Operational considerations and challenges of biochemistry laboratories during the COVID-19 outbreak: an IFCC global survey

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_cclm-2020-0710_s_999_w2aab3b7b1b1b6b1aab1c13b1Aa"><jats:title>Objectives</jats:title><jats:p>The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 conducted a global survey to understand how biochemistry laboratories manage the operational challenges during the coronavirus disease 2019 (COVID-19) pandemic.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0710_s_998_w2aab3b7b1b1b6b1aab1c13b2Aa"><jats:title>Materials and methods</jats:title><jats:p>An electronic survey was distributed globally to record the operational considerations to mitigate biosafety risks in the laboratory. Additionally, the laboratories were asked to indicate the operational challenges they faced.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0710_s_997_w2aab3b7b1b1b6b1aab1c13b3Aa"><jats:title>Results</jats:title><jats:p>A total of 1210 valid submissions were included in this analysis. Most of the survey participants worked in hospital laboratories. Around 15% of laboratories restricted certain tests on patients with clinically suspected or confirmed COVID-19 over biosafety concerns. Just over 10% of the laboratories had to restrict their test menu or services due to resource constraints. Approximately a third of laboratories performed temperature monitoring, while two thirds of laboratories increased the frequency of disinfection. Just less than 50% of the laboratories split their teams. The greatest reported challenge faced by laboratories during the COVID-19 pandemic is securing sufficient supplies of personal protective equipment (PPE), analytical equipment, including those used at the point of care, as well as reagents, consumables and other laboratory materials. This was followed by having inadequate staff, managing their morale, anxiety and deployment.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0710_s_996_w2aab3b7b1b1b6b1aab1c13b4Aa"><jats:title>Conclusions</jats:title><jats:p>The restriction of tests and services may have undesirable clinical consequences as clinicians are deprived of important information to deliver appropriate care to their patients. Staff rostering and biosafety concerns require longer-term solutions as they are crucial for the continued operation of the laboratory during what may well be a prolonged pandemic.</jats:p></jats:sec>

Changes in clinical laboratory operations and biosafety measures to mitigate biohazard risks during the COVID-19 pandemic

“…The International Federation of Clinical Chemistry and Laboratory Medicine Taskforce on COVID-19 did a global survey between April 16 and May 1, 2020, to better understand how biochemistry laboratories have mitigated biohazard risks during the COVID-19 pandemic. 4,5 1210 responses were analysed, 1067 of which were from hospital laboratories that handle moderate volumes of samples daily. 4 During the survey period, 186 laboratories restricted tests on patients with clinically suspected COVID-19 and 171 laboratories restricted tests on patients with confirmed COVID-19.…”

“…4 During the survey period, 186 laboratories restricted tests on patients with clinically suspected COVID-19 and 171 laboratories restricted tests on patients with confirmed COVID-19. 5 The most common restric tions were on tests of pleural fluid and respiratory samples followed by faecal tests, urine tests, and direct microscopy. 5 819 laboratories had increased the frequency of disinfection, most usually from once a day to four times a day.…”

“…5 The most common restric tions were on tests of pleural fluid and respiratory samples followed by faecal tests, urine tests, and direct microscopy. 5 819 laboratories had increased the frequency of disinfection, most usually from once a day to four times a day. 5 Use of pneumatic tube transport to deliver samples was reported to have diminished since the start of the COVID-19 pandemic, with hand deliveries increasing, and more layers of plastic bags were used to contain samples from patients with suspected or confirmed COVID-19.…”

“…5 819 laboratories had increased the frequency of disinfection, most usually from once a day to four times a day. 5 Use of pneumatic tube transport to deliver samples was reported to have diminished since the start of the COVID-19 pandemic, with hand deliveries increasing, and more layers of plastic bags were used to contain samples from patients with suspected or confirmed COVID-19. 4 992 laboratories denied requests for add-on testing for patients with clinically suspected COVID-19 and 814 laboratories denied requests for add-on testing for patients with confirmed COVID-19.…”

COVID-19 Pandemic Once Again Exposes the Weakest Link in Laboratory Services: Specimen Delivery

“…Strategic reduction of hospital personnel caused by staff splitting into teams to maintain a functional workforce may be considered an additional important contributing factor. 7 , 8 …”