USMS Member Elizabeth Lowe Saves Lives in the Bay Area With Mobile COVID-19 Testing Clinic

Elizabeth Lowe and her mobile COVID-19 testing unit arrived in June at a residential care facility in Marin County, California, just outside of San Francisco. Outfitted with a repurposed commuter shuttle van and Home Depot toolboxes repurposed to tote medical supplies, Lowe’s team set up three testing stations in the building’s parking lot. They worked with the staff to devise a system: testing took place outdoors to minimize possible transmission, and staff lined up residents—many of whom were in wheelchairs or beds—at a distance inside the facility, wheeling them out one by one to be swabbed.

That day, Lowe’s team set a record: 189 tests in less than four hours. The doctor was exhilarated. A competitive swimmer for most of her life and member of Tamalpais Aquatic Masters, she knows her staff finds humor in her numbers-driven goals, but more than that, there’s an overwhelming pride. That many tests in so little time is a milestone, and it’s also a testament to a program Lowe built from scratch this spring, when the novel coronavirus shut down the United States and put medical professionals across the country on notice.

A primary care physician at MarinHealth Medical Center, Lowe saw her practice grind to a halt in mid-March, when non-essential medical visits went by the wayside. Lowe and her colleague, Irene Teper, determined the best way to pitch in against the virus was to create an off-site clinic; that way, they could test COVID patients while keeping their office a safer space for patients who needed urgent, non-COVID care.

At first, their new drive-through clinic was swamped. But about two weeks into its existence, Lowe says, testing volume at the clinic dipped. Something didn’t add up, though. Hospital admissions were skyrocketing. “We were like, where are these people?” recalls Lowe, 54. “Who are these people who we're not seeing in our clinic yet are showing up in the hospital?”

Lowe found her answer quickly: They were largely coming from skilled nursing facilities and residential care facilities for the elderly. In addition, infections were skyrocketing in the Canal, a densely populated Latinx neighborhood in nearby San Rafael, where much of the population was designated as essential workers. Lowe knew neither of those groups would be able to access the acute care clinic, so she devised a solution, commandeering a van that sat idle due to a lack of commuters and packing a rolling suitcase with whatever supplies she thought she might need. She set off to those facilities and the Canal, administering swabs that she’d bring back to her clinic to be analyzed.

Over the past five months, Lowe’s operation has evolved into a well-oiled machine. She traded in her suitcase for the toolboxes and now has two vans, a nurse practitioner, a fleet of college interns, and she recently added an EMT. She received a grant to fund her mobile unit for a year.

Lowe says she hasn’t worked this hard since she was a resident physician in Chicago in the 1990s, but amid the chaos she’s found gratification. Lowe’s team has saved countless lives in the Canal and helped lower the number of infections in skilled nursing and residential care facilities across the area. “The thing that's really fun is the work ethic has been so high,” she says. “Everyone wants to step up and do more. And this kind of collaborative team effort … is very similar to being on the swim team, where you're kind of doing your individual sport, but it's always more fun on a relay—and you never want to work out by yourself.”

By the end of summer, Lowe was splitting her time between her private practice, where volume has been increasing, and the mobile unit. She’s also itching to get back in the pool, though most in her area have been closed since the onset of the pandemic. Those that are open, she says, require swimmers to make reservations days in advance, something her schedule won’t allow. Instead, she’s embraced open water swimming this spring and summer in the frigid San Francisco Bay, workouts that serve a dual purpose. Besides keeping her active, they serve as a shower after a long day in PPE.