When we started getting ready to deal with the COVID-19 pandemic caused by the SARS-CoV-2 virus, little did we know that it was going to be with us for the long haul. By the third week of March, we were ready to handle people who came for testing to our laboratory. However, preparations began about two weeks earlier.
The first step in all of this was to create an awareness about the infection amongst the staff, clearly explaining to them the risks involved. All the staff who were willing to be frontline workers were trained on all aspects related to their area of work. Staff were given prophylactic hydroxychloroquine as in March, this was possibly the only drug thought to help lessen the severity of infection.
Our focus was always to ensure that anyone who came for testing left the premises satisfied and in the shortest possible time. So, what did we actually do:
a) As we had the lockdown to deal with simultaneously, we made arrangements for our staff vis a vis, transport, accommodation and food for those who were willing to come, but could not, for any of the reasons listed above.
b) A separate area was made for the sample registration and collection area for those clients who would be coming for testing, keeping in mind the safety of the client and our staff.
c) Laboratory disinfection protocols were put in place and are being scrupulously monitored to this day.
d) All staff were sensitized to the necessity for frequent hand washing, maintaining safe physical distance and the need for the essential PPE depending on the area of work. This wasn’t always easy especially in hot Chennai. We could only try and lessen the hardship involved by introducing a roster system so that they needed to be in full PPE on every alternate day. Another thing we did was to rotate the registration staff between A/C and non-A/C areas as some of the samples we received in bulk were registered in AC rooms. A roster system was followed even for the technologists who did the sampling.
e) Housekeeping staff were trained in additional procedures, like sanitising door handles, chairs and tables almost continuously.
f) Customer support staff were trained in patient client handling in the COVID area, as the levels of anxiety of all these people was always high.
g) Round the clock administrative and IT staff were available to sort out any glitches that could happen like failure of the UV lamp (which effectively inactivates airborne microbes) in the collection area, or the air handling unit in the processing area, or any software related problem.
h) All clients who came to the lab for testing irrespective of what test they had come for are being provided with surgical masks in case they don’t have one.
i) Temperature check is now done for everyone who enters the laboratory.
j) Hand sanitizer is made available at strategic locations in both COVID and non COVID areas of the lab.
The technical staff in the processing lab look like aliens in their apparel, with their N95 masks with respirators and their voices sound like from outer space when we attempt to speak to them from outside the processing lab. Safety of our staff was/is of prime importance.
As the virus raged on we realised that it was now well and truly in our midst and we needed to take additional safety precautions. Even though the lockdown was periodically lifted, we decided that the staff in the non-technical areas of the lab, could take turns in coming to work, the A/Cs were switched off in confined spaces, the lift was made operational only in select situations – everything done to minimize the risk of transmission of this infection.
A little over 100 days after the virus entered our lives, where are we? We had requested our staff to stay away from work at the first sign of any symptom that could be potentially a COVID-19 infection.
A few of the non-technical staff did pick up the infection, but thankfully a very mild one that cleared spontaneously in a couple of days. All the staff who had interacted with them were also screened after three-four days, whether or not they had symptoms. Anyone who tested positive was reported to the local health authorities and followed the protocol of self-isolation or admission in a COVID Care Centre. All staff who tested positive were strictly allowed to rejoin work, a minimum of three weeks after the symptoms had disappeared, as per the health authority’s advice.
So, can we relax and treat this as any ordinary flu that we are all used to, year after year? My answer as I write this is an emphatic NO.
As more and more information on the virus is known, we realise that it can be more serious than initially thought to be. While the mortality rate is still fairly low in India (less than 3%) as compared to other countries, the biggest worry about this virus is its unpredictability. We just don’t know who the unfortunate people are, who are going to be hit badly by it. While broadly we know that mortality and morbidity is more in those who are above 60 and in those who have chronic underlying illnesses, there have been several unexpected fatalities.
Information about airborne transmission of this virus has now emerged. This means that we can no longer be complacent about wearing masks only in crowded areas. We need to wear masks when we are outside our homes. We need to be obsessive about washing our hands with soap and water or with sanitiser. We need to be aware of the physical distance we keep from others when we interact with them, even with our masks on. There is no end point to the safety measures that can be implemented. For a good and safe effective vaccine, it might take a year or more, even if fast tracked. Until then, we need to give this virus the respect it deserves, in our own interest.
Dealing with several hundred patients every day requires tremendous patience, commitment and truly high motivation levels- truly not meant for the faint hearted. This has been a challenge for all of us in the laboratory on all fronts, and while we have coped so far, I do hope that this pandemic dies a natural death soon and we can get back to a “new normal” life soon.
Dr Saranya Narayan is Technical Director and Chief Microbiologist at Neuberg Diagnostic.