CoBUSters: organization and deployment of a mobile Covid-19 test team for large-scale testing in collectivities as a societal outreach from a university hospital.
Authors: Hans Guy , Apers Jolijn , Vanmechelen Michael , Claes Brigitte , Moons Kristel 
Published: January 2024

During the summer of 2020, government agencies in Belgium were hasty to create additional test capacity for the diagnosis of acute infections with SARS-CoV-2. Large-scale initiatives were necessary to absorb the waves of covid-19 infections throughout all levels of society.
Within the Antwerp University Hospital (UZA) we realized that it would be impossible to perform large-scale testing of schools, universities, companies, or other collectivities if sampling capacity would not be made available within the collectivities themselves. A large number of scholars or students would not be able to move toward test centers. So, we created a mobile testing team that on-call would be sent to the collectivities to perform testing within the schools, universities, and companies. The test team started in October 2020 with a single bus which was transformed to accommodate the administrative handling of the test e-form, the scanning of the eID of the person to be tested, as well as the sampling through a nasopharyngeal itself. The structure of the bus allowed to perform the testing of 12 students every 15 minutes. Within a couple of weeks, the demand for large-scale testing increased to more than 1000 a day. Towards the end of 2020, a second bus was put into operation. During the year 2021, additional vans were put into operation as the daily number of tests further increased.
The mobile test team remained in operation until the end of May 2022. During this lifespan, more than 200,000 nasopharyngeal samples were collected by the test team. The highest number of tests on a single day was 4,200. The mobile test team operated within three Belgian provinces, serving more than 2,500,000 people. Besides the testing teams, we created a dispatching team which was evaluable 7/7 for calls and registration of demands for new testings. Besides schools, we performed collective testing in colleges, universities, nursing homes, large companies, prisons, and hospices for homeless people. We even performed large-scale tests within municipalities at the hights of the covid waves. TAT for reporting results was less than 24 hours after sampling.
The mobile test team, CoBUSters, became known throughout the entire country as a truly innovative social project. Many wondered why a hospital developed a service that was well outside of the regular hospital-related activities. We however did this because this aligns with our mission as a community-based hospital with a strong societal-oriented focus. Hospitals should not remain within their walls, but when society needs them they should quickly develop activities to support society as a whole. This project allowed us also to interact on an almost daily basis with healthcare providers on the first line of healthcare (GPs, home care nurses). From the hospital, we provided the services that the first line could have never mobilized like administrative and nursing staff or manipulation of huge numbers of PCR tests. Together we were able to protect our collectivities against massive outbreaks of the SARS-CoV-2 virus. Even tertiary hospitals have a fundamental societal role when called upon. We should never forget this.