First COVID-19 saliva test in US can be taken at home via tele-medicine
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Interview'COVID-19 can get into cats, tigers, dogs. Be prepared'

First COVID-19 saliva test in US can be taken at home via tele-medicine

Jay Tischfield, head of the Rutgers University Cell and DNA Repository, says his lab is ramping up capacity to analyze 50,000 spit samples a day

Distinguished professor of Genetics, Dr. Jay A. Tischfield, Rutgers-New Brunswick. (Courtesy Rutgers)
Distinguished professor of Genetics, Dr. Jay A. Tischfield, Rutgers-New Brunswick. (Courtesy Rutgers)

A Jewish-American scientist who helped pioneer a COVID-19 saliva test — one of the earliest successful coronavirus tests — said that his lab, Rutgers University Cell and DNA Repository’s Infinite Biologics in New Jersey, is readying to provide and analyze 50,000 tests per day, many of which will be harvested by patients in their own homes. This would more than double its current capacity of 20,000.

In May, Jay Tischfield, the founder, scientific director, and CEO of RUCDR, received emergency-use authorization from the FDA for the lab’s saliva coronavirus test, which became just the third to win such authorization at the time, and the one only authorized to use saliva collection as opposed to nasal and throat swabs. Test results can be provided by his lab in roughly 48 hours, said Tischfield.

“We responded, luckily, rather early,” Tischfield told The Times of Israel. “I decided [the pandemic was] going to get worse. It was not going to disappear.”

In announcing the emergency authorization, FDA commissioner Stephen M. Hahn said in a May press release: “Authorizing additional diagnostic tests with the option of at-home sample collection will continue to increase patient access to testing for COVID-19. This provides an additional option for the easy, safe and convenient collection of samples required for testing without traveling to a doctor’s office, hospital or testing site.”

In addition to heading RUCDR, Tischfield is a professor of genetics at Rutgers, a professor of pediatrics and psychiatry at the Robert Wood Johnson Medical School, and the executive director of the Human Genetics Institute of New Jersey. But COVID-19 has placed his role at the lab at center stage.

RUCDR is among the nation’s largest gene research labs and works with the National Institutes of Health (NIH) as well as pharmaceutical companies such as Merck and Pfizer. During the pandemic, RUCDR has repurposed itself to test for COVID-19, through both its saliva test and a genetic testing service, according to a Rutgers release. Up until three months ago it was licensed for complex molecular tests and some cancer tests.

In this April 24, 2020, photo, a woman is tested for the coronavirus by a nurse tech at a drive-thru testing site in Bono, Arkansas. (Quentin Winstine/The Jonesboro Sun via AP)

“I think what happened here is, the country learned it [was] vulnerable,” Tischfield said. “We spend $7 trillion on defense every year — I should know — against the invading menace that will come and bring the country to its knees. No foe has ever done this to us — not 9/11, Pearl Harbor, anything. Because people can’t see [the virus], they don’t understand it”

Because people can’t see the virus, they don’t understand it

And, Tischfield cautioned, this virus is not unique. “There are other coronaviruses, other classes of virus… As we encroach upon environments of wildlife — bats, pangolins, civet cats, whatever — we come into contact with them, or worse yet, have them in meat markets. Viruses can jump species. COVID-19 can get into cats, tigers, dogs… We better be prepared. We better have a test.”

Tischfield is hopeful about the current research response.

“I think the signs are positive for a vaccine,” he said. “Until we get a vaccine, we have to be very careful. We have to test a great deal.”

Performed at home, under physicians’ guidance

A coronavirus testing station run by Maccabi Healthcare Services (courtesy of Maccabi Healthcare Services)

He sees the RUCDR test as a way to take some of the stress off beleaguered health care professionals who must use scarce resources of personal protective equipment (PPE) such as masks and gloves.

Although the emergency-use authorization does not mean future FDA approval for over-the-counter at-home testing, Tischfield said that individuals can already take the test at home under the guidance of a physician.

“There is no true at-home test at present without a physician’s order,” Tischfield explained. “All tests need to be ordered by a physician or similar. However, once ordered our saliva test can be administered at home usually with everything done via telemedicine.”

The process begins when an individual reports COVID-19 symptoms to their physician, who prescribes a test. It features a saliva collection device — a test tube with a screw top. The potentially infected individual spits into the tube and sends it by mail for analysis. RUCDR developed the test in partnership with two companies — Spectrum Solutions, which makes the tubes, and Accurate Diagnostic Solutions, which sends test kits to individuals and posts results online for them to access. Tischfield estimated the cost to the individual at around $125.

According to Tischfield, the RUCDR saliva test can detect about two percent more cases than tests using throat swabs. He cites a Yale study that finds saliva samples better at detecting cases than throat swabs in general. And, he said, “our false positive rate is very, very low,” although it is “impossible to determine” the false negative rate. While RUCDR does mostly saliva testing, it also does “some swabs” according to the terms of its emergency-use authorization, he said.

Illustrative: A hospital employee wearing protection mask and gear shows a cotton swab for taking mouth specimens at a temporary emergency structure set up outside Brescia hospital, Lombardy, on March 13, 2020. (Miguel MEDINA / AFP)

While the test is currently limited to individuals reporting COVID-19 symptoms, Tischfield hopes the FDA will also test ostensibly healthy populations, which he contends is vital to containing the spread and “should have already been [done] yesterday.”

Early bird catches the Trump tweet

Tischfield’s dislike of delay has an unlikely inspiration: legendarily cantankerous cartoon character Donald Duck. He is a longtime collector of Donald memorabilia, including 175 T-shirts, over 100 ties and an estimated 75 figurines. He loves the character’s family motto, “Always exasperated, always frustrated.”

“That’s me,” Tischfield reflected. “I have no patience for the FDA, for example.”

Sometimes, however, the government has moved with speed. When RUCDR received emergency-use authorization, a White House coronavirus task force member reached out to the lab to offer aid.

“The test hit it big in terms of PR,” Tischfield said. “The president mentioned it twice. The White House contacted [RUCDR chief operating officer] Andrew Brooks, who had the primary responsibility for the development of the test. They asked, ‘How can we help you?’”

Illustrative: US President Donald Trump speaks with reporters about the coronavirus in the James Brady Briefing Room of the White House, May 22, 2020, in Washington. (AP Photo/Alex Brandon)

Several hours later, Tischfield recalled, “CEOs of companies that produce equipment we use called [to ask] ‘How can we help you?’ We got more equipment.”

Help has also come from local government. Residents of New Jersey’s Middlesex County, home of Rutgers, can take the test at a drive-through location after the county partnered with Rutgers and an area health network, RWJBarnabas, to make it possible. It is reportedly the first drive-through testing center in the nation to use saliva tests.

Tischfield grew up not far from Jersey but a world away from the university research hub that has become his milieu.

A Brooklyn native, Tischfield recalled, “I grew up knowing two kinds of people only. I knew Jews, and I knew Italian Catholics. The neighborhood was about half and half.”

Dr. Jay Tischfield, of the Rutgers University Cell and DNA Repository. (Courtesy Rutgers)

He went to Brooklyn College before going north to attend graduate school at Yale. He recalled that mostly everybody at the prestigious Ivy League university treated him kindly, as did Yale as an institution, but he recalled several instances of anti-Semitism.

One weekend, Tischfield said, he was working with “a rather famous professor” in the professor’s lab. The professor had brought along his son, who began chatting with Tischfield.

“He told his son to get away from me,” Tischfield said. “Then he said he was very upset that Yale was accepting my kind of people. I did not quite get it for a few seconds. Then it hit me.”

Dr. Jay Tischfield and family, 2017. (Courtesy)

After graduating from Yale, Tischfield went on to live all over the country, with stops in San Francisco; Cleveland; Augusta, Georgia; and Indianapolis.

“In Augusta, I encountered some racism,” Tischfield recalled. “It was not as bad against Jews as against blacks… In Indianapolis, I did not experience anti-Semitism despite it being the home of the Ku Klux Klan… A large fraction of my neighbors were Jews.”

He found a home in New Jersey just over two decades ago after receiving an invitation from Rutgers, where he and his wife raised three sons. He described his current community as diverse and welcoming.

Asked to what degree his faith helps him today during a complex time for the nation and world, Tischfield responded, “I am not a believer but I do believe in Jews and Jewish culture, which has always told me to ‘Heal the World.’ As a scientist, faith makes no sense to me and I don’t ‘feel’ it; prayer makes even less sense yet I belong to a Reform Temple and am committed to Jewish causes.”

“I guess that I feel that I need to set a good example as a recognized Jew and I’ve learned that good deeds are their own reward,” Tischfield reflected. “Besides doing an occasional mitzvah, setting a good example has clear earthly professional rewards.”

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