St. Jude Children’s Research Hospital made a commitment early in the pandemic to test all its employees regularly for COVID-19 regardless of symptoms. The tactic has enabled the institution to be a leader in research on the immune response of the virus.
Starting at the end of March, St. Jude instituted a standard for all employees to get tested for COVID-19 once a week. The program is one way the Memphis, Tenn.-based hospital is protecting employees and patients from transmission because it is detecting cases of the virus even among asymptomatic individuals, said Dr. Aditya Gaur, director of clinical research for the infectious diseases department.
Getting tested regularly is an expectation for employment at St. Jude, which is unique to the industry with most healthcare systems typically only testing their employees when they suspect exposure to COVID-19 or they are displaying symptoms.
Regular testing of employees doesn't guarantee reduction in transmission of COVID-19, said Dr. Andrew Furman, executive director of the clinical excellence program at ECRI. A person can be exposed any day after they test negative and the institution still wouldn't know until the person is tested again. It's also incredibly costly and puts supply chain at risk when conducting so many tests on a routine basis, he added. ECRI recommends mask wearing, hand washing and social distancing to reduce transmission among healthcare workers.
The research team at St. Jude is leveraging the COVID-19 test data to understand immune responses for the coronavirus. Right now, it’s unclear when people generate immunity and how long it lasts. Answers to these questions are critical as drugmakers work to bring a COVID-19 vaccine to market quickly, said Paul Thomas, a member of St. Jude’s immunology department.
“There is a lot of pressure to understand who (the vaccine) is going to protect, how it’s going to protect them and how long it’s going to protect them," he said.
The COVID-19 test data from St. Jude is ideal for researching immune response because it involves samples of participants who test negative for the virus, which allows researchers to understand what their immune system is like before exposure to COVID and if it indicates how they responded to the virus.
“You can do that in any study, but you need to have a time machine, so we were trying to do that without the time machine,” said Josh Wolf, member of the infectious disease department.
The research is being funded in part by the National Institutes of Health. St. Jude’s work is part of a group of studies NIH is funding focused on testing healthcare workers for the virus and tests for antibodies.
Employees volunteered to participate in the study. Besides weekly testing, the participants agree to have blood samples collected about every three months or if they test positive while enrolled in the study. Blood samples are taken again of infected individuals about three to eight weeks after exposure. Wolf said St. Jude’s institutional review board, employee relations group, legal group and human resources department worked together to make sure recruitment followed regulatory guidelines.
Of St. Jude’s 4,500 employees, a little over 1,240 are now participating in the research. About 100 of the participants are Black, and St. Jude made a concerted effort to recruit them. Minority populations are historically underrepresented in clinical trials, so it was important for St. Jude to try to address that, Wolf said.
St. Jude set up focus groups and meetings with departments with high concentrations of Black employees to talk about the study and any concerns they have about participating.
Concerns that came up about the research were if blood samples will be used for research beyond the study and what would happen to samples after the study was complete. Wolf said employees were assured the blood samples are only used for the study purposes and weren’t available for commercial use.
