Resilience and Protection of Health Care and Research Laboratory Workers During the SARS-CoV-2 Pandemic: Analysis and Case Study From an Austrian High Security Laboratory

Abstract

The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with SARS-CoV-2 such as autopsies, establishment of virus cultures and infection models, development and verification of diagnostics, performance of virus inactivation assays to investigate various antiviral agents including vaccines and evaluation of decontamination technologies in high containment biological laboratories (HCBL). Performance of autopsies and laboratory work increased substantially during the pandemic and thus led to highly demanding working conditions with working shifts of more than eight hours working in PPE that stressed individual limits and also the ergonomic and safety limits of PPE. We provide detailed insights into the challenges of the stressful daily laboratory routine since the pandemic began, lessons learned, and suggest solutions for better safety based on a case study of a newly established HCBL (i.e., BSL-3 laboratory) designed for autopsies and research laboratory work. Reduced personal risk, increased resilience, and stress resistance can be achieved by improved PPE components, better training, redundant safety measures, inculcating a culture of safety, and excellent teamwork.

Keywords: COVID-19 pandemic; SARS-CoV-2; biosafety level-3 (BSL-3); occupational challenges; personal protective equipment (PPE); research laboratory workers.

FIGURE 1

(A) Personal protective equipment (PPE) variant 1 consists of a single-use coverall (Cat. III, type 4-B/5-B/6-B), apron with long sleeves, a double layer of shoe covers worn over crocs, a double layer of differently colored gloves, e.g., green nitrile gloves as the inner layer and white gloves as the outer layer, FFP3 mask, goggles and face shield. (B) PPE variant 2 corresponds with variant 1 but FFP3 mask, goggles and face shield are replaced by a powered air-purifying respirator (PAPR, e.g., Jupiter™ Air Filter Unit with two A2BEKP filters and 8 h rechargeable batteries) connected to a hood assembly providing head, face and shoulder coverage. (C) PPE variant 3 consists of a Tychem 2000C protective suit (Cat. III, Type 3/4/5/6) which protects against biological substances, and is impermeable to liquid and particles. Outer layers of gloves and chemical protective boots are sealed with adhesive tape. The hood is ventilated by the same PAPR used in variant 2. (D) PPE variant 4 consists of a one-piece Tychem ProChem protective suit (CPM F1 H L2, Cat. III, Type 3/5) with integrated boot socks and gloves, resistant against biological hazards, particles, and liquids. (E) Two biosafety cabinets category II connected to the exhaust air allow parallel work with different agents. (F) Incubators for cell culture and bacteria. (G) The chemical shower is an additional safety device for decontamination of corpses in a body bag after autopsies and lab workers by means of different processes and disinfectants. (H) Disinfectants are fumigated through eight nozzles (red arrow) into the shower cabinet and (I) incubated for a defined time period. RLWs must move to ensure safe distribution of the disinfectant.