Staying One Step Ahead
We asked pathologists and laboratory medicine professionals to tell us how their professional and personal lives have changed during the COVID-19 pandemic
Vikki Rand, Saswati Das | | Quick Read
Vikki Rand, Head of Biosciences Research at the National Horizons Centre, Teesside University, Darlington, UK
The National Horizons Centre (NHC) is a state-of-the-art bioscience facility established to bring together research, teaching, and enterprise. We only officially opened last October, but it’s fair to say the team and I have had to dramatically refocus our immediate priorities in response to COVID-19.
As with other universities, our teaching has moved online and lab-based experiments are on hold, but we have made the most of working from home. Although we are used to working together at the NHC and thrive on in-person scientific discussions, we have stayed connected online to develop projects, write grants, submit papers, and share our research via online seminars. Importantly, we have focused on growing our research and enterprise partnerships with companies, NHS trusts, and other stakeholders. We have also given virtual tours of the NHC to show what we can offer.
Within days of the WHO’s declaration of a global pandemic, we supplied a significant amount of specialist equipment to North Tees and Hartlepool Hospitals NHS Foundation Trust. The equipment will automate COVID-19 viral RNA extraction from clinical specimens, which will be instrumental in scaling up COVID-19 testing. In addition, the University has offered lab and bench space, specialists within the NHC to help run the tests, and consumables – such as gloves and pipettes – that are in short supply. We have also provided other NHS trusts with specialist PCR machines to run the current tests and offered equipment for high-throughput sequencing of the virus. We look forward to the pressures on the NHS easing so that we can continue our collaborations with pathology labs and clinicians across different disease areas.
NHC colleagues have really stepped up to the challenge of finding new ways to work under lockdown – and our areas of investigation have evolved. Beyond our immediate response, we are part of a study working with clinicians from local NHS Trusts to understand the clinical course of COVID-19 cases in the region and in other countries. This study uses clinical data collected from COVID-19 patients, which we are analyzing to identify risk factors associated with patient survival that could guide future treatment strategies. In parallel, we are developing biological studies to investigate several aspects of COVID-19 and underlying conditions such as respiratory disease. One such area is investigating the “cytokine storm,” a common complication of not only COVID-19 but also other diseases.
Since joining Teesside University and the NHC in October, I am thoroughly enjoying my new role – but it has been an interesting start. Within my first six months we opened the NHC, closed it again, and provided equipment, reagents and PPE to local NHS Trusts. Not quite what I had planned, but I am very impressed with the dedication, tenacity, and positivity of my new colleagues in these challenging times. Scientists like me are facing the greatest professional challenge of a lifetime – and it is our responsibility to rise to that challenge. We need to not only embrace emerging research opportunities, but also to inspire future scientists. It is a particularly difficult time for our school leavers, who would normally be doing their exams. As a university, education and training is at the forefront of our mission and we are working with local authorities, colleges, and industry to develop new opportunities. One (very topical) area of growth is the development and manufacturing of advanced therapies, including vaccines. The NHC’s strengths in life sciences, bioprocessing and education makes us ideally placed to develop a workforce with the skills that are in such clear demand.
Saswati Das, Specialist (Chemical Pathology), Central Government Health Services, Dr. Ram Manohar Lohia Hospital, New Delhi, India
Over the past five months, the COVID-19 pandemic has engulfed the entire world. Since its December 2019 identification in Wuhan, China, the disease has spread across many continents and claimed many lives. Laboratories around the world have risen to the challenge of meeting COVID-19 diagnostic needs – and it has highlighted the pronounced effects laboratory reports have on patient management, bringing laboratorians to the forefront of the healthcare system. Lab managers have had the daunting tasks of raising labs’ biosafety levels, dealing with staff shortages, managing resources, and enhancing team resilience.
COVID-19 posed a novel challenge to laboratory leaders. The World Health Organization classified SARS-CoV-2 as a BSL-2 pathogen (to be handled in biosafety cabinets using standard precautions). In the laboratory, there is always a risk of occupational exposure to COVID-19. Our work generally requires several staff members’ presence in the laboratory at the same time – but, because social distancing was mandatory during the outbreak, we had to make changes. Our lab rearranged workstations, segregated teams, and introduced online training.
The first step toward change was to identify the risks of raising our biosafety level and define standard protocols to mitigate them. One of the most important actions we took was to educate staff about the potentially devastating outcomes of poor safety practices – which also gave us an opportunity to retrain everyone in standard safety skills. We conducted biosafety audits to measure compliance, surveyed staff on safety practices, and – crucially – encouraged feedback. Finally, we designed contingency plans to cope with different staffing levels, so that we could continue to operate if staff members were infected, quarantined, or unable to commute.
A major challenge we faced was rapid validation of new COVID-19 tests. Dozens of tests appeared within a short span of time. Many were based on molecular testing, which not all staff were trained to perform. With the number of samples increasing constantly, staff from other departments in the laboratory had to be pulled in and trained to meet the testing demands. Another concern was the availability of reagents and personal protective equipment. We designated a team leader in every shift who, as well as managing staff, was responsible for maintaining stock, ensuring adherence to turnaround times, prioritization/deferral of laboratory tests, and updating the health status of all lab staff. Team leaders reported directly to the laboratory manager, establishing a chain of command.
In this time of crisis, we had to strike a balance between protecting the vulnerable and supporting the administration. Disruptions were inevitable and, sometimes, difficult choices had to be made. Since the beginning of the pandemic, laboratory teams have been relentlessly conducting COVID-19 tests at a rate of hundreds each day. This has taken a toll on the staff and fatigue has set in. To help, we instituted adequate rest between shifts, provision of food and accommodations, peer counseling, and regular team briefings to ensure health and wellbeing.
Laboratory leaders worldwide have devised innovative action plans to navigate the pandemic. We have learned lessons that will remain with us for years to come. As technology advances (and creativity blossoms), we must continue to develop new strategies and redesign our laboratories and workflows so that we are prepared for the next pandemic – or any future crisis we may encounter.
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