May 8, 2020, 8:15 a.m.
Carefully carrying the day’s COVID-19 samples, Hayley Glantz walks past idle centrifuges and empty beakers to her lab bench and gets to work.
The start of her shift looked a lot different a couple months ago. For one, the research technician in Dr. Julie McElrath's lab at Fred Hutchinson Cancer Research Center typically handles HIV. And the large space around her would have been bustling with colleagues and whirring machines at work analyzing DNA and RNA samples.
Then the pandemic hit.
The McElrath Lab, like all others at Fred Hutch, ramped down to just one person at a time. Fred Hutch required the bulk of its employees to work remotely. They were drastic but science-based moves aimed at stopping the spread of COVID-19.
Like every other organization, Fred Hutch has no playbook for how to get employees back on-site amid a pandemic. But it does have decades of study into the biology of cancer, the intricacies of the immune system and the scourge of viral diseases. So Fred Hutch is tapping its scientific expertise to move forward.
“The Hutch has a unique opportunity to lead, to show the country how we can reopen and how we can safely work,” said Dr. Thomas Lynch, president and director of Fred Hutch and holder of the Raisbeck Endowed Chair. “And science is going to guide our decision-making.”
Glantz’s new work routine reflects that roadmap. It was science behind the symptom-screening station she had to pass when she arrived. It was science that quieted the lab around her, and it was science behind the masks she wore in the office and the lab.
And it’s driving her current project: searching blood taken from COVID-19 patients for signs of an immune response. What she finds could help fill in knowledge gaps about the disease — and help inform decisions to bring more colleagues back into the lab alongside her.
“That’s the ultimate goal: to get everyone back to work, and doing that safely,” Glantz said. “It’s cool and humbling to be a piece of the puzzle.”
On Jan. 31, Fred Hutch’s Dr. Trevor Bedford published a short blog post that hinted a huge crisis was brewing. Bedford found genomic evidence that the novel coronavirus, as it was called then, could spread easily between people. Weeks later, he would announce that the virus had been creeping silently across Washington state.
The pandemic had arrived.
On March 2, Fred Hutch activated its Incident Command team. Leaders from across the organization — infectious disease experts, virologists, operations managers, to name a few — started to discuss how to respond. Three days later, Fred Hutch’s remote work policy kicked in. It was based on the effective — but blunt — tool of physical distancing.
And it’s still in use, even as Fred Hutch looks to bring more employees back to its labs.
“At this point, the main thing we can do is control our density on campus,” said Dr. Niki Robinson, Fred Hutch’s vice president and deputy chief operating officer. “Until physical distancing isn’t the only intervention we know of that works against COVID-19, we’re approaching these efforts with the goal of keeping the number of people on campus as low as possible while still being able to achieve our mission and our goal of near-zero transmission on campus.”
So far, it’s working, Robinson said. There have been no known transmissions between Hutch employees.
Another key tool to keep employees safe is mandatory symptom screening. All visitors to campus are funneled through one of five screening stations, where a screener asks whether they have symptoms of COVID-19 or have had a positive test within the past 30 days. If any answers are yes, they head home and get referred for testing.
Prominent signs in parking garages and building entrances announce the mandatory screening. Visitors and employees can’t miss them — and that’s by design, said Dr. Steve Pergam, an infectious disease expert at Fred Hutch and its clinical-care partner, Seattle Cancer Care Alliance.
Pergam wanted those signs front and center to hammer home the importance that if you’re symptomatic, you need to isolate and stay at home.
“Employees everywhere don’t want to let down their colleagues, so there can be a tendency to go to work even when you’re sick with a cold or the flu,” said Pergam, the Incident Command team’s medical adviser. “But as a research facility, we need to change that culture. In the era of COVID-19, coming to work sick is no longer OK.”
The data suggest the message is getting through. When symptom-screening stations launched on the Fred Hutch campus in mid-April, 2.2% of employees had symptoms and were sent for COVID-19 testing. By the first week of May, it was down to .2%.
Fred Hutch refers any employee with symptoms to an internal survey that helps the Hutch’s Occupational Health team determine whether a test is called for. Testing will play a critical role as Fred Hutch brings more employees back to campus. On the Fred Hutch campus and beyond, Pergam said, tests will serve the same purpose as early-warning tsunami buoys bobbing in the ocean. If we see a swell, we can act.
“The more testing there is in the community, the better it is for all of us,” Pergam said. “This is how we can identify small pockets early instead of waiting for a large cluster to happen.”
Fred Hutch scientists are running studies to help gauge the prevalence of COVID-19 in the Seattle area. McElrath, a world-renowned HIV expert who holds the Joel D. Meyers Endowed Chair, is running several of them.
One of her studies, funded by a gift from the Bezos Family, is looking at the prevalence of the disease on the Fred Hutch campus. About 500 employees have volunteered to give blood and nasal samples for the study. On May 14, preliminary results from that study, along with data from across Washington state, led Fred Hutch to bump up the number of employees in a lab to one per bay, or workbench.
Robinson said the Incident Command team sees the Hutch’s back-to-campus efforts not as an on/off switch but a dial. The number of people on campus will gradually go up when the science says it’s safe: low prevalence of COVID-19 on campus, no clusters of cases, no evidence of employee transmission. Fred Hutch can quickly turn that dial back down if the number of infected people rises either on campus or in the community.
And the priority will be bringing lab staff back on campus to drive scientific progress. Those who can reasonably do their jobs remotely will be the last to come back.
Meanwhile, Incident Command continues to plan for any scenario, Robinson said. Work is underway on an internal smartphone app for symptom checking. That will prevent congestion at the screening stations, which can’t handle a significant increase in employees. And a Hutch team is working with external partners to develop a smartphone app to help Fred Hutch’s Occupational Health team with contact tracing if an employee tests positive.
Safety is the top priority as Fred Hutch works to ramp up its labs. And the research that takes place in those labs is more important than ever, said Dr. Maria Lemos, a staff scientist in the McElrath Lab (and Glantz’s manager).
“It feels to me that many are waiting at home for the scientific community to offer alternatives, like treatments, diagnostics and vaccines,” Lemos said. “The limitations on the number of persons in the lab and the restrictions on physical distancing limit our capacity to do that work. We have worked in shifts and postponed a lot of important work in order to do the most valuable research safely. But finding ways in which we can increase our throughput and maintain healthy working conditions will speed our ability to provide answers to the community on COVID and on other diseases.”
Organizations across the country are struggling to figure out how to bring their employees back on-site safely. And to fulfill its mission — eliminating cancer and related diseases as causes of human suffering and death — Fred Hutch needs to get its scientists back in its labs. So, it’s those scientists who are showing the way.
“We're this research organization that can use all this incredible expertise we have inside our walls to drive how we safely and effectively move people on and off campus,” Robinson said. “All of our actions have been led by science. That’s the way we ramped down, and that’s the way we will ramp back up.”
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