|
 
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| EDITORIAL |
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| Year : 2020 | Volume
: 22
| Issue : 1 | Page : 2-4 |
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Positive aspects of the COVID-19 pandemic
Sanjay Bhattacharya
Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| Date of Submission | 15-May-2020 |
| Date of Decision | 12-Jun-2020 |
| Date of Acceptance | 13-Jun-2020 |
| Date of Web Publication | 13-Aug-2020 |
Correspondence Address:
Dr. Sanjay Bhattacharya
Department of Microbiology, Tata Medical Center, 14 Major Arterial Road, Newtown, Kolkata - 700 160, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jacm.jacm_9_20
How to cite this article:
Bhattacharya S. Positive aspects of the COVID-19 pandemic. J Acad Clin Microbiol 2020;22:2-4 |
The COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the first global outbreak of infectious disease in the 21st century, which has shaken the social, economic and healthcare infrastructure of almost 200 countries.[1] There have been few others since the turn of the millennium, such as the SARS epidemic in 2002, Middle East respiratory syndrome CoV in 2014, Zika outbreak in 2015–2016 and the Influenza pandemic in 2009.[1],[2],[3],[4] However, none of the above matches the on-going pandemic in terms of social impact, economic stagnation and healthcare upheaval across diverse countries in such a short span of time. Ever since its onset in November 2019 from Wuhan in China, millions have been infected, tens of thousands have died and global economies have seen an unprecedented scale of recession.[1],[5]
Despite the challenges to healthcare delivery, the COVID-19 pandemic also provides vital opportunities for the healthcare provider and administrator, the infection prevention and control (IPC) specialist and the molecular diagnostic industry. This article reflects on the potential positive consequences of this outbreak on the public healthcare, diagnostic and preventative systems of our time.
| Molecular Biology and Diagnostics | |  |
COVID-19 pandemic and its effect in India are witnessing an unparalleled growth in medical diagnostics, research and development industry, specifically in relation to molecular diagnosis of viral infections. The number of new government laboratories enabled to do molecular diagnostic tests and private laboratories volunteering to be part of the novel CoV diagnosis network has seen a significant rise.[6] The knowledge, skills and protocols required to perform real-time polymerase chain reaction (RT-PCR)-based diagnosis are increasing daily. Laboratories are now in the process of developing and sustaining essential molecular biology skills for nucleic acid extraction, PCR and post-PCR analysis of the results. Pre-analytic variables such as optimal collection, transport under cold chain and storage of samples (before and after processing) are being standardised.[6],[7],[8],[9]
The requirement for RT-PCR consumables such as extraction kits and reagents (master mix, probes and primers) and disposable miscellaneous consumables (PCR tubes, pipette tips and personal protective equipment [PPE]) is in overwhelming demand, at present.[7] We also see increasing demands for automated machines for nucleic acid extraction (QIAcube Connect, NUCLISENS easyMAG, QiaSymphony, KingFisher™ Flex Purification System, etc.) and RT-PCR (Rotor GENE Q 5 PLEX PCR, QuantStudio 3 and 5 Real-Time PCR Systems). The Indian Council of Medical Research (ICMR) is constantly providing guidance to users on testing strategies, sampling (collection, transport and packaging), PCR kit evaluation and sources of reagents. Standard operating procedures for nucleic acid extraction and PCR performance are freely available from the ICMR, Centers for Disease Control and Prevention (CDC), WHO and European Centre for Disease Prevention and Control. More importantly, biosafety considerations about laboratory, personal and biosafety are being reviewed in all testing laboratories.[10],[11]
| Hospital Infection Prevention and Control | | |
Many aspects of IPC before the COVID pandemic were neglected and poorly funded, which included and ranged from availability of hand sanitisers and PPE, general cleanliness of healthcare facilities, to more complex requirements, such as negative pressure isolation rooms and management of air-handling units. Reports from many hospitals suggest that the compliance of healthcare workers (HCWs) and support staff to hand hygiene protocols and PPE use (especially face mask) has gone up significantly. Stockpiling of such essential PPE consumables has also seen a rise during this period.[10],[11],[12]
Hospitals are investing a substantial proportion of their resources on IPC, staff training and visitor–patient education and awareness. The use of disinfectants and cleaning agents has also increased, not only in healthcare institutions but also in the community. What countless educational meetings during the pre-COVID era could not achieve in terms of consistent compliance to IPC practices, are currently happening on a global scale, mostly as a response to the COVID fear.[13]
However, we also find that PPE is being used indiscriminately (such as shoe covers and other extended PPE where the N95 mask, eye protective goggles and proper hand hygiene would suffice).[14],[15],[16],[17],[18] There are also situations where disinfectants (especially the more expensive ones) are being overused without much thought (large-scale fumigation of healthcare facilities hosting COVID patients) where thorough surface cleaning and disinfection is sufficient in most cases.[19] It would be an interesting exercise to monitor the outcomes of the COVID pandemic on healthcare-associated infections (HCAIs). It may not be inconceivable to suppose that multidrug-resistant organism-related HCAIs may see a dip during this period of heightened IPC awareness and compliance.[13]
| Public Healthcare Delivery Systems | | |
COVID-19 has sensitised millions of people to many aspects of communicable diseases, modes of transmission of pathogens and safety measures, such as good sanitation and hygiene, social distancing, respiratory etiquette, waste disposal and clinical management pathway at the community level. This has developed within the three months of this outbreak, through mass awareness campaign using the print and electronic media and multiple internet platforms such as Facebook, Twitter, WhatsApp and other mobile applications.[20],[21],[22]
The advisories from the state (Ministry of Health [MOH]) and central governments (MOH and Family Welfare), ICMR as well as the National Centre for Disease Control have shown dynamic activism through multiple bulletins on diagnostic guidelines, strategies and clinical recommendations. Many of these resources are being updated daily with an abundance of information related to all aspects of health, preventative, diagnostic, curative and rehabilitative care.[23] Laboratories with little prior experience of molecular biology are being invited to perform RT-PCR in this uphill battle. Drugs, medical equipment and PPE are being made available to various tiers of healthcare system (from primary to tertiary care centres). Special emphasis has been put to protect HCWs, with multiple strategies developed to enable prompt diagnosis and treatment for all HCWs as and when needed.
| Establishment of a Network of Laboratories for Managing Epidemics and Natural Calamities (Virus Research and Diagnostic Laboratory) | | |
The Virus Research and Diagnostic Laboratory (VRDL) Scheme of the Department of Health Research (DHR)/ICMR has helped in ICMR's COVID Laboratory Capacity Building Initiative. The scheme was approved by the Union Cabinet where it was envisaged to set up 160 VRDLs in most of the government medical colleges of the country in the 12th plan period (2012–2017). These VRDLs have been established in a three-tier mode, namely regional, state and medical college level with different biosafety level. Till date, DHR has funded 105 VRDLs (nine regional level, 22 state-level VRDLs and 74 medical college-level VRDLs). Out of which, 85 VRDLs are functional. Two resource centres providing support for the network are the National Institute of Virology, Pune, and the National Institute of Epidemiology, Chennai. The DHR website provides details about the location of these VRDLs, equipment list, staffing, as well as achievements.[23] In the context of the COVID-19 pandemic, these laboratories have now formed a strong network with additional laboratories from private medical colleges and hospitals. These networks have made possible an unprecedented coalition of private–public partnership in meeting the challenge set-up by this pandemic.[24]
In conclusion, the COVID pandemic is similar in terms of global scale calamity to the first pandemic of the 19th century, the 1918 Spanish Flu. It is to be hoped that when this event joins the annals of history, we achieve a better world.[25],[26],[27],[28],[29],[30]
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