By Gregory Hovan, Microbiology Manager I, Delaware Public Health Laboratory
The United States has more COVID-19 confirmed cases and deaths than any other nation, as shown on the COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). This has affected all public health laboratories in their mission to support and protect the health and well-being of the population. For those involved in laboratory biosafety and security, increased pressures to respond and adapt to demands and responsibilities have called for involvement with a large team of professionals focused on the management of a pandemic.
For years, the State of Delaware public health system has made efforts to provide a high degree of cooperation and coordination among partners, contractors, personnel, vendors and others to ensure that laboratory and other public health services are effectively and reliably provided on a consistent basis. For example, efforts were made to develop robust systems for samples to be transported, processed and reported (data entry, etc.) within a short turnaround time even when facing a surge in laboratory workloads. At the Delaware Public Health Laboratory (DPHL), COVID-19 has led to changes in how services are provided in support of surveillance programs, as well as primary health care programs.
Balancing the risk
When pandemic surge testing began, contract personnel were brought in to work alongside full-time laboratory staff. To ensure biosafety protection for the entire laboratory staff, regardless of position or tenure, personnel received pandemic organism-focused biosafety training. This shaped part of the onboarding process for new personnel and reinforced the awareness and knowledge for full-time personnel. Training was customized to the levels of knowledge and skills within each laboratory group—that is, data entry staff received less detailed technical training than more specialized technical positions.
Beyond in-house training, outreach activities supported other state clinical laboratory partners regarding the new and emerging pandemic-associated biosafety principles and practices. Much of this required input from real-life experiences in other public health laboratories and agencies. As this happened, measures were taken to coordinate activities among different organizations, such as hospitals, clinics, academic institutions and others. Within this effort, knowledge and information from APHL and our partners such as the American Biological Safety Association (ABSA) and the US Centers for Disease Control and Prevention (CDC), was shared.
Changes in roles and responsibilities
As the pandemic evolved, the specific responsibilities of a Safety Officer also had to adapt as new knowledge was gained. There were key elements that had to be considered in the role of Safety Officer, which include:
- Learning from this experience in preparation for similar future events
- Testing the extent to which the laboratory, as an organization, can change and adapt in response to a major event
- Maintaining good working relationships among internal work units as well as with external vendors and partners to ensure a coordinated flow of activities and the provision of needed materials and supplies
- Training and outreach to reinforce the concepts and practices related to safety and security, especially when dealing with an infectious agent.
What became a large part of the Safety Officer’s responsibilities was to assess a myriad number of Food and Drug Administration (FDA) Emergency Use Authorization (EUA) test methods for COVID-19. This assessment ensured that any test method could be reliably used in a clinical setting for patient management. Once a reliable test method was selected, a risk assessment followed to ensure the safety of personnel during testing practices. This was done in cooperation with the Internal Biosafety Committee (IBC) and the laboratory manager responsible for the logistics of implementing the test method.
Once the test method was implemented, considerations were also given to testing personnel exposure to the virus. This was managed using personal protective equipment (PPE; respiratory protection, etc.), the identification of safe entry and exit points, ensuring proper environmental temperature and humidity conditions, limitations on testing group clustering as well as clustering in meetings, training classes, etc., and the frequent use of disinfectants. All of these activities were then reflected in changes made to laboratory policies.
COVID-19 has highlighted the need for not only established biosafety and biosecurity protocols in the laboratory, but also the need for a person or team to focus solely on protecting all laboratory personnel in every position, especially during a pandemic. It is essential for any Safety Officer to become very aware and involved in routine laboratory response activities with a focus on mitigating risks and ensuring the safety of all personnel.
Read more biosafety stories and lessons learned in the Summer 2020 edition of Lab Matters magazine.
