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Establishing Emergency Response for COVID-19 Pandemic - Coggle Diagram
Establishing Emergency Response for COVID-19 Pandemic
1) Establishing Organization
Supporting Department
(b) Purchasing
(i) Procurement
(ii) Sub-con
(a) Technical
(i) Setting up laboratory
(iii) Sanitization of lab
(ii) Ensure lab in compliance to standards
(iv) Document control
(c) IT
(i) Electronic data is safe from compromise
(ii) Data backup is always available
Analysis Department
(a) Swab
(i) Sample collection
(ii) On-site staff
(iii) Patient registration
(b) Unboxing
(ii) Verify patient sample with request form
(iv) Heat inactivation of sample
(i) Take out from triple layer packaging
(iii) Register with internal system
(d) RNA Extraction
(i) Extract RNA from sample
(ii) Spike step with internal control
(e) RT-PCR
(i) Perform RT-PCR
(ii) Analyse data
(iii) Verify data
(b) Registration, Reporting & SIMKA
(i) SIMKA patient ID registration
(ii) Reporting all data
(iii) Liaise if needed for retest
Management
Conduct meeting with government bodies
Relay Information and decisions to
2) Establishing Workplace
(a) Swab site
(i) Open area
(ii) Less foot traffic
(b) Unboxing
(i) BSL 2
(ii) Full PPE
(iii) BSC for inactivation
(c) Registration
(i) Key in
(ii) Validator
(d) RNA Isolation
(i) BSC to avoid contamination
*Team Leads
Ensure staffs are clear on role
Ensure staffs follow each workplace SOP
Staffs communicate on working stage as working side by side
3) Establishing Instrument
(i) RTK-Antigen
(a) Benefits
Cheaper
Lower TAT
Effective screening tool
(b) Disadvantages
Less Sensitive
Need to do PCR if positive
(c) Method
Detecting COVID antigen on the virus
(ii) RT-PCR
(a) Benefits
Gold standard
Result widely accepted
Accurate and sensitive
(b) Disadvantages
Expensive
Longer TAT
(c) Method
Detect virus genome
Low Cycle Threshold
High viral load
High infectability
Early infection stage
High Cycle Threshold
End infection stage
Recovering
Genes
N gene
ORF1ab gene
S gene
E gene
RdRP gene
(d) Kits and Equipments
Biorad
QuantStudio
Liferiver Biotech
TaqMan
*Team Leads
Ensure all staffs are well trained in handling instruments
Report if error is detected to prevent further delay
4) Establishing Method
(a) WHO Method
(i) Gene Flow Detection
(Singleplex = Serial)
E gene
RdRP gene
N gene
No internal control
Single run
(b) Liferiver Method
(i) Multiplex detection
(Parallel)
E gene
RdRP gene
N gene
Internal control present
(c) Taqman Method
(ii) Multiplex
(Parallel)
S gene
RdRP gene
N gene
Internal control present
*Team Leads
Discussion on how to improve methods
Liaise with health authority on updates
5) Challenges
(a) Contamination
Sanitize lab
Proper separation of work area
Identifying source
(c) Budget
Leads to insufficient kit
Insufficient PPE
Ceased support from governement
Expensive kits
(b) Turnaround Time
Late arrival of samples
Insufficient manpower
Unexpected absence