Published on November 16, 2020
Last Friday, we hosted a Town Hall for researchers at WashU and discussed the increase of reported COVID-19 cases in the St. Louis region and across the U.S. Our guest speaker, Victoria Fraser, MD, provided her keen perspective and insights into the current crisis. A recording of the Town Hall is available on the OVCR website. Below is a summary of the topics that were presented.
New St. Louis County Orders
St. Louis County has issued a new Safer at Home Order that goes into effect Tuesday, November 17th. Some of the new restrictions include:
- No in-person dining
- No gatherings of more than 10 people
- Businesses should reduce to 25% occupancy limits
- Only leaving home for essential activities – going to work is included in essential activities.
Research Activity on Campus is Dependent on Reducing the Spread
At this point, we are not anticipating a shutdown like we experienced in March. At the beginning of the pandemic, we were very cautious and conservative because we did not know very much about how the virus was spreading or the best ways to reduce the spread.
We now know much more about how the virus is spread and have measures in place to better minimize transmission. The virus is spread predominately by exposure to respiratory droplets when a person is in close contact with someone who has COVID-19, and that the combination of physical distancing and universal masking is highly effective to prevent the spread of the virus. You can visit the CDC website for information on how COVID-19 spreads and their latest information on masks and recommendations to prevent transmission.
Last March, we initially closed down most research at WashU. We then began gradually increasing research activity to the point where we are now, which is close to normal. We have remained focused on three simple public health measures for our research groups: wear a mask, reduce density/keep six feet or more between people, and wash your hands frequently.
These simple measures have proved to be effective, and we have not seen transmission in the labs when these measures are followed, even when positive cases have been identified on campus. We need everyone to continue to be vigilant and to follow these proven measures to reduce transmission.
Preparations for Potential Ramp Down
While we hope there will not be a need to ramp down again, all research groups should make preparations for another potential ramp down. This would involve a reduction of on-campus research activity:
- to revert to the previous 60-80% activity for Yellow Level,
- to Orange Level when we had 25-50% activity, or
- to Red Level where we had only essential research activities.
When making a plan to reduce activity, calculate the total number of hours that would be spent by everyone in your research group if there were no restrictions. If required to reduce activity to 60%, simply multiply that total number of hours by .6, and then develop a schedule for everyone in your group that does not exceed that number of total hours on campus.
In addition to a reduction of time, it is imperative to also keep on-campus density as low as possible. Every lab group should schedule people in shifts so that the entire group is not on campus at the same time. Even in labs that are sparsely populated, it is still vital to schedule shifts. Overall low density is needed across campus, including hallways, elevators, breakrooms, etc. Breakrooms are probably the most important because people must remove their masks while eating and drinking. Keep breakrooms at very low density with a minimum of six feet between people. If you require an exception to having shifts, talk to the Associate Dean for Research at your school (Danforth Campus) or your Department Chair (School of Medicine).
Clinical and Non-clinical Human Subjects Research
Given the rise in COVID-19 cases in our area and the St. Louis County “Safer at Home” order that goes into effect on Tuesday, November 17th, Principal Investigators performing in-person human subjects research should consider the safety of their study participants. PIs should consider cancelling or postponing some human subjects research visits to Danforth and Medical Center campuses that occur solely for the purposes of research. Participant research visits can continue when it is believed the benefit of participating is greater than the risk, including:
- potential benefit to the welfare of the participant (including direct benefits to the participant or indirect wider benefits to people with their condition), and
- the research visit is needed to prevent substantial compromise to the integrity of the study, thereby invalidating the participants’ previous service to the study.
These judgements should be made by the PI of each study.
With the COVID patient population rapidly increasing in our hospitals, many clinical procedures are being cancelled and clinical staff are being redeployed. Therefore, it is more important than ever that researchers ensure that clinical space, equipment and/or clinical personnel that are needed for the research have the capacity to accommodate the research prior to sending a participant to a clinical area.
Surveillance Testing for Researchers
Surveillance testing has been a subject of discussion for many months at the highest levels of leadership. At this time, we are not doing surveillance testing of our researchers, and there are several reasons why.
- Frequent testing without public health measures does not work, but universal masking, physical distancing, and symptom screening do work.
- There is concern that when individuals receive a negative result from a surveillance test they may become overconfident and relax their public health measures. A negative test only means the virus was not detected at the time of the test and does not mean that they are virus free when they get the results or anytime thereafter.
- The university elected to surveillance test undergraduate students as an early warning signal. This population was chosen because they tend to live and eat communally, are young and may be less likely to adhere to public health measures, and because of their age, are more likely to be infected and asymptomatic. In this population of higher risk folks, even now, asymptomatic tests have a positivity rate of 0.6%.
- Expanding surveillance testing at this point when we need our resources for symptomatic patients would not be wise. Testing and the highly labor-intensive follow-up resources, including communicating test results and contact tracing, are still in very short supply. We are conserving our resources for diagnostic testing which we know to be effective. Because contact tracing is highly labor intensive, St. Louis County is asking people to take more personal responsibility for informing their contacts, self-quarantining, and isolation because the county public health contact tracers are overwhelmed and cannot keep up. We support this request – if you test positive or have been exposed, please inform those that you were in close contact with recently.
Dissemination of Information About a COVID-19 Positive Researcher
There has also been some concern expressed that our researchers are “in the dark” with respect to their risk if they are not informed about a COVID-19 positive case in their lab, on their floor, in their building, and so on. We are not disseminating this information for a couple of reasons.
First, we have to protect the privacy of personnel with respect to their health status. Not only is this a requirement, but we do not want anyone to avoid reporting symptoms or a positive COVID-19 test result because they are afraid of repercussions from their colleagues. Even a de-identified announcement can (and would) result in the person being identified.
Second, by the time we know that a person has tested positive, they have already been sent home – usually two or more days prior to our receiving the positive diagnosis. Any contacts on campus have already occurred. If our public health guidelines (masking, physical distancing, hand hygiene) were followed, the risk of COVID spread is very, very low. This is based not only on our experience here at WashU but the experiences at our peer universities and other businesses. If the public health guidance was not followed (there was an extended interaction – 15 minutes or more per day at close range) the exposure has already happened, and our contact tracers in Occupational Health/Student health will communicate with the person. Bottom line – protect yourself and your colleagues, wear a mask, keep six feet apart and wash your hands.
Holiday Travel and Gatherings
Many people have questions around travel and gatherings over Thanksgiving and the holiday breaks. It is possible that travel will be restricted for some members of the university community. We are strongly urging everyone in our WashU community to curtail social activities including:
- Keep your “bubble” small
- Don’t attend unmasked gatherings with those outside your “bubble”
- Avoid eating indoors at bars and restaurants
- No large Thanksgiving or holiday meals with extended family
- If you are dining with people outside your bubble, eat outside if possible, open windows to provide better ventilation and/or arrange the chairs to be six feet apart.
We know how hard this year has been for all of us and that the next few weeks and months will continue to be discombobulated and very challenging. Please do everything you can to keep your spirits up and care for your family, friends, and colleagues (while wearing a mask!).
We thank you for your continued efforts to reduce the spread of COVID-19 and keep our campus safe.
Jennifer Lodge, PhD
Vice Chancellor for Research