-It's morning in Manassas, Virginia, outside Washington.
LabQuest flight 651 has been in the air since before dawn.
Inside those coolers and boxes,
blood and other bodily fluids from across the country.
In this time of coronavirus with cases again on the rise,
tackling it takes testing and it takes speed.
For that, you need a ground game and an airline.
Across the Hudson River from New York City
in Teterboro, New Jersey, couriers at Quest Diagnostics
are getting ready for their nightly runs.
This run into Manhattan at the height of rush hour,
9th Avenue should not look like this.
But the city, still under lockdown from coronavirus.
-I've been working for 26 years for this company.
So I've really known a lot of routes.
We just came here to pick up these two patients.
Gonna get the specimens back to the lab on time.
-It's after closing time
and a day's worth of specimens like blood
or other fluids are waiting, some at room temperature,
others frozen or just refrigerated.
COVID-19 swabs are kept here
to keep the virus alive for testing.
By 7:00, it's back to New Jersey,
leaving behind a city on edge over a pandemic
and protests over police brutality.
With so many routes and so many couriers,
Quest has a drive-through.
Into the night, the big sort begins.
It's a job of separation and identification,
making sure the right specimens get to the right lab
and nothing is lost.
Quest actually saw business tumble
at the start of the pandemic.
Volume down more than 40%.
With medical offices closed, there was no need for lab work.
Now the challenge is keeping up with all of the normal testing
and COVID-19 on top of that.
These are vials with COVID swabs,
the image blurred to protect patient identities.
-It's really only been a little less than three months
that we actually basically ramped up our operations
to go from zero tests to where we are as a company.
I think we're around 100,000 a day at this point.
-Developing a laboratory test, then rolling it out,
usually takes months, even years.
During the pandemic, Quest didn't have that kind of time.
-With COVID, everything was sort of shrunk dramatically.
-So everything is moving fast.
After the big sort,
specimens head to other parts of the building
for testing or across the street to the Teterboro airport.
Whatever cannot be tested here gets flown to another lab,
including COVID-19 swabs.
By 1:45, the night's flight is leaving,
but we're staying behind.
Specimens take priority over passengers.
-We look at every specimen being a life.
And there are two really big components
that we're focused on, and that's time and temperature.
So from a timely delivery, sometimes to move forward
via ground is really not an option for us.
-So they move by air on Quest's own airline,
based in Reading, Pennsylvania.
And those planes haven't just been moving specimens.
-At the outset of the pandemic,
there was a need for our laboratories
to really increase testing capacity
but was really up to our Quest Air operation
to move a lot of those components, testing equipments,
reagents to our laboratories
to get up and running really very quickly.
-The airline's day starts at 2:00 with this meeting,
planning a night of flying.
-The forecast -- we have a quasi-stationary front.
-Quest has a fleet of 23 planes, serving about 63 cities a night.
-That's gonna fit 180 of those bags full.
-Scott Borton is director of national air logistics.
-Definitely a unique operation and I feel it takes
a unique person to do this work.
A little harder work with regard to loading and unloading
and we kind of have muscled through it quite a bit,
but the big thing is, is the operation
runs differently than like an airline.
-Different because during the day, pilots sleep
while their planes get a look and a polish
by the maintenance staff.
Flying small planes in the middle of the night
through all types of weather with a time-sensitive cargo
takes a certain kind of pilot.
-Not one of those jobs where you get a lot of glory.
We certainly look for guys that are self-motivated.
-How many empties do we have? -A lot of personal integrity.
You're out there by yourself predominantly
with very little supervision.
-By early evening, pilots like Michael Debkowski show up
for their night of flying.
He's been doing this for 20 years.
-If you manage your sleep correctly,
it's really not that big of a deal.
The weather, of course, is always a factor
in aviation, for sure.
We have four seasons.
We have thunderstorm season, we have fog season,
then it goes into winter,
and then it goes back into fog season,
and then it just kind of starts on over.
-By 7:35, he's off, flying what's called the soul crusher.
It's a brutal route through the south,
scooping up specimens across multiple stops,
dropping them off in Manassas before landing back in Reading
at 4:36 in the morning.
-This job has always had a sense of purpose.
We're doing things that people are relying on answers
that they're waiting for.
And now during this time of COVID,
the sense of urgency and purpose is certainly heightened.
-But there's one last flight of the night or morning or day.
Back in Manassas, the Quest Diagnostics van heads off
with 66 coolers and boxes to this lab nearby.
And LabQuest 651 is filled with empty coolers.
It's going home to Reading.
This Pilatus PC12 will do it all again tomorrow.
Every specimen, a person needing a test.
And these days, the need is everywhere.