Research Projects Involving Human Subjects Contingency Planning

Changes to IRB-Approved Protocols

• Changes to IRB-Approved protocols may occur due to this unprecedented outbreak. According to IRB policy, any changes in IRB-approved research procedures must be reported to the IRB and may not be implemented prior to review and approval by the IRB, except when necessary to eliminate apparent immediate hazards to the subject. This is permitted by both the Common Rule (38 CFR §16.108(a)(3)(iii)) and by FDA regulations (21 CFR §56.108(a)(4)).
• Beyond the regulation, we also have a responsibility to ensure the safety of our research team members and staff. Therefore, interim measures to reduce immediate hazards to research participants and staff may be warranted. This may result in deviations from IRB-approved study procedures prior to securing IRB approval. By policy, protocol deviations must be reported to the IRB within 5 business days.You must also submit these in COEUS as “Reportable New Information (RNI)”.
• If apparent immediate hazards will be sustained for a duration that would practicably allow for an amendment covering such changes to be developed, reviewed and IRB-approved, then a protocol modification must be sought.
• Instructions for submitting a Modification or an RNI are found on the IRB’s webpage [DOC].
• Assistance is available
  • If you have any questions related to the information above or need assistance in determining whether a planned change to research procedures requires review, please contact hrpp@drexel.edu or call 267-359-2471.
  • If you have any issues accessing COEUS or submitting a deviation and/or modification, contact coeus-help@drexel.edu and cc: hrpp@drexel.edu.

Drexel Human Research Compliance

• Our Human Research Protection Program (HRPP) and the IRB are fully functional and operating at standard capacity. We expect this to continue even if the University moves to remote work plan for contagion control purposes.
• Program staff are able, and ready, to work remotely if necessary.
  • Program and staff email addresses continue to be monitored with the same or greater frequency.
  • Please note when logging into https://drexel.zoom.us/ there is HIPAA compliant and standard variation. For human subjects research, they must choose the HIPAA compliant option.
  • IRB meetings will be conducted via Zoom.
• We are also closely monitoring the impact of COVID-19 on research operations, including our own staffing levels and quorum for IRB meetings.
• New updates impacting human research will be communicated as soon as possible.

Provided below are operational considerations that research teams should evaluate when planning for potential disruptions to projects involving human subjects and to ensure the safety of research subjects and research team members conducting the research. It is STRONGLY encouraged that each team review and incorporate these considerations and complete the Research Project Management Contingency Planning Template [DOC] and consider these guidelines:

• Investigators are encouraged to implement procedures to screen research subjects at every encounter and to incorporate telephone screening prior to scheduled visits for potential infectious risk (see suggestions below). See the CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Note that incorporation of this screening does NOT require IRB approval.
• Please keep formal notes documenting all screening questions and answers.
• Investigators are encouraged to use their judgment when considering approaches to reduce the risk to subjects and study staff. Examples could include:
  • Conducting study visits by phone rather than in-person (e.g. surveys, focus groups)
  • Allowing study visits “out of window” or cancel them if not safety related.
• Given this considerable uncertainty, the University strongly encourages its research community to suspend new human subjects research projects involving in-person participant contact and/or domestic or international travel. If delay is not possible, researchers are advised to submit IRB protocols that includes study procedures that allow for flexibility / alternatives to in-person participant contact.

• Cancellations
  • While some research participants may self-elect to cancel appointments, Investigators may also consider conducting interviews/assessment remotely. Rescheduling cancellations should be done in consideration of the ongoing situation and in accordance with University guidelines.
• (Update 1 - 03/14/2020 4:45PM) Pre-Screening for Participants Prior to Coming Onsite for Research Participation
  • For research studies that continue to bring in enrolled participants, we recommend the following screening procedures:
    • Call participants prior to their appointment. Remind them of CDC guidelines and screen participants with the following questions:
      • Have you been in contact with anyone suspected or known to have Coronavirus or to anyone who is in quarantine?
      • Have you traveled outside of the U.S. in past 21 days?
      • Have you been to New York, California, or Washington in the past 21 days?
      • Have you had a fever (>100.4°F) within the last 21 days?
      • Have you been sick (fever, coughing, sneezing) in the past 14 days?
      • Are you currently having any of the following symptoms?
        • Cough
        • Shortness of Breath
        • Sore Throat
        • Malaise (feeling poorly)
        • Chills
        • Pneumonia
        • Altered Mental Status
        • Vomiting
        • Severe headache
        • Muscle aches
  • Recommendation: If individual response yes to any of the questions, it is recommended that participant be refused and contacted at a later time for re-screening/enrollment.
  • A copy of this questionnaire is available for use here [DOC].

• For Studies With Repeated Sessions/Monitoring

  • it is recommended that the individual screening be administered before every visit.

• Research Projects That Have Groups
  • At this time University guidelines does not recommend gatherings of groups larger than 100 individuals. For groups smaller than this, investigators should ask the following additional questions:
    1. Does the meeting/program require personal interaction or contact?
    2. Will participants be from the high-risk categories, including individuals over the age of 60 and/or those that have chronic diseases like heart disease, diabetes and lung disease.
    3. Are participants coming from high risk locations/areas?
    4. Are there elevated risk for investigators conducting the program?
  • If the answer to any of these questions is "yes"– it is recommended to set up a Zoom option for your program/meeting if available.
  • If the answer to all of these questions is "no" – conduct the recommended individual pre-screening (above) for each group member.

• For Projects Requiring Home Visits
  • If possible, it is recommended that home visits be transitioned to remote visits by telephone or ZOOM. If that is not possible, pre-screening procedures (see above) should be conducted prior all face to face visits.
  • The decision to conduct home visit or off-site testing should be discussed with the research leader/PI
  • Additional considerations regarding having students conduct home visits should be considered by the research leader/PI and the Graduate College guidelines
  • This includes informing research subject that their appointments will be postponed until further notice.
• Encountering a COVID-19 Subject During Research Project
  • If a case of COVID-19 has been identified in a research subject,
    • Provide participant with a surgical mask if on site and possible.
    • Participant should be instructed to:
      • Return home and contact their primary care provider for guidance and testing.
  • Research staff should:
    • Suspend the research activities related to affected participant until HRPP provides clearance to resume the project.

• Email COVID19health@drexel.edu. In this email provide your name and a phone number that you can be contacted at. A Drexel representative will contact you.

• Contact HRPP (hrpp@drexel.edu; 267-359-2471)
• Contact the Research Lead/PI

• For Projects Involving Investigational Drugs

  • Develop a plan to cover cases where investigational drug could not be dispensed to participants. Discuss possibility of shipping research supplies or investigational medication to participant.
  • If this were to happen, consider plans to safely transition participants to the most appropriate clinically available medication(s). This transition must include consultation with the IRB, study sponsor (if applicable), medical provider, and members of the care team.

• Ensure remote access, wherever possible, to files, data, servers, etc. Check that all members of your research team who might need to work remotely have access to computers that are able to connect to research files and meeting software (such as Zoom).
• Privacy and confidentiality provisions remains critically important at all times, even when working remotely. Please note that access to, storage and treatment of sensitive information, including data governed by HIPAA regulations, must comply with university and other policies for security of research data.
• Research teams should obtain contact information for research participants should they need to reach out to them. This information should be accessible remotely yet stored securing following University guidance (see above).
• Do not use personal email to conduct clinical research activities or for correspondence of any kind.

It is recommended that investigators consider a plan for maintenance for their individual lab/research spaces and in particular focus on ensuring regular cleaning of any space, equipment, etc that may continue to be regularly used or shared.

Immediate Measures to Avoid/Reduce Transmission in Research Settings

• Personnel who are feeling unwell are REQUIRED to stay home until they no longer have symptoms.
  • Students who do not feel well should immediately call Drexel Student Health Center at 215.220.4700.
  • Faculty/Staff who do not feel well should contact their primary care provider for guidance and testing. Immediately after calling your provider, please email covid19@drexel.edu and provide your name and a phone number that a Drexel representative can contact you at. It is imperative that Drexel University is aware of any exposure risk to the members of the Drexel community.
• Practice the recommended personal hygiene measures regularly.
  • Wash hands frequently with soap and warm water for 20 seconds. Hand sanitizer is not a substitute for hand washing in the laboratory.
  • Disinfect common rooms/laboratory areas and touch points, at least daily,
    • Utilize the disinfection method found in this guidance [PDF]
    • Touch points include but are not limited to doorknobs, sink handles, refrigerator/freezer doors, fume hood sashes, telephones, pipets, shared equipment, etc.
• Implement measures to reduce density and allow for “social distancing” of lab/research personnel.
  • For example, increase spacing between researchers where possible to >6 feet, have personnel come to the lab in shifts, allow alternate benches to be unoccupied.
  • This should not come at the expense of safety, there should always be a someone else in the research space at the same time as you in case of emergencies.
  • Reduce non-essential in-person meetings. Use remote work technologies such as Zoom.
• Promote opportunities for research personnel to work remotely - both to allow for social distancing, or in case they need to self-isolate on short notice.
  • Test out remote work technologies (such as Zoom, Lab Archives) immediately.

This guidance is also available here [PDF]

Methods for Disinfecting COVID-19 from Surfaces

NOTE: If you have an existing Biosafety Protocol please follow the disinfection techniques detailed in that protocol.

As campus remains open for research and other activities that do not involve gathering of large number of people, it is important to continue to practice good hand hygiene. In addition, we recommend that high touch surfaces (e.g. door knobs and handles) as well as lab benches be treated with agents that will kill viruses. EPA has issued a list of commercially available agents, which can be accessed by clicking here. If commercially available agents are not readily available, the following can easily be prepared and filled in spray bottles for use:

• 70% Ethanol (NOT 100%)
  • Requires a 5 minute dwell time to effectively kill viruses
• 70% isopropyl alcohol (rubbing alcohol)
  • Requires a 5 minute dwell time to effectively kill viruses
• Diluted bleach (20 ml of bleach diluted to 1 liter H2O)
  • Requires a 10 minute dwell time to effectively kill viruses

Spray the surfaces and wipe them down after the appropriate dwell time (above) to achieve disinfection.

References:

• https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
• https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html

This guidance is also available here [PDF]