ASCLS-IN

The Indiana Chapter of the

American Society for Clinical Laboratory Science

  • June 16, 2021 12:38 PM | Daniella McCurdy (Administrator)

    Geno Leser MT(ASCP), MLS Specialist (SBB, SC, SH, SM, SCT, SLS)

     

    As laboratorians we find ourselves in an unparalleled and historic situation in the laboratory. Never before had the modern world experienced a pandemic of this particularly insidious nature and magnitude, nor had the world's research and clinical labs had such powerful and effective tools to diagnose, prognose, and aid in treatment.

    At a recent conference at a Central Indiana Diagnostics facility (Burnham et al), national experts discussed the basics of lifecycle measurement of the virus and their impact on vaccines.  We ended up with some very satisfactory answers on one hand and some big question marks on the other for our profession including our interaction with other health care professions and our ability to serve the public.

    Once the severity of the pandemic became obvious, the best-equipped research and development companies all over the world began the process of developing direct viral testing, rapid PCR testing, and immunoassay testing. The results of this response are familiar in clinical laboratories throughout the United States and around the world.  The laboratory community has been key in discovering and communicating the fact that current testing is able to detect, with 82 - 95% sensitivity, current strains of the virus.

    Vaccines directed at the most common strains known appear to be stabilizing new infections rates as of this date. This combined with face coverings, social distancing, and frequent sanitization have caused a plateau and decline in numbers of the new seven-day rolling case averages.

    Multiple diagnostics companies have created immunoassays directed at physical components of the coronavirus, such as the spike protein. Different from the nucleocapsid-directed immunoassays that detects the presence of the antigen, this detects whether the patient has been exposed to the pathogen or the vaccine before. It is effective in showing the amount of protection against the virus.

    Given the context of early 2020, all of this has brought us into better understanding to develop  better tools quickly and effectively. There are still limitations to clinical effectiveness, though.

    There is a concern that the tests, while demonstrating presence or absence of a response to the product for which it is testing, are subject to the ability of an elderly or immunocompromised patient’s ability to create a robust immune response versus that of a person with a healthy immune system.

    Another complication is that diagnostic testing can't tell us the whole story about a virus. Mutations of the virus, such as B.1.1.7, P1, P.1.526, P.1.351 and P.1.617, have been reported globally and new variants are still being identified.

    Once the changes to the virus start circulating into the general populations, will the current vaccines still be effective? Will the immunoassays we've developed be able to track them given the fact that they were not manufactured to identify the new variants?  What happens when these new variants arrive on our shoreline? With the accessibility and ease of global travel the spread of new variants is inevitable and only a matter of time.

    Conversely, what if new variants within the United States (such as one recently emerged from Washington Heights, NY) migrate to countries outside the US? The herd immunity that's been established between natural infection and vaccines has been largely directed toward the state of the virus early in the pandemic.

    There is also the possibility of another breakout infection. This situation occurs which the vaccine has been given but does not confer immunity in the patient.  This prevents the body from mounting an immune response to the vaccine so if the patient is infected naturally, the patient is not protected and contracts COVID-19.  The data is only now being collected as the populace is immunized, so the prevalence of this situation is unknown but important to overall immunity in the human population.

    Using the model of the respiratory influenza virus that most of the population is familiar with, the severity of the influenza virus is lessened when the body's immune system has previously been exposed to a similar variation either by vaccination or natural exposure.  However, if a pathogen is different enough in morphology then it may cause a full-blown infection with severe heath complications. This occurs because the natural or vaccine immunity is unable to assist because it does not recognize this strain of virus. When coupled with concomitant illnesses and infections from a weakened immune response, the results were catastrophic and could be again. 

    The best-case scenario is that the genetic sequences represented by the mRNA and S protein already exposed to the body will be enough to mount an immune response that does not create an overwhelming inflammatory response that has proven fatal to so many people. We will only know the answer to this from the laboratory work being done to detect it and the tracing that models the spread of the variants and how effective the clinical and public health counter measures are.

    The worst-case scenario is that not only would the vaccine fail to create immunity but the monoclonal antibody testing also fails to detect a new infection or detects a titer of antibody that is ineffective against the new antigen. The result would be a temporary return to square one, with rising infection rates and little ability to combat it until multivalent vaccines and polyclonal immunoassay tests are developed. The analogy is a very good catcher's mitt with a few holes in it used to catch golf balls instead of baseballs. This is certainly not where we hoped we would be a year from now.

    As other variants become dominant in other parts of the world and as the variant here in the United States travels abroad, we are faced with continued COVID-19 spread and the continued need for in vitro monitoring.  However, at this time we are no longer alone without resources.  The research community has continually acquired data on the nature of emerging variants and is creating multivalent PCR and immunoassay tests.

    The question remains will volume and type of testing go up or down over the long-term?  The answer is obviously situational. Immunizations and infections from which patients have recovered are leading to greater herd immunity, lowered incidence and prevalence. This has, in turn, meant some shift back to conventional, non-COVID-19 focused laboratory medicine. 

    The factors countering this will be the uncertainty factors of viral mutation, incorporation of those mutations into multivalent vaccines, and time lag leading to community spread. One only needs to look to world hotspots of infection to see this in action and it can happen here, as well.

    Though there has been a shift from PCR toward antigen and antibody testing, particularly monitoring antibody response and reduced immune response over time, it will be resource-intensive either way. It is part of the pound of prevention that is necessitated when the pound of cure is ignored or circumvented.

    So, what can we, as laboratorians, do to help?  We must be prepared for the next waves of this pandemic through properly targeted research and clinical funding, continued adequate staffing resources through education and retention, preservation of the laboratory supply chain, and increased public education about the laboratory’s role in combating the pandemic. 

    We must continue to support expert plans while retaining a critical approach to ensure their integrity. As an example, vaccine information must be made available all the time, particularly with multivalent vaccines in the near future.  Our best resources remain reputable national and international sources to counter questionable social media outputs, which well-intended or not, lack intellectual rigor.

    We must support hospitals, health systems, and laboratories other than our own to address current shortcomings.  Finding the gaps in laboratory service provision ought to be the shared responsibility of every level of service provision. Those that are currently doing this in a collaborative manner are to be applauded and reinforced.

    Finally, we must address equal access to care. Doing what is economically possible to support underserved urban and rural vaccinations and healthcare provisions (including self-isolation and quarantine in the public sector) minimizes viral mutation, incubation and outbreak.  Together, the laboratory industry can continue to be the bellwether of patient care during this COVID-19 pandemic, supporting future efforts leading to eventual eradication.

     

     

    References 

    Burnham, Carey-Ann Ph.D., Farnsworth, Christopher Ph.D., O’Halloran, Jane PhD, Parness, Laura, MD, McMullin, Allison. “COVID-19 in the Vaccine Era Diagnostic Topics Roundtable” Roche Diagnostics Corporation teleconference, 02/02/2021.

    “COVID-19 Antibody Testing”, Versiti Beacon Club Newsletter, 10/15/2020.

    “COVID-19 Survivor Meets Lifesaving Plasma Donor”, Versiti Beacon Club Newsletter, 11/04/2020.

     

  • February 02, 2021 1:58 PM | Daniella McCurdy (Administrator)

    Daniella McCurdy CLS(ASCP)CM

    As the President of ASCLS-IN I recently had the privilege of attending the Emerging Laboratory Managers Collaborative Conference (ELMC2). If you are a manager and missed the conference I highly recommend attending some of these sessions when they are made available to purchase by ASCLS, or attending other laboratory leadership conferences like this. They provide you with a significant amount of information on laboratory leadership in a short amount of time.

    I have not been a manager myself yet, but have been a leader and an engaged employee; so the topic of employee engagement was one that really interested me. I will first pose the question: to the managers “Do you think you are helping your employees to feel more engaged?” and to the employees “Do you think that you are an engaged employee?”

    Eric Stanford, MHA, MLS (ASCP)CM presented some wonderful information on what makes up an engaged employee and thus sparked my interest in the topic. He referred to 3 general types of employees that you may find in a work place:

    • Engaged: This person is one who feels a passion for their work and a connection to their company. They are the person who is working to move their company forward.
    • Not-Engaged: The person that is “sleepwalking” through their day and not putting in the energy or passion for their work.
    • Dis-Engaged: The person who is unhappy to even be at work and is actively trying to pull their co-workers and company down.

    The ultimate goal as a manager is to have as many of your employees as possible in the engaged category and as few as possible in the dis-engaged category. So how do you do this? First you must know why it is important to do this. By having more of your employees under the engaged category you and your company can benefit from the following rewards (Wickham, 2020) (J. Eric Stanford, 2021):

    1. Increased Employee and Patient Safety
    2. Higher Productivity & Profitability
    3. Better Employee Health & Happiness
    4. Greater Employee and Patient Satisfaction
    5. Better Home Life
    6. Lower Absenteeism
    7. Higher Employee Retention & Loyalty
    8. Better Quality Work

    To enhance your employees engagement as a manager here are some suggestions that were put out by (J. Eric Stanford, 2021):

    • Be sure that you are engaging with your staff regularly (not just giving them gifts and/or food around special holidays.) Round with them, talk with them, let them feel that their concerns are actively heard and act on them when possible. If there are concerns of theirs that cannot be acted on explain why.
    • Make sure that your employees know what is expected of them and that they have the materials they need to complete their tasks.
    • Communicate the business strategies that the laboratory, and/or company, are undertaking and allow employees to express their opinions about them and feel heard.
    • Provide recognition for employee’s good work and achievements; The RISE Method is great for this! (Achievers, 2016) (J. Eric Stanford, 2021)
    R (Recognize) recognize employees good work consistently; set aside time for this weekly if possible
    I (Immediate) recognize employees good work as soon as it happens if you can; the sooner you recognize it the more likely they are to repeat it
    S (Specific) be specific about what exactly the employee did and why it was important to the company; make sure it matches the level of good work done as to not seem insincere
    E (Encouraging) make sure that recognitions provide positive encouragement; create an environment of recognition where employees are also recognizing each other, and are receiving recognition in the form they find to be most meaningful to themselves
    • Regularly gather opinions and feedback from your employees and your peers on how you are doing as a manager and what you can do to improve. Then make those improvements where appropriate, and let the employees see you trying to do so.
    • Provide employees the opportunities to take on leadership/advanced roles when possible.
    • Engage authentically, and actively listen to your employees to help cultivate feeling of psychological safety. (A feeling that it is safe to express your opinions and you won’t be punished for it (Tera Webb, 2021).)
    • Allow employees to have friends or mentors at work that help them to feel safe and provide enjoyment to their job.

    So I ask you again, to the managers “Do you think you are helping your employees to feel more engaged?” and to the employees “Do you think that you are an engaged employee?”  My hope is that with this information and a little effort that your answer is or will soon be “Yes!




    Achievers. (2016, June 2). [engage] The Employee Engagement Blog. Retrieved from Achievers: https://www.achievers.com/blog/4-employee-recognition-best-practices/

    J. Eric Stanford, M. M. (2021, Jan 15). The Engaged Employee.

    Tera Webb, M. M. (2021, Jan 16). Psychological Safety in Healthcare: The Role of the New Clinical Manager.

    Wickham, N. (2020, May 7). Why is Employee Engagement Important? 14 Benefits Backed by Research. Retrieved from Quantum Workplace: https://www.quantumworkplace.com/future-of-work/14-benefits-of-employee-engagement-backed-by-research

  • December 15, 2020 1:26 PM | Daniella McCurdy (Administrator)

    Here is the information that the CDC has posted so far on what you need to know about the new COVID-19 mRNA vaccine.



  • November 02, 2020 12:40 PM | Daniella McCurdy (Administrator)
    • We are looking for 5 professionals to lecture a 1 credit hour PACE session on the topic of their choosing at the ASCLS-IN Annual Meeting next spring. Date tentatively set for Friday March 26th, 2021. If you are interested please let us know!
    • We are planning to hold the 2021 ASCLS-IN Networking Event at Indiana City Brewery on the evening of Thursday March 25th, 2021.
    • The Lab Week Walk/Run had a great turn out of both professionals and students this year. Thank you to everyone who turned out to socialize with their fellow CLS students and professionals on that brisk mid-day walk!
    • ASCLS-IN website will be switching platforms in 2021 to a microsite through the ASCLS national’s website platform.
    • The reward recipient of the ASCLS-IN Scholarship received her second installment of $500 for maintaining employment in Indiana after graduation.
    • The ASCLS-IN and CICBF scholarship application deadlines for this year have been moved to December 1st, 2020.
  • October 29, 2020 12:53 PM | Daniella McCurdy (Administrator)

    As we are moving closer to November many of us never could have imagined that we would still be waiting for a COVID-19 vaccine to be made available to the public. It seems that this year's fall and winter holiday season will be much more complicated than usual; with wearing masks, washing hands, hand sanitizer, and 6 feet distancing practices all being a normal occurrence at the moment.  We may now have another preventative measure we can take this winter to protect those we love from the silent transmission of this virus.


    Mouthwashes, Oral Rinses May Inactivate Human Coronaviruses

    October 19th,2020

    Penn State

    HERSHEY, PA — Certain oral antiseptics and mouthwashes may have the ability to inactivate human coronaviruses, according to a Penn State College of Medicine research study. The results indicate that some of these products might be useful for reducing the viral load, or amount of virus, in the mouth after infection and may help to reduce the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

    Craig Meyers, distinguished professor of microbiology and immunology and obstetrics and gynecology, led a group of physicians and scientists who tested several oral and nasopharyngeal rinses in a laboratory setting for their ability to inactivate human coronaviruses, which are similar in structure to SARS-CoV-2. The products evaluated include a one percent solution of baby shampoo, a neti pot, peroxide sore-mouth cleansers, and mouthwashes.

    The researchers found that several of the nasal and oral rinses had a strong ability to neutralize human coronavirus, which suggests that these products may have the potential to reduce the amount of virus spread by people who are COVID-19-positive.

    "While we wait for a vaccine to be developed, methods to reduce transmission are needed," Meyers said. "The products we tested are readily available and often already part of people's daily routines."

    Meyers and colleagues used a test to replicate the interaction of the virus in the nasal and oral cavities with the rinses and mouthwashes. Nasal and oral cavities are major points of entry and transmission for human coronaviruses. They treated solutions containing a strain of human coronavirus, which served as a readily available and genetically similar alternative for SARS-CoV-2, with the baby shampoo solutions, various peroxide antiseptic rinses, and various brands of mouthwash. They allowed the solutions to interact with the virus for 30 seconds, one minute, and two minutes, before diluting the solutions to prevent further virus inactivation. According to Meyers, the outer envelopes of the human coronavirus tested and SARS-CoV-2 are genetically similar, so the research team hypothesizes that a similar amount of SARS-CoV-2 may be inactivated upon exposure to the solution.

    To measure how much virus was inactivated, the researchers placed the diluted solutions in contact with cultured human cells. They counted how many cells remained alive after a few days of exposure to the viral solution and used that number to calculate the amount of human coronavirus that was inactivated as a result of exposure to the mouthwash or oral rinse that was tested. The results were published in the Journal of Medical Virology.

    The one percent baby shampoo solution, which is often used by head and neck doctors to rinse the sinuses, inactivated greater than 99.9 percent of human coronavirus after a two-minute contact time. Several of the mouthwash and gargle products also were effective at inactivating the infectious virus. Many inactivated greater than 99.9 percent of virus after only 30 seconds of contact time and some inactivated 99.99 percent of the virus after 30 seconds.

    According to Meyers, the results with mouthwashes are promising and add to the findings of a study showing that certain types of oral rinses could inactivate SARS-CoV-2 in similar experimental conditions. In addition to evaluating the solutions at longer contact times, they studied over-the-counter products and nasal rinses that were not evaluated in the other study. Meyers said the next step to expand upon these results is to design and conduct clinical trials that evaluate whether products like mouthwashes can effectively reduce viral load in COVID-19-positive patients.

    "People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with," said Meyers, a researcher at Penn State Cancer Institute. "Certain professions including dentists and other health care workers are at a constant risk of exposure. Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing, or sneezing. Even if the use of these solutions could reduce transmission by 50 percent, it would have a major impact."

    Future studies may include a continued investigation of products that inactive human coronaviruses and what specific ingredients in the solutions tested inactivate the virus.

    - This press release was originally published on the Penn State Website

  • August 21, 2020 1:21 PM | Daniella McCurdy (Administrator)

    ASCLS Today

    ASCLS eNewsBytes

    ASCLS Society News Now

    Visit the above links for more news from ASCLS!
  • February 10, 2019 8:27 PM | Norma Erickson

    When I was “growing up” as a laboratory student in Indiana in 1970, there was a name synonymous with blood banking --Narcissa Hocker. Narcy, as she was known to her friends, was the supervisor of the blood bank at the Indiana University Medical Center in Indianapolis. Her reputation as the queen of blood banking was known throughout the state. She retired in 1992 as Emeritus Associate Professor from the IU School of Medicine. Even after her retirement, she was still involved in the blood bank at IUMC, returning weekly to help record data and teach students laboratory technique. At the age of 95, she died on May 26, 2018. On February 5, 2019, the IUPUI Faculty Council honored her with a memorial resolution.

    Narcissa Hocker, 1965  Narcy was a great supporter of the Indiana Medical History Museum in Indianapolis, the oldest preserved pathology laboratory in the US. In 2005, as part of the Museum’s celebration of National Laboratory Professionals Week program, she participated in a panel discussion that recalled the early years of training for medical technologists. In the discussion, she revealed two things that have stuck with me over the years. 1) Her first career choice was physician--she wanted to be a missionary doctor, but was advised to become a medical technologist instead; 2) during a time when laboratory workers wore white nurse’s uniforms and white shoes (no nurse’s cap, of course), they frequently tucked a floral handkerchief loosely in their front pocket so a burst of color would pop out. Narcy said the all-white uniforms were so boring.

    IU Medical Technology Class 1945-46

    IU Nursing Students with caps, no date given 

    Hocker, Sandra Rothenberger, Gayola Beach, 1970

    I have no doubt that Narcy would have helped many people as a missionary doctor, but her work in transfusion medicine touched many lives also, as you can read in the Council’s memorial resolution. The laboratory profession and the School  were immeasurably fortunate to have her.

    My interpretation of the bright handkerchiefs? I can’t help but wonder if there wasn’t another reason for the colorful display. I later learned that Narcy was not the only woman who received that same career advice. Perhaps these lively, dedicated, science-loving women were not merely making a fashion statement. Perhaps they were saying “I am a woman in white...but I am not a nurse.”

    I recently found some of my mother’s flowery handkerchiefs when cleaning out her house. I don't have a front pocket anymore, but maybe I’ll just pin on one of those handkerchiefs during Lab Week. If anyone asks, I can tell them about Narcy and her fellow women in white.

    Narcy Examining the Blood Supply, ca.1945 (with a handkerchief in her front pocket)


    All photos from Ruth Lilly Special Collections and Archives

    University Library, IUPUI

  • December 21, 2018 10:53 AM | Norma Erickson

    ASCLS follows up its position paper on the laboratory workforce shortage by posting fourteen position statements meant to offer solutions for the problem. Number ten addresses laboratory certification as essential for "appropriately educated and adequately trained staff." The program directors of Indiana’s Medical Laboratory Science (MLS) and Medical Laboratory Technology (MLT) programs team up form the Consortium of Indiana Medical Laboratory Educators (CIMLE), a non-profit educational organization. The Consortium offers a one day comprehensive review course for Clinical Laboratory Science. Presenters are current or past instructors for clinical laboratory science programs in Indiana. The review course targets students currently enrolled in laboratory science clinical programs who are preparing to sit for national certification exams after graduation.  They also participate in a match process to place students in the best programs for their needs.

asclsindiana@gmail.com

Copyright, ASCLS-IN 2019-2020


ASCLS-IN is a 501(c)6 non-profit organization, Indiana

Powered by Wild Apricot. Try our all-in-one platform for easy membership management