Situation:

The coronavirus (COVID-19) pandemic has presented an enormous challenge to individuals and organisations worldwide. Adapting to living with the threat of the SARS-CoV-2 virus among our communities has required significant changes in how we behave and operate.

Our position:

At Richmond Research Institute (RRI), as a not-for-profit clinical research organisation focused on medicines and patient safety, we were acutely aware we had access to resources and expertise we could re-deploy to start COVID-19 testing quickly. Originally born out of the necessity to protect and enable progression of our existing research work, we knew we needed to act.

Our COVID-19 response:

Working with our partner organisation, Richmond Pharmacology Limited (RPL), the initial emphasis of our COVID-19 response was on staff, clinical trial volunteers, and visitor safety. At their London Bridge clinical trial facility which we use for our studies, RPL acted quickly and responsibly to mitigate the risks, implementing strict entry control measures for access to the research unit, evaluating key indicators such as symptom scores, body temperature, travel history, and contact tracing for anyone entering the building. The wearing of masks inside the research unit is mandatory and the number of people on site is limited to enable social distancing.

COVID-19 testing regime:

Routine testing of staff, trial volunteers, and visitors began on 19 March 2020. The rigorous testing procedure consists of multiple tests to ensure the results are reliable. This includes a Polymerase Chain Reaction (PCR) test to detect whether SARS-CoV-2 genetic material is present in mouth/throat swabs (active infection), as well as two antibody tests i.e. a rapid finger prick test to detect the presence of anti-SARS-CoV-2 antibodies, and an antibody test on venous blood samples to detect and measure the level of anti-SARS-CoV-2 antibodies. The turnaround time for PCR testing is just 20 minutes and the rapid antibody test takes an average of 30 minutes to show results. Results from the antibody level measurement test are available in 24 hours.

This suite of tests enables quick identification of visitors and staff with active infections and those who have been infected previously. Only individuals testing negative by PCR are allowed into the research unit. Clinical trial participants and visitors are tested each visit while staff are tested every four days. For PCR positive cases RPL notify Public Health England and advise individuals to self-isolate. They also text the individuals regularly, seeking a response to monitor their condition and be available if they need help seeking medical attention.

Test results:

As a research institute we saw an opportunity to turn the COVID-19 testing initiative into a research project by taking RPLs data, managing it beyond the narrow remit of RPLs work and to present it live on the institute website. Our results have followed the national trend. The majority of PCR-positive cases (active infections) were detected in March and April 2020. The number of active infections has since tailed off during subsequent months as a consequence of nationwide lockdowns and stricter measures to control virus spread implemented by the government. We detected a few positive cases in June and July as lockdown restrictions eased. Based in the centre of London at London Bridge, we are aware that the test results are a potential sentinel for additional waves of COVID-19. That is why we monitor our results daily and update our testing results on our website (https://www.richmondresearchinstitute.org/covid-19-testing) for public view on a weekly basis.

Expansion to community testing:

As the testing capacity expanded at RPL, we extended the invitation for COVID-19 testing to families of staff and the local community. By offering tests to local businesses, schools, and other members of the community, we aim to address shortcomings in national COVID-19 testing provisions. We wanted to provide reassurance among members of the public and allow people to make informed decisions by weighing up the risks they may pose to others around them.

COVID-19 testing school teachers:

For example, we arranged testing for more than 50 staff from a local primary school. As teachers and students return to school, Charles Dickens Primary School wanted to offer some reassurance and certainty in an uncertain time with the aim of opening as widely and safely as possible. Of 50 staff none tested positive by PCR, however 7 (14%) tested positive for antibodies showing previous infection. This is a snapshot in time of the COVID-19 status of staff at this central London school. The school funded the material costs for the tests. RRI and RPL contributed staff resources to sample, process, and report the results. We would be delighted to take another snapshot, for example, during the autumn term after the school summer holidays. This will depend on available funding; if you would like to support this activity please contact us at i.atkin@richmondresearchinstitute.org to discuss.

Summary:

To date we have performed over 3,000 PCR and antibody tests on over 900 people. The COVID-19 testing system is now part of the ‘new normal’ at RPL. From the institute’s perspective we are capturing data on symptoms and demographics as part of this activity and adding to the body of work characterising COVID-19 and risk factors. For example, we are an active study site contributing to the Lean European Open SARS-CoV-2 Survey (LEOSS https://leoss.net/).

At the beginning of this year, we could not have anticipated that a fifth stream of research called ‘COVID-19’ would be added to our existing research portfolio of Cardiac Health, Clinical Trial Design and Methodology, Hepatology and Ethnic and Sex Differences in Physiology & Drug Responses. The agile nature of the institute has enabled us to adapt quickly during these challenging times.

For more information and to view COVID-19 test results updated weekly visit: https://www.richmondresearchinstitute.org/covid-19-testing