Dr Shashi Sudan Sharma, Dr Amrish Sarup Kohli
A wise mind has brilliantly shared his thought “The best safety device is a careful worker who thinks that when we work together for safety we are safe.”
Bio-safety is the way through which we keep our laboratory warriors safe from the invisible pathogens that are being processed there for their identification. More the danger higher should be the level of protection. And the eligibility of being dangerous could be anything. It could be the virulence of the pathogen to cause the disease. It could be the ease of transmissibility of that pathogen to enter the human body through the chosen route. It could also be the limit of treatment options available to infection or disease if at all this happens. The level of anticipation of that danger will determine the level of bio-safety. Thus accordingly, the bio-safety levels are segregated into four groups. These are bio-safety level 1, bio-safety level 2, bio-safety level 3 and bio-safety level 4. The type of process that the laboratory chooses is also detrimental to the selection of a particular bio-safety level for a specific anticipated agent. As an example for SARS-CoV-2, the virus that caused COVID pandemic, the routine diagnostic procedures like RTPCR and True-Nat would demand for processing the virus in bio-safety level-2 but if the isolation of the same virus is desired, we need to process the virus at bio-safety level-3.
This was 31st of December 2019, that the WHO China country office was informed of cases of pneumonia of unknown etiology that were detected in Wuhan city, Hubei province of China. After a short interval on 7th January 2020, a new strain of Coronavirus was identified and named SARS CoV-2 by WHO. It did not take enough time to spread like a wild fire and shook the globe. Strategic approaches begun by the nations, objectives were set, containment plans were made and action plans started getting devised for cluster containment. Active surveillance began in the containment zones and the whole health infrastructure was involved. This bought about the up-gradation and strengthening of the VRDL network laboratories that were the mainstay to test the samples and diagnose the cases.
The aim here of reopening of the doors of the past is to refresh our memory to any such conceivable and anticipated threats of aggression in our future. The humanity needs to be prepared always and the minds need to be refreshed. The general public must inculcate in their habits all the standard precautions and hence there is a need for enumerating the same in order to be remembered and bought into practice:
Hand hygiene.
Use of face mask in a proper way.
Follow the appropriate protocol of waste dispersal and management.
Regular disinfection of the house and work places.
Safe use and disposal of sharp items.
Adherence to respiratory hygiene and cough etiquette in the public.
There are very few untreatable deadly pathogens that enter the human body with ease and cause death with certainty like Lassa virus, Ebola virus and Marburg virus and bacteria called Bacillus anthracis that inevitably need the highest level of bio-safety. Here in the bio-safety level-4, only the most sensitized scientists and workers with the highest levels of skills, knowledge and awareness of spread of such rare but obnoxious pathogens can entry. The up-gradation of the level of bio-safety in the medical colleges and their extension to the outskirt laboratory facilities has become the need of the hour. The protection of our workers is and always will be our topmost priorities.
GMC Jammu had emerged as a lone warrior during the inspissations of the COVID-19 pandemic when the health system knew the least about how the virus would behave in the health ecosystem of our communities. Very soon, the department of Microbiology was turned to the core of the battle field in the war against the pandemic. In that journey of our struggle, we bought a lot new to GMC Jammu and rendered illumination of knowledge and awakening to the community. We crossed the barriers and stepped outside the boundaries of GMC to help the community in pain. We carried out sessions of teaching the covid appropriate behavior to the general masses and did not stop until we were satisfied that they have accepted it as a norm. Within the dimensions of medical college, new and state of art machines like COBAS were bought from government of India and after successful installation it gave us a rocket boost to test the virus as far as the number of daily testing was concerned. Our microbiology laboratory was raised to bio-safety level-3. Not one but two level 3 laboratories have been bought to the credit of GMC Jammu. The readers must know the difference between the various levels of bio-safety and what does the up-gradation of bio-safety levels mean in reference to protection of the warriors of life that work in the laboratories fiddling with the deadly virus.
BIOSAFETY LEVEL 3 LABORATORY
BSL-3 laboratories are capable of handling microbes that can cause serious or potentially lethal disease through inhalation and that was well applicable to SARS-CoV-2, the virus responsible for COVID-19. The fruits of blessing in disguise that were born out of the branches of miseries of a much expanded tree of pandemic was the coming up of many BSL-3 laboratories in the UT of JK.
Microbes found within bio-safety level 3 settings are so serious that work is often strictly controlled and registered through the appropriate government agencies. Laboratory personnel are also under medical surveillance and may require immunizations for the microbes they work with.
Common safety controls within a BSL-3 lab include:
The use of PPE.
The use of solid front wraparound gowns, scrub suits and/or coveralls is often required.
Access to a hands free sink and eyewash station available near the exit.
Sustained directional airflow to draw air into the laboratory from clean areas toward potentially contaminated areas.
Self closing set of locking doors with access away from general building corridors.
Access to BSL-3 laboratory is restricted and controlled at all times.
BIOSAFETY LEVEL 4 LABORATORY
A rare existence of Biosafety level 4 labs is witnessed throughout the world and even the most developed nations have a countable numbers of such laboratories. As the highest level of biological safety, BSL-4 labs work with highly dangerous and exotic microbes such as Ebola and Marburg viruses. Infections caused by these types of microbes are often fatal and come without treatment or vaccines.
In addition to biosafety level 3 considerations, biosafety level 4 laboratories must follow these safety protocols:
Personnel must change clothing before entering the facility and shower upon exiting.
All materials must be decontaminated before leaving the facility.
Personnel must wear the PPE from lower BSL levels, as well as a full body, air supplied, positive pressure suit.
Access to class III biological safety cabinet.
BSL-4 labs are extremely isolated, often located in an isolated and restricted zone of a building or in a separate building entirely.
We could not desire of more than establishing BSL-3 laboratories in our UT. However, desires still carry their wings to fly in limitless skies. Who knows if we may get the rarest BSL-4 level laboratory in our UT. The achievements of COVID-19 though need to be kept intact and the resources that have been gathered need to be maintained. We all cannot afford to forget our past, nor can we afford not to anticipate the dangers that our future may again throw over us in an uglier manner.
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