Challenges in the establishment of a biosafety testing laboratory for COVID-19 in Bangladesh.

Afzalun Nessa,Samprity Islam ,Md Abdullah Omar Nasif ,Shahina Tabassum,Asish Kumar Ghosh ,Amirul Huda Bhuiyan,Tahmina Akther,Sharmin Sultana,Munira Jahan,Paroma Deb,Saif Ullah Munshi

doi:10.3855/jidc.14415

Abstract

At the beginning of the coronavirus disease 2019 (COVID-19) pandemic in Bangladesh, there was a scarcity of ideal biocontainment facilities to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a risk group of 3 organisms. Molecular detection of SARS-CoV-2 must be performed in a BSL-2 laboratory with BSL-3-equivalent infection prevention and control practices. Establishing these facilities within a short timeframe proved to be an enormous challenge, including locating a remote space distant from the university campus to establish a laboratory, motivating the laboratory staff to work with a novel pathogen without any prior experience, allocation of funds for essential equipment and accessories, and arrangement of a safe waste management system for environmental hazard reduction. This report also highlights several limitations, such as the facility's architectural design that did not follow the biosafety guidelines, lack of continuous flow of funds, and an inadequate number of laboratory personnel. This article describes various efforts taken to overcome the challenges during the establishment of this facility that may be adopted to create similar facilities in other regions of the country. Establishing a BSL-2 laboratory with BSL-3-equivalent infection prevention and control practices will aid in the early detection of a large number of cases, thereby isolating persons with COVID-19, limiting the transmission of SARS-CoV-2, and promoting a robust public health response to contain the pandemic.

Highlights

On March 11, 2020, the World Health Organization (WHO) declared that the suppression of the coronavirus disease-19 (COVID-19) pandemic must be through isolation, treatment, and tracing [1]
After the first case was detected on March 8, 2020, the Ministry of Health and Family Welfare (MOH&FW) of the Government of Bangladesh decided to initiate COVID-19 identification and expand SARS-CoV-2 testing laboratories throughout the country to control the spread of the virus [2]
The initial challenge was to locate an ideal space for a biocontainment facility that limited person-to-person transmission due to the intermingling of COVID-19 patients with non-COVID-19 patients attending the hospital for other health-related services; this was managed by designating a separate building

Summary

Introduction

On March 11, 2020, the World Health Organization (WHO) declared that the suppression of the coronavirus disease-19 (COVID-19) pandemic must be through isolation, treatment, and tracing [1]. Planning phase Initially, relevant guidelines on COVID-19, biocontainment laboratory, biosafety levels, real-time reverse transcriptase-polymerase chain reaction (RTPCR), and infection prevention and control (IPC) circulated by the Centers for Disease Control and. The participants were trained to maintain biosafety precautions at all times, the use of personal safety equipment according to the CDC guidelines, sample collection techniques from the nasopharynx/throat, molecular detection of SARS-CoV-2 RNA using reagents and instruments, safe waste disposal, and regular decontamination and maintenance of the instruments. The long queue of patients was systematized by creating prior online bookings for the daily testing slots This laboratory received samples of suspected COVID-19 patients after evaluation at the fever clinic, health care workers who developed COVID-19-like symptoms, and patients admitted under the hospital's COVID-19 and non-COVID-19 sections as directed by the University authority. Many admitted that they were infected through contact with family members or friends, probably resulting from unenthusiastic health safety [13]

Discussion

Limitations

Conclusions