Testing times - maintaining specialised laboratory testing under COVID-19
Updated: Jun 23
Professor Simon Heales and Dr Derek Burke of the Enzyme Unit at Great Ormond Street Hospital describe their journey through COVID-19 and how they have had to rapidly adapt to maintain their specialised laboratory services.
On February 13th this year we departed Orlando after attending another successful WORLD lysosomal meeting. We were full of enthusiasm and ideas with regards to new tests and research that we could implement to improve the outcome for the patients and families that we serve. Little did we know that everything was about to change.
COVID-19 had been mentioned whilst we were away but I don’t think any of us thought that it would impact upon us. Within a few weeks the country was in lockdown. Many people were instructed to stay at home and work from home (where possible). The media was going wild about testing, and the lack of it. Laboratories were in the news! Well some laboratories. Despite not being headline worthy, we needed to think and plan for how we could maintain our essential “routine” and our specialised laboratory services in the event of significant staff absence due to illness or isolation. Even in a pandemic, children would still be born with complex metabolic conditions and our treated patients would need to be monitored. We had to come up with a plan and yet be mindful of the need to liberate some of our scientists to front line virus, and then later, antibody testing.
"Even in a pandemic, children would still be born with complex metabolic conditions and our treated patients would need to be monitored."
The NHS can sometimes be accused, often unfairly, of being inefficient and overcomplicated. However, with a pandemic to deal with this could not be further from the truth. Rapid and effective decisions were made and staff from different disciplines and organisations started working closely together. Barriers melted away! From our perspective, we reviewed our “testing menu” and agreed to provide a core repertoire. For the lysosomal services, this included glycosaminoglycans (GAGs) and lysosomal enzyme assays. Working with other specialised laboratories, in particular Manchester, enabled us to cross cover in the event of the virus striking down one of our labs; hopefully not both at the same time ! Locally, we adopted practices such as splitting into two teams who would work alternate weeks, introduced social distancing to the labs and encouraged home working, where appropriate, e.g. for authorising and reporting of lab results. Our laboratory management meetings were replaced by virtual Zoom meetings with a 30 minute maximum time allocation – net result being efficient and to the point meetings. We are tempted to retain this approach! Importantly, the Zoom (and Teams) platform permitted multi-disciplinary meetings with clinicians and health care professionals to continue.
"Staff from different disciplines and organisations started working closely together. Barriers melted away!"
To date, our approach has worked very well and our key specialised services have been maintained despite at times significantly less staff due to illness, social isolation and secondment to other sections. It has been particularly satisfying/emotional to receive emails of thanks and support from clinicians, patient support groups etc. during this time. This success is undoubtedly down to the dedication and commitment of all our staff; a “can do” atmosphere is palpable across our organisations.
"Our key specialised services have been maintained despite at times significantly less staff due to illness, social isolation and secondment to other sections."
We have provided here some insight to our approach to ensuring service provision. However, similar success stories are to be found in other NHS laboratories across the country. Amongst these are our newborn screening and rapid response laboratories who have also maintained their services. So on a Thursday night, we have always provided an extra clap for the laboratory services that are not currently media worthy. We are looking forward to the next WORLD meeting.
With thanks to Professor Simon Heales and Dr Derek Burke at the Enzyme Unit, Great Ormond Street Hospital & Neurometabolic Unit, National Hospital, London for providing this article.