PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Engaging Non-Traditional Partners to Build Biosafety Practices
By Michael Marsico , MS , senior specialist , Biosafety and Biosecurity
When safely and correctly implemented , pointof-care ( POC ) tests can play an important role in helping to contain the COVID-19 pandemic . Such technologies are often implemented in non-traditional testing sites ( NTTLs ) that operate under a Centers for Medicare and Medicaid ( CMS ) Clinical Laboratory Improvement Amendments of 1988 ( CLIA ) Certificate of Waiver . Since personnel at these facilities are usually non-laboratorians who can lack the experience to safely perform testing , these sites rely on public health laboratories for guidance and support . Below are three perspectives on how public health laboratories have engaged these sites across their jurisdictions .
Dallas County Health and Human Services
Mary Markarian , BSN , RN , Acute Communicable Disease Epidemiology Division
David Stringer , technical and general laboratory supervisor
Throughout the COVID-19 pandemic , Dallas County engaged long-term care facilities ( LTCFs ) to provide biosafety and infection control guidance . Dallas County processed over 30,000 COVID-19 specimens , of which approximately 10,000 specimens came from LTCFs within Dallas County alone . Early in the pandemic and before the surge began , the Dallas County Laboratory provided on-site consultation to LTCFs and the Dallas County Jail . Dallas County Laboratory staff toured facilities , discussed and implemented risk assessments , addressed engineering controls ( or lack thereof ) with LTCFs ,
DIGITAL EXTRA : APHL in collaboration with the US Centers for Disease Control and Prevention
( CDC ), will continue to provide biosafety resources to PHLs for non-traditional laboratory outreach . For questions , please reach out to biosafety @ aphl . org
. and discussed standard procedures for operating the rapid antibody / antigen test . Instructions were also provided on packaging and shipping , since all LTCFs delivered their own samples to the laboratory . To aid facilities and ensure appropriate sample storage , shipping containers were provided by Dallas County .
Dallas County also stood up a LTCF Epidemiology Team , who provided PPE usage guidance to administrators and nurses , and discussed ways to optimize PPE and proper disinfection of surfaces . The daily guidance that the Dallas County LTCF Epidemiology Team provided to manage the COVID-19 outbreak was instrumental to LTCFs ensuring monitoring of over 150 LTCFs within Dallas County , including nursing homes and the Dallas County Jail . Of those facilities , approximately 100-120 LTCFs utilized the Dallas County Laboratory for COVID-19 testing . It is imperative LTCFs understand response strategies and who the local contacts are to obtain guidance . Public health must actively maintain the relationship established with LTCFs so when the next outbreak occurs , all stakeholders are on board .
Colorado Department of Public Health & Environment
Peter Davis , responsible official , BT coordinator and biosafety officer
Over the course of the pandemic , the Colorado Department of Public Health and Environment ( CDPHE ) Laboratory Services Division ( LSD ) has promoted cultures of safety directly and indirectly . CDPHE LSD developed guidance on many topics , including packaging and shipping , patient sampling , sampling product information , sample handling , risk assessment and large scale sampling plans . Each topic was used as an opportunity to build safety practices and guidelines into documents that did not directly reference safety . This unique opportunity made safety inherent to each procedure and did not require
24 LAB MATTERS Summer 2021