COVID-19 Impact Part 2: Preparedness and Response Across North America and Europe- Q&A

how do you manage training of new staff with the requirement to social distance 6 feet?

Training of new staff while adhering to the 6 ft social distancing measures primarily posed an issue in the lab. Starting a COVID biobank definitely proved some challenges as we had a fixed square footage of our lab. We were advised by UHN Safety to limit number of people in the lab to 4 people at a given time, with only 1 person per hood. This proved to be difficult but doing any training outside the lab or offsite helped to limit the amount of time needed in the lab to what's required. (Heidi Wagner)

We did not have any new staff during this period. All students were told to study form home and could not do any lab training. Here in Verona, all hospital based staff are required to wear masks and gloves at all times and in the office spaces the rule is one person for every six square meters so in fact we have had reduced numbers at work. (Rita Lawlor)

I know PPE and some laboratory consumables are in short supply - did you face any other critical issues with vendors during this time?

UHN has been managing PPE levels for all staff and has been outsourcing them from other vendors/suppliers. Turnaround time for PPE has been longer than anticipated but not impossible. It has also been dependent on which vendors/suppliers had available PPE. High in demand PPE like hand sanitizers, specific masks, and gloves eventually sold out and we had periods of waiting or using alternatives until vendors were replenished in stock. Moreover, Issues we encountered were mainly the speed of getting supplies we needed to start the COVID-19 Biobank rather than the item itself. (Heidi Wagner)

As I mentioned in the presentation, there was difficulty in getting access to both virus extraction and testing kits, in particular the extraction kits for automated extraction and even more so the plastic tubes, microplates and other consumables needed for the extraction. (Rita Lawlor)

Did any of your biobanks need to do onboarding/training of new staff during this crisis and if so, do you have any guidance on doing that effectively?

During this pandemic, most of our team have moved remotely. We have on boarded 2 new members remotely to the MGB team which has proven quite successful using varies methods of communication such as phone, skype, teams, email etc. (Heidi Wagner)

We did not have any new staff as in fact most of our staff were sent home. Our biobank staff were reassigned for testing based on their capability to handle the samples using both manual and automated methods. (Rita Lawlor)

Did you find that the services offered by your biobank were supported by remote work when not COVID specific?

Day to day biobank tasks such as patient-facing sample procurement had halted and could not be transferred remotely During this time of working remotely, we were able to do the prep work needed for a quick turnaround time once we are able to get back on site. Available time gave us an opportunity to do database updates and system improvements. Other remote tasks included data abstraction projects, data pulls, finalizing on near-complete sample pulls and releases, etc. While we are still able to do work, it is not sustainable for a long period of time. (Heidi Wagner)

We did not have specific services active during the lock down that were not covid specific other than data analysis which was still feasible but only for samples that had already been characterized or whose images had been acquired digitally. (Rita Lawlor)

I am quite interested in learning more about communication strategies for working remotely. What are things that work and things that do not?

Microsoft teams has been our team’s primary method of communication as it did not rely on the cellular service, allowed screen sharing, chat groups etc. It was also declared as UHN’s preferred method of communication among research groups during this pandemic from a security standpoint. (Heidi Wagner)

Sample vital types. Are you seeing any sort of standardization?

Standard sample types such as plasma, serum, and urine have been collected. PBMC has especially been in high demand - posed as a challenge as it is not routinely used for patient care and is relatively time sensitive for processing. (Heidi Wagner)

With regard to COVID testing, we have seen a variety of vial types. This is dependent on the process and procedure being used for testing but also is affected by the availability of tubes and vials and tests given the huge demand. With regard to our biobanking, our stocks are calculated to permit three months of collection but as the collection was stopped we did not require to consider alternatives. (Rita Lawlor)

The pandemic required flexibility and new approaches. Which change in approach/ way of working would you like to keep once we go back to a more normal situation again?

Maintaining level of flexibility, ability to create workarounds, and resolve challenges quickly. (Heidi Wagner)

We are seeing an increasing number of requests for samples/data from academics with time on their hands. How are you managing the increased requests when these academics consider them "urgent" and COVID-19 is impacting staffing levels.

Take it one day at a time. While we can still begin initiating and planning projects and requests, it is important to be transparent with study teams and provide realistic timeframes of sample releases especially with provincial/national/international restrictions imposed. For the most part, study teams and researchers have been flexible with the current situation and have not placed any pressure or "urgency" to receive samples. Restrictions have been imposed on their end as well, and so they were also unable to receive samples. (Heidi Wagner)

Are there any different lab safety handling protocols for Covid-19 positive samples by biobank staff?

Lab safety handling of COVID-19 positive samples dependent on viral load of samples (varies on sample type - saliva has higher viral load); More PPE required = level 2 masks, gowns, goggles, gloves; All stations are wiped down with disinfectant prior to use for processing; Constant disinfection of surfaces; Ensure inventory of PPE is maintained. (Heidi Wagner)

Is it acceptable to have a trainer and trainee wear ASTM level masks and eye protection but not social distance?

No – although ASTM masks (Level 3) helps with fluid, blood, or aerosol exposure, social distancing is an extra barrier of protection. (Heidi Wagner)

Do you have plans or guidance that you're using to restart operations & services during safety limitations?

Under guidance from UHN, we are doing a multi-phase re-start to resume non-COVID-19 research. We currently started phase I where 25% of research was allowed to restart. These guidlines includes PPE, re-start approval, max. number of people allowed at specific locations etc. (Heidi Wagner)

Storage of samples from Covid19 positive patients (eg: blood derivatives, biopsies) at -80C or in liquid nitrogen: any special precautions, any dedicated freezers or liquid nitrogen tanks? (Heidi Wagner)

Yes – we keep COVID-19 samples in separate freezers. (Heidi Wagner)

When updating/reviewing SOPs did you add a pandemic response?

We did not add a pandemic response as the protocols that we were updating were regarding the samples processing and registration and these would not necessarily be operational during a pandemic. Our protocols for sample processing already have security checks and measures for potentially infected samples (not specifically COVID) as part of our sample processing as we collect tissue and blood. (Rita Lawlor)

What additional measures to cope in this new COVID era are proving most difficult to achieve for your biobank?

In the COVID period we have not been operating as a biobank. Biobank operations were halted as we had no prospective collections due to surgery being halted. Research was not considered an essential service and so research laboratories were closed and therefore samples were not required. Now that we are operational again in the next phase of the COVID era, we are actively performing both biobanking and continuing our covid testing so integrating both services is challenging. That said, the number of samples to collect and process has halved as there are less surgeries and this will continue to the end of the year. (Rita Lawlor)

Are there limitations on the consent to allow specimens to go outside of the country (or data) to work in collaborative projects?

We are subject to GDPR which requires specific conditions for sending samples and more so data to third countries, i.e. those outside the EEA particularly if these countries do not have an adequacy decision which means they have been evaluated by the EEA and considered to have an appropriate level of data protection. Many samples originally collected at the start of the pandemic would not have had specific consent but could have been used under the condition of public interest. In the meantime the ethics and privacy offices have developed specific consent for the collection and use of these samples and data for research which also includes the possibility to share samples abroad but always in respect of the GDPR and the national derogations of this. (Rita Lawlor)