Anthony and his staff prepared for the responsibility by building competence and capacity in the first few weeks. “Ayaw naman namin na sumugod agad, tapos papadalhan kami ng 100, tapos magkaka-delay,” says Anthony. “Ang takot namin yung maba-backlog o ma-contaminate yung process, so ayaw namin yung mabilisan.” For now, some 32 tests are processed a day [as of this writing, June 12], but TDF is working on speeding up the process.
““Honestly, I was also very excited because for a lab person, it was new, and you realize you can already help in detecting COVID, you can help the government, you can help other people.””
Anthony walks laymen through the procedure, which begins with receiving the samples. “Once we receive it, of course we need to verify the data and the labels. Ayaw natin magkaroon ng maling report, di ba? Baka yung pasyente mong negative, ma-report mo as positive kung napagpalit mo yung samples. So doon pa lang, dalawang tao na ang gumagawa.”
The samples are received from the courier and brought into the laboratory, Anthony continues, where a staff member awaits. The samples are carefully opened inside a sterile cabinet, in case of leak and contamination. Labels, documents, seals, even name spellings are checked and double-checked. Late arrivals are stored in the refrigerator, to be processed the following morning.
Testing Step 1: Interviews. Ayala citizens wait for their turn, as the staff collects their medical history, symptoms, and contact history. Among the first to be tested in May are frontliners from BPI, Globe, IMI, and MDC.
Testing Step 2: Extraction. Social distancing and plastic partitions help protect both the staff and the patients. All medical waste are discarded in yellow wastebaskets that are safely disposed.
Testing Step 3: Labeling. Medical technicians carefully label nasal and throat swabs of Ayala citizens before sending them to the laboratory via courier. Different sample gathering sites set up in business units like Globe, BPI, and Manila Water or at the central site at the Makati Stock Exchange send their samples to TDF for analysis.
Testing Step 4: Analysis. Once samples are received by the lab, the staff verify the data before analyzing the samples—a rigorous process that requires at least 3 people to complete.
All in a day’s work. Anthony reviews the results of that day’s testing. The center processes about 32 samples a day.
Genetic makeup
Inside the coronavirus molecule, Anthony explains, is the ribonucleic acid (RNA) that determines its genetic make-up; this is what the laboratory team extracts and purifies. It will take up to five hours to perform RNA extraction on some 30 samples.
The next step, master remix preparation, entails adding a “primer” of chemicals to make the RNA multiply, so the presence of the virus can be better detected. This is also done under sterile, cold conditions to prevent contamination. “Para kang naliligo sa alcohol palagi,” observes Anthony.
After mixing for around 20 minutes, the material is taken to the PCR machine, which resembles a microwave oven with test tube holders inside. At the end of the process, there will be millions of copies of the RNA, and fluorescence is an indicator or the presence of the virus.
Anthony refers to “certain parameters” that must be satisfied. Laboratory staff look for patterns in the resulting graphs that determine a minimum threshold, and even then the cycles are examined repeatedly before concluding that a sample is positive.
COVID 19, UP CLOSE. Colorized scanning electron micrograph of a cell heavily infected with SARS-CoV-2 virus particles (yellow), isolated from a patient sample. The black area in the image is extracellular space between the cells. Image captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. (Source: NIAID National Institute of Allergy and Infectious Diseases)
Anthony volunteered to be the first patient tested at TDF after the staff training at RITM. Although he was anxious about the result, “Honestly, I was also very excited,” he admits, “because for a lab person, it was new, and you realize you can already help in detecting COVID, you can help the government, you can help other people. We said, ‘This is it. There’s no turning back.’”
After working hours, Anthony, who has a wife and a toddler at home, shifts to driver mode, dropping off co-workers as far from his Cubao home as Novaliches and Makati. What keeps him going, he says, is seeing how hard his staff works. “Naglalatag sila sa floor para lang makatulog. So wala rin akong karapatan magreklamo na pagod ako.”
“Pero ang pinaka-nagpu-push sa akin para magtuloy-tuloy is, gusto na natin talaga matapos itong COVID,” Anthony says. “We need to do our part if we want to end this pandemic. At kahit gaano ka-init yun sinusuot namin, kahit gaanong nakakangalay yung process namin, at the end of the day, meron kang isang mapapangiti pag negative yung resulta niya.” #
Additional scientific imaging courtesy of the National Institute of Allergy and Infectious Diseases (NIAID)
PUBLISHED AUGUST 26, 2020
