---
title: "The six-step testing process for a novel pathogen"
description: "How a sample gets from patient to result when no rapid test exists."
canonical: https://tomsharman.com/bookshelf/biological-war/the-six-step-testing-process-for-a-novel-pathogen/
updated: 2026-11-03
---

# The six-step testing process for a novel pathogen

> How a sample gets from patient to result when no rapid test exists.

Annie Jacobsen's framework, from Biological War, pp. 108 to 160.

Framework 1 of 3 from [Biological War](https://tomsharman.com/bookshelf/biological-war/index.md) by Annie Jacobsen. Category: Hiring and teams.

## The steps

1. **Sample collection.** A sterile swab collects mucus or tissue from nose or throat, sealed in a tube with preservation fluid and labelled.
2. **Paperwork.** Patient name and date of birth are printed and attached, and an electronic order is created with a time stamp.
3. **Physical transport.** A medical courier authorised for contagious pathogens carries the sample in an insulated pouch.
4. **Pathogen test prep.** A technician logs the sample by barcode, confirms its integrity and prepares it.
5. **Testing.** Rapid antigen (about 15 minutes), PCR (about 1 to 3 hours) or culture (about 1 to 3 days), reviewed by a human supervisor.
6. **Delivery of results.** A human pushes the electronic result to the facility, the patient or both.

## Where it comes from

From chapter: Part III: Once It’s Here, It’s Already Too Late, pp. 108–160

Day Four shows the plague reaching Los Angeles and the wider world. Four bodies are found on Skid Row, a misdiagnosed patient contaminates Los Angeles General Medical Center, and superspreader events hit a cruise ship and a US aircraft carrier. Russia blames marmot meat from a wet market, a story the CIA analyst rejects because marmots hibernate in January, echoing the 1979 Sverdlovsk anthrax cover-up. The World Health Organization's system is built for certainty rather than speed, testing a novel pathogen takes six slow steps, and the US has about 100 high-level isolation beds. Sick migrants flee the Dominican Republic by boat, the president issues a WARNORD for domestic military deployment, and the Diamond Princess sends a distress call.

## The animation

24 seconds, 4:5, no sound.

- MP4: https://tomsharman-downloads-006143767029.s3.eu-north-1.amazonaws.com/downloads/bookshelf/biological-war/the-six-step-testing-process-for-a-novel-pathogen.mp4
- MP4, dark: https://tomsharman-downloads-006143767029.s3.eu-north-1.amazonaws.com/downloads/bookshelf/biological-war/the-six-step-testing-process-for-a-novel-pathogen-dark.mp4
- Still: https://tomsharman-downloads-006143767029.s3.eu-north-1.amazonaws.com/downloads/bookshelf/biological-war/the-six-step-testing-process-for-a-novel-pathogen.png
- Still, dark: https://tomsharman-downloads-006143767029.s3.eu-north-1.amazonaws.com/downloads/bookshelf/biological-war/the-six-step-testing-process-for-a-novel-pathogen-dark.png