Warping of Time Carol A. Pech Nearly a year into the pandemic, we are too familiar with the twisting and blurring of time it has brought us. I find it hard to remember how our sense of time worked before COVID crashed over us. If you happen to be a musician (guilty), you know how to read through new-to-you complex pieces of music to see how it goes—slow here, fast there, tricky in places. Although I had the same instinct in the run-up to the pandemic, we had no such luxury. We played as we went, and this is part of that story. Prelude I would not characterize myself as a prepper, but so I become by early February. I advocate for getting ready, and my colleagues ask whether I think we truly need to start preparations now. The virus isn't in our community yet—or so we think. My response is that I believe so, since if the virus comes—and we do not know that it is already in our midst—my sense is events will unfold quickly. This is the best guess I will make about time all year. Shortly afterward, leaders further up the chain of command ask for our continuation of operation plans (COOPs). I work in the institutional review board (IRB) office at a large research university with an equally large human participant research program. IRBs of our size always need to be in continuous operation, so the COOP exercise seems like administrative busywork, although at least it gives us the sense that we are actually preparing. For exactly what, though, we have only a vague idea. This changes in mid-March when, while searching for Covid resources on other IRB websites, I find a west coast research university with a list of FAQs for researchers. As we start liberally borrowing from them, we meet with their IRB director for advice. What we hear: figure out how to implement the new public health exception in the federal regulations, which we have not yet used. Prepare for an influx of emergency, one-time use requests for remdesivir, presuming we can get any. Working remotely and handling a flood of information will stress staff, with no easy fix. Figure out how you will obtain informed consent from patients in isolation—we have never had to think this through. Researchers will have a ton of questions. Get ready. And good luck. Around the same time, our biggest viral research lab reaches out about collecting samples from COVID-positive patients since we already have community spread. This is sobering news. [End Page E19] A week later, I send the email to our office telling everyone to go home for the duration, now going on a year. And another week later, campus leadership announces that face-to-face interactions with human subjects that are not directly therapeutic must stop. All research procedures that can be done remotely must be done so. And our ordinary sense of time at last slips away. Presto The blurring of time accelerates in April and May. We are drafting and posting guidance for our researchers as quickly as we can—often every day, sometimes twice a day. As forewarned, our office is fielding an almost overwhelming number of questions from study teams. With leadership on the clinical trials side, we coordinate on reviewing the influx of Covid studies that need approval yesterday. Staff are indeed stressed and to help us try to keep pace and informed, I send out daily COVID updates—today's new FAQs, news from the FDA, COVID studies in the pipeline. And I always include a signoff to be well, whatever that means. Despite our best efforts to stay on top of everything, we are scrambling, particularly with issues we have never faced before. Do we have an FDA-compliant system for documenting informed consent? We do not, so we work on getting that moving. Do study teams need to submit changes to their protocols to reflect pandemic-related modifications? Sometimes yes and sometimes no. What online platforms for study visits are HIPAA-compliant? Two, and not the ones that study teams want to use...