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Recap of Previous COVID-19 TAHSN Communications for Basic Science Chairs

April 13, 2020

Dear colleagues,

It has come to our attention that some prior University messages distributed to Council of Health Sciences and clinical programs, as well as messages from TAHSN Committees (ex TAHSNr, TAHSNe) may not have reached you, or may have been lost among the large number of communications you are receiving about COVID-19. We want to take this chance to reiterate some of the key points that were relayed through those communications and to provide some new information about contract handling at UofT during the COVID-19 pandemic.

  1. Graduate students carrying out Off-campus research.
    • All unpaid learners (including pre-licensure learners and registered healthcare professionals) were suspended from undertaking clinical placements at our affiliated TAHSN hospitals. Programs and divisions were strongly urged to do the same at other clinical and community sites. Arrangements may be made for virtual placements at the discretion of the program director and host institution(s).
    • Graduate students doing their research at TAHSN hospitals OR other off-campus sites (e.g. community organizations) are permitted to continue with their research projects if their research is: a) deemed “essential research” [*]; b) the student agrees and c) the departmental graduate coordinator or chair agrees. Graduate students who are NOT doing such research are NOT permitted on site at TAHSN hospitals and are encouraged to consult with their supervisor and graduate coordinator on work-from-home arrangements. See TAHSNr Template Message (enclosed).
      • [*] Please note that “essential research” refers to projects that have been specifically approved as such by the hospitals or University.
    • If you have graduate students engaged in research that has been approved as “essential”, graduate coordinators are asked to do the following (sample checklist enclosed):
      1. Maintain a list of graduate students participating in off-campus research that has been approved as “essential”;
      2. Confirm the nature of the research as it relates to any potential additional risks of COVID exposure (see sample attached);
      3. If there is an elevated risk of COVID exposure, confirm that the student is aware of the need to access appropriate Personal Protective Equipment. Attached is a PPE Memo for TAHSN-wide guidance on appropriate PPE that should be availed to students. If you have any concerns that PPE is not available to these students, please contact Lynn.Wilson@utoronto.ca.
  2. Summer Research Opportunities
    • UofT has not yet made a final decision to close its campus-based wet labs throughout the summer of 2020. That said, it would be wise for Programs that offer an undergraduate research program to halt any new offers for positions in an undergraduate research program.
      • For any new offers for UROP, UTEA or GLSE award programs, please contact Allan Kaplan to confirm that funding will be available from the Faculty and that the program can be deployed effectively (i.e. through remote or dry-lab projects). For hospital funded programs please make sure through your Research Office that funds are still available
      • For offers that have already been extended, please consider whether any wet-lab based research projects can be converted into dry-lab or remote research work.
      • For offers that have already been extended, if you wish to cancel them, please contact Jean Robertson for advice and next steps;
  3. Contracts affected by COVID-19

A reminder that a full list of COVID-19 related Communications are available on the Faculty of Medicine’s dedicated webpage. While TAHSN committees may not have updates available on this platform, we are working on facilitating a more streamlined communication mechanism with you on these matters, and will be sharing relevant updates on a timely basis.

Thank you for working with us to help support our students, faculty and community during this incredibly challenging time

– Lynn, Allan and Rick

TAHSNr Message

Dear <>,

Effective March 16, 2020, all non‐essential on‐site research activities will be scaled back for an initial period of three weeks until Monday April 6th.  

We continue to closely monitor the evolving situation with COVID‐19. Based on resource demands both human and material as well as the need to embrace directives on social distancing; the TAHSN research leadership have collectively agreed to scale back and in some cases to halt all non‐essential on‐site research activities. This has also been balanced against our need to protect our staff, students, clinicians and patients.  

Guidelines for consideration (these can be adapted to the needs of individual sites):

  • All Principal Investigators are asked to scale back and in some cases to halt non‐essential clinical research activities.  
  • Principal Investigators will work with their organization to establish approaches for their teams to work remotely.
  • Some employees will need to be redeployed and assist with clinical services on site.  
  • We will continue research studies that are part of essential clinical care, as well as specific projects related to the COVID‐19 pandemic.  
  • Graduate students who have clinical contact with patients who are non‐essential are treated in the same way as any other unlicensed learner and placements / in‐hospital or hospital research facilities will be paused.
  • Graduate students who have no clinical / public‐facing contact and are in labs in the research institutes may continue with projects that are part of essential clinical care or related to the COVID 19‐pandemic so long as they feel comfortable doing so and their graduate department Chair or Coordinator has approved.
  • Graduate students who have no clinical / public‐facing contact and are in labs in the research institutes should continue work from home as non‐essential clinical research activities are paused.
  • Graduate students should not be redeployed as they are not generally considered health care workers.
  • Graduate students whose research has been paused should consult with their academic supervisors regarding next steps.

Next Steps:

This pause will be assessed on a regular basis and will be in effect at least until April 6h . This timing is aligned with the current provincial shutdown of public schools and we believe this provides a satisfactory window for re‐evaluation. We will continue to monitor the situation and will discuss reconvening activities closer to the week of April 6th.   

Opportunities for investigators to lead or be engaged in projects designed to improve outcomes related to COVID‐19 should be explored.   

We recognize that this is a very unusual situation and we want you to know that supports are available. Thank you for your understanding and please do not hesitate to touch base with by phone/email .

Regards,

XXXX

Personal Protective Equipment (PPE) Use across TAHSN Institutions

All TAHSN hospitals are following the March 25 2020 Public Health Ontario Recommendations for the Use of Personal Protective Equipment, PPE, for Care of Individuals with Suspected or Confirmed COVID19: https://www.publichealthontario.ca/-/media/documents/ncov/updated-ipac-measures-covid19.pdf?la=en

The recommendations are as follows:

  1. Droplet and contact precautions for routine care of patients with suspected or confirmed COVID-19;
    • Surgical/procedure mask
    • Isolation gown
    • Gloves
    • Eye protection (goggles or face shield)
  2. Airborne, droplet and contact precautions for aerosol generating medical procedures* (see page 4 of link above) in patients with suspected or confirmed COVID-19.
    • N95 respirator (fit-tested, seal-checked)
    • Isolation gown
    • Gloves
    • Eye protection (goggles or face shield)
    • Negative pressure room, if available.

The specific type of mask, gloves, gowns and protective eyewear may vary based on what is currently available at each site. All TAHSN hospitals have PPE components that meet or exceed the minimum established safe requirements as outlined above. Please familiarize yourself with the specific PPE components and policies of your work site. Training and practice in donning and doffing of PPE is imperative, as performing these steps carefully is extremely important for your safety.

Available supply of PPE also varies across the hospitals. The Ontario government has requested that all hospitals work to conserve PPE to ensure all necessary components are available to those who need them as the number of COVID-19 cases rise. The conservation approaches being used across the sites may vary, again based on the specific types and amount of PPE a given hospital has available.

This is a time when stewardship of PPE is crucial. Everyone must do their absolute best to use PPE appropriately, as outlined above, for the safe care of suspected and confirmed COVID-19 patients. Importantly, we want to emphasize that PPE stewardship does NOT mean making PPE unavailable when it is truly needed. We wish to ensure you that you will not be asked to provide clinical care to suspected or confirmed cases without the appropriate PPE, as defined above.

 

* Aerosol Generating Medical Procedures: Endotracheal intubation, including during cardio-pulmonary resuscitation; Cardio-pulmonary resuscitation during airway management; Open airway suctioning; Bronchoscopy (Diagnostic or Therapeutic); Autopsy; Sputum induction (Diagnostic or Therapeutic); Noninvasive positive pressure ventilation for acute respiratory failure (CPAP, BiPAP3-5); High flow oxygen therapy

SAMPLE: COVID Essential Research – Graduate Student Checklist – Faculty of Medicine
  1. Name of Student:
  2. Name of Supervisor:
  3. Name of Research Project:
  4. Name of hospital/entity that confirmed the project is considered “essential research”:
  5. Description of the Project as it relates to heightened COVID risk:
    • Do you interact with patients? If yes, please describe.
    • Do you interact with members of the public? If yes, please describe.
    • Do you handle any patient samples, infected cells/samples, or virus or other pathogens? If yes, please describe.
  6. Are you aware of how you can access Personal Protective Equipment (PPE) at the site, and do you have sufficient appropriate PPE available?
  7. How do you get from home to the lab, and are there concerns regarding exposure for virus during transit?
  8. Do you have co-habitants at home to consider from the perspective of exposure?