Walk-up patients sit socially distanced and await their first shot. University of Oregon begins to distribute Vaccines to Students and Faculty on April 21, 2021. (Maddie Stellingwerf/Emerald)

The University of Oregon’s Monitoring and Assessment Program found a way to collect saliva samples, rather than nasal swab samples, to conduct COVID-19 testing. Doug Turnbull, the director of the Genomics and Cell Characterization Facility which oversees MAP, said this new method is more timely and cost effective.

“The lab process is much faster and easier for running the same PCR test on saliva rather than the swab,” Turnbull said. “It’s sort of a lower touch procedure in the lab. We’re using fewer consumables, which makes it cheaper.”

Turnbull said MAP will still offer some nasal swab tests — as certain individuals might have trouble producing saliva and some cultural groups have an aversion to spitting.

The process for getting this test approved was long, he said. Turnbull said that, in August of 2020, Yale University found a way to do saliva tests and proved there were several advantages over the PCR test UO was conducting. However, there were some downsides to this approach.

“The original Yale protocol required this very time consuming enzymatic retrieval of the saliva samples that had to be done prior to running the PCR test, and that particular procedure is so laborious that running the original Yale saliva test would be slower than running our original nasal swab test,” Turnbull said.

UO started communicating with Yale to show a different protocol — developed at the University of Illinois — that UO used in their lab and worked better. In March, Yale received approval from the U.S. Food and Drug Administration for the modified process, which heats the saliva until near boiling for half an hour, instead of the more hands-on process Yale used before.

Turnbull said the team heard from Yale in early June that the FDA approved the final automated workflow process.

While Turnbull said this is “very unfortunate timing,” since the process would’ve been useful when infection numbers were higher, MAP executive director Brian Fox said testing numbers are still strong.

“They have come down since the peak in early winter, and fortunately we're starting to see many of our students being vaccinated,” Fox said. “Once students are fully vaccinated, then they have rolled off the required testing. That's great for the students to be vaccinated, no longer have to be weekly tested.”

Hannah Tavalire, the scientific coordinator for MAP, said vaccinated individuals should still get tested if they are symptomatic.

While the actual processing of the test is faster and cheaper, Tavalire said obtaining the samples takes more time than the nasal swab test.

“You walk up, you hold the swab in your nose for ten seconds and then you switch the other side,” Tavalire said. “I would say the whole experience on average from when you walk in the door is maybe four to five minutes. Depending on your age and any medications you’re on or your ability to produce saliva, it can take people two or three minutes to come up with the volumes that we need to do the test.”

Tavalire said MAP is rethinking its collection model to make obtaining saliva more efficient. The test only requires a small amount of saliva to be read, but as robots are now conducting the test, individuals need to produce 600 microliters — about an eighth of a teaspoon — so the saliva reaches a point where the robot can reach in and access it.

“We bought these robots that make it easier for a single person to run many hundreds or thousands of tests without a ton of human hands needed for the process,” Turnbull said.

Fox said MAP has done a lot of work to get to this point for a more effective form of COVID-19 testing.

“I would just highlight how hard the lab team has worked to scale up testing, to utilize the capacity at a research institution at UO, and put them into play to confront the pandemic,” Fox said. “We’ve really mustered the resources in the institution to operate at really high scales to keep our students and our community safe.”