Belleville clinic works to care for Amish during pandemic

Medical director worries about impact of virus

BELLEVILLE -- At first glance, many parts of Mifflin and Huntingdon counties seem to offer little more than serene farms and Amish buggies on county roads.

Locals can even be heard saying, "Nothing ever happens around here." But look a little closer and you will find a genetic research clinic tucked among the Amish farms in Belleville. The clinic is set apart for not only the work it does with genetic diseases but now for the way it is helping educate the Amish and Mennonite communities and offering testing during the COVID-19 pandemic.

Take a stroll through the intimate campus of Juniata College in Huntingdon and find in their Center for Entrepreneurial Leadership (JCEL) a state-of-the-art laboratory bringing innovative testing solutions to hospitals and clinics during the COVID-19 pandemic.

Dr. Holmes Morton, medical director of the Central Pennsylvania clinic in Belleville, came here with a vision to care for those among the Amish community with genetic diseases. The Central Pennsylvania clinic is modeled after a clinic in Lancaster that Morton and his wife started more than 30 years ago. Morton also helped start similar clinics in Ohio, Indiana, Wisconsin and Kentucky. As the coronavirus pandemic made its way toward this region, Morton began offering drive-thru COVID-19 testing for the Amish and Mennonite community. He was concerned about the impact this virus could have on them.

"We have a high-risk group of patients who have lung disease, congenital heart disease, who have immune disorders and blood disorders, all of whom will be made unstable by respiratory infections including COVID-19," Morton said. "So, part of our mission is to educate the community about the need to avoid gatherings where asymptomatic-but-infected and contagious individuals will come in and shake hands with everybody and pass the virus around.

"The problem with this epidemic is that many of the infections begin with people who are not symptomatic or have mild respiratory symptoms like a cold or runny nose are infectious and they are going to gatherings of people whether it's church or a wedding or a funeral or an auction that raises money for good causes. They are going into these crowds and infecting 5 or 10 people and then those 5 or 10 people infect 5 or 10 more and then you have an explosion like we have in New York."

Offering the type of COVID-19 testing that Morton made available to his patients was possible because of his partnership with Dr. Gina Lamendella. Lamendella is a Valko Endowed Professor of Biological Sciences at Juniata College in Huntingdon.

Lamendella had asked Morton in January 2020 to be the medical director of Contaminations Source Identification, a clinical diagnostics company and lab facility in Huntingdon. CSI was founded by Lamendella and two Juniata College alumni, Justin Wright and Gary Shope in 2018.

Morton coming on board was an important part of the growth process for CSI as it would allow it to get its Clinical Laboratory Improvement Act certification.

Lamendella and Morton originally met at JCEL when they both rented space for their endeavors. JCEL is where Morton started before building the Central Pennsylvania Clinic in Belleville and was also the birthplace of CSI.

"Dr. Morton rented space next door to us and that is how we got to know each other," Lamendella said. "He works on looking at genetic risk factors for diseases in the Amish and Mennonite communities and so everything just sort of came together beautifully because Juniata was launching a master program in bioinformatics, which is computational biology, so taking all of this genetic data and making sense of it. There is just a ton of synergy between the two of us and he is such an amazing human being in terms of everything he has done. So, when we were looking for a lab director for CSI, I couldn't think of anybody better and so I humbly asked him if he would serve as our director. And he was excited to accept."

And now with the current pandemic, that work has taken on a heightened importance.

"When COVID-19 hit we basically have worked around the clock to validate our own test system, which is now as of April 1 up and running," Lamendella said. "That test system is called CSI-DX and is much more sophisticated than the tests that are out there right now. The current testing systems sometimes have a rate of sensitivity as low as 66% so we are missing a lot of potential individuals that are seeming asymptomatic and that might be missing those individuals. Our goal was developing a test that was really sensitive.

"Essentially what we do is we sequence all of the genomes in a nasopharyngeal swab and we have our own bioinformatics. It's a patent pending system called Rapid DX. COVID-19 is an RNA virus and so it's changing its genome very quickly, its mutating. That is why doing this RNA sequencing is much more robust because we are able to see all the strains of COVID that might be floating around, and we are keeping up real time with its evolution. Because this pathogen is constantly changing as it's moving its way through the population."

Lamendella went on to say, "It's really state-of -the-art technology that we have developed and it so cool that we are able to meet the needs of an at-risk population like the Amish or Mennonite. The other cool thing is 8 of the 10 employees at CSI are Juniata College graduates so we have this very young talent that many of them could have gone on to their M.D. or Ph.D. but decided to stay and work on this team science approach to really come together to meet the needs of our community. So, it's a really beautiful thing.

"I think the real message here is that it is team science that put us in the position to be able to pivot to COVID-19 testing so quickly. From the testing personnel that are there around the clock that have validated the assay. To the team that has the expertise that has of all the computer science and the bioinformatics that goes into analyzing the data as well as the molecular expertise that our team has in terms of processing the samples. It's very rare to have all that expertise under one roof, then including Dr. Morton's medical background. It's amazing to me that in the middle of nowhere we have all come together and made this happen. It's almost miraculous in a way."

None of the cases of COVID-19 in Mifflin County are patients Holmes has treated or tested, nor has the facility had any positive test results at this time. Morton said his team is gearing up for the possibility of an outbreak in the area and is prepared if it happens.

CSI is now fully certified by the state and have CLIA and Pennsylvania Department of Health laboratory compliance. It is working to network with regional hospitals to help with COVID-19 testing and preparing to be able to do hundreds of tests a day if needed.