Special Considerations for Human Neuroscience Research in the Midst of the COVID-19 Pandemic

sars-cov-2-and-EEG

Special Considerations for Human Neuroscience Research in the Midst of the COVID-19 Pandemic

State/provincial and federal government regulations will vary. Follow your institutional and regional/federal governmental regulations first. These recommendations represent guidelines to ensure adherence to a basic standard in the absence of any other guidance.

Research methods such as EEG, fNIRS, eye-tracking, TMS and other non-invasive technologies used in Human Neuroscience Research Laboratories provide valuable means of understanding the functions of the human brain in a wide range of research disciplines, including psychology, audiology and speech pathology, otolaryngology, vision science, neuroscience, sports medicine, rehabilitation, psychiatry, clinical research and clinical trials for a wide range of interventional drugs and/or devices.

SARS-CoV-2 Risk for Non-Invasive Human Neuroscience Laboratories

The transmission risk for Human Neuroscience Research Laboratories is similar to that for businesses providing personal care services such as haircuts and manicures. Non-invasive Human Neuroscience Research Laboratories do involve close contact between the participant and the experimenter over an extended period of time, often in an enclosed space. As such, they present a risk for spreading the SARS-CoV-2 virus responsible for the COVID-19 pandemic of 2019/2020. SARS-CoV-2 is an airborne pathogen, so we advise that researchers operate with the assumption that every participant and every research staff member has a high likelihood of being an asymptomatic carrier of the virus, thus making every research procedure involving a participant and an experimenter an opportunity for cross-infection. Be sure to educate yourself in best practices for working in the presence of a highly contagious airborne pathogen.

Slides Outlining PPE Use and Procedural Updates 

We are pleased to be able to share these slides outlining our recommendations regarding PPE use and updates to operating procedures.

Getting Labs Back Up and Running 

Many human neuroscience research procedures involve a similar amount of personal contact, for a similar amount of time, as a personal care service such as a haircut. In many states, the personal care group of businesses are allowed to reopen during Phase Two — but with strict rules about social distancing, facility occupancy with respect to capacity, and cleaning.

As with personal care business personnel, research lab staff should wear face coverings when in contact with participants, and participants are strongly encouraged to wear face coverings. All chairs, gowns, lab-coats, aprons, tools and other reusable equipment that may come into contact with a participant should be cleaned between participants. This includes head-caps, chin straps, electrodes, optodes, chin / forehead rests, manual response devices, microphones (if within 3 feet of the participant), touchscreen displays, TMS head-coils, head measuring devices (measuring tape or electronic measurement stylus./ receiver), body mounted motion tracking sensors, and any other research technology that has been in the vicinity of, and may have come into contact with, the participant.

We expect our understanding of how SARS-CoV-2 spreads to evolve over time, so each research institute and researcher should take responsibility for updating their protocol based on new guidance as time goes on.

Daily Screening of Laboratory Staff

In accordance with OSHA Guidance on Preparing Workplaces for COVID-19 (https://www.osha.gov/Publications/OSHA3990.pdf) we recommend screening laboratory staff daily using something like our free Employee Daily COVID-19 Screening (Google Form).

Screening of Participants

Access to COVID-19 testing likely be much easier in some types of institutions than others. When possible, a negative result on a COVID-19 test with a quick turnaround and a low false negative rate would be the ideal to ensure the safety of all concerned. Since virus tests are in short supply at the date of this writing, we anticipate that most research labs will need to rely on other methods of screening participants.

At minimum, we recommend that participants be asked screening questions similar to those laboratory staff are asked each day, and have their temperature taken to ensure no fever, before being permitted to enter the research laboratory.

Personal Protection, Cleaning, and Disinfection

We have prepared a new section on the website for you to be able to order PPE and cleaning supplies to keep your participants and yourselves safe.

What kind of special protective gear, cleaning products, and equipment will you need to operate your lab in light of the continuing spread of the coronavirus that causes COVID 19? We have some ideas, but we would love to hear your ideas. Please participate in our PPE survey! Click the image below to take the survey.

Personal Protective Equipment (PPE)

We anticipate that the types of PPE required, and the source of the PPE (institutional versus laboratory-provided), will vary from lab to lab. Note that most Human Neuroscience Research Laboratories are more like a typical workplace than a healthcare setting. Nonetheless, CDC Guidelines for the use of PPE in a Healthcare Setting are informative in describing how to select PPE, proper techniques for donning and doffing, etc. In addition to vigorous screening, we recommend the following:

For Participants

  • Cloth face covering with ear-loops
  • Face shield supported by eye-glass frame (when possible)
  • Washable gown

For Experimenters

Duration of Stay in the Laboratory Environment

CDC Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel (HCP) with Potential Exposure to COVID-19 suggests that close contact over the course of 15 minutes of a HCP with a confirmed COVID-19 case would warrant self-quarantine if the following conditions were true:

  • HCP not wearing a respirator or facemask
  • HCP not wearing eye protection if the person with COVID-19 was not wearing a cloth face covering or facemask
  • HCP not wearing all recommended PPE (i.e., gown, gloves, eye protection, respirator) while performing an aerosol-generating procedure

In an abundance of caution, we recommend behaving in each research interaction as if both the participant and the staff member are COVID-19 positive, both from the perspective of exposure time and the perspective of PPE use. When possible, limit the number of people involved in each interaction, and keep the duration of close contact to a minimum.

When possible, arrange all pre-screening and intake paperwork so that it can be administered either in advance on-line or in an open area with appropriate social distancing.

It is in the very nature of research laboratory environments that they are small, and unfortunately often not well ventilated. Make a special effort to limit the amount of time that participants and staff must spend in a small, poorly-ventilated space like a shielded room or sound-attenuated booth.

Air Cleaning with a HEPA Filter

Since the air in many laboratory environments can be quite still, one might imagine that the conditions may be conducive for an airborne pathogen to hang around well after the departure of an infected participant. CDC recommends filtration of recirculated air with a HEPA filter in facilities where confirmed COVID-19 cases are isolated. A small, poorly ventilated lab space or recording chamber may benefit from operation of a HEPA filter between participants. See https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/air.html for background on HEPA filters. Small, inexpensive models are available at most home goods stores.

Disinfection of Equipment and the Laboratory Environment

One of the most commonly asked questions lately is about what type of disinfectant to use on research instruments, such as EEG electrodes and caps, fNIRS optodes and caps, chin rests, response devices, furniture, etc used in research laboratories.

Our recommended disinfectant for use with all of our products is Clorox Healthcare Hydrogen Peroxide Cleaner and Disinfectant (hereafter CHHPCD). CHHPCD is listed on the EPA site as effective against SARS-COV-2 with an exposure time of 2 minutes. You can get the EPA registration number at this page, and enter it at List N on the EPA site to see that it is listed. This product is recommended for use on fabric, and we know it to be safe for the caps and electrodes, so it will continue to be our first choice. CHHPCD is a proprietary blend of hydrogen peroxide with an activator to boost its effectiveness. See these links for additional background:

See this informative article for some background on effectiveness claims: https://www.infectioncontroltoday.com/environmental-services/select-effective-disinfectants-use-against-novel-virus-covid-19

Unfortunately, as of June 8, 2020, CHHPCD is out of stock virtually everywhere. We will continue to do our best to restock.

What alternatives are there in case CHHPCD remains in short supply?

One alternative to CHHPDC is Clorox Clean-Up (CCU), which we PRESENTLY HAVE IN STOCK. CCU is effective against SARS-COV-2 with an exposure time of 30 seconds. Note that CCU contains bleach, so there may be some effect on the service life of the products. See below for more on this.

Another alternative is Cavicide, which we do not stock, but we are able to get rapidly. Cavicide contains Isopropanol, so it may behave like Isopropyl and other alcohols (see below), which have a tendency to dry out the wire insulation and induce cracking, moisture ingress, corrosion of the wire, and eventual breakage.

We are often asked to endorse or approve the use of other brands of disinfectant products that we do not carry. We have had a great deal of practical experience with disinfectant products over the years, but that does not qualify us to judge the effectiveness of every product on the market. However, some of these other products may be perfectly fine to use. It is important to point out that most branded disinfectant products incorporate chemicals that, while effective at eliminating pathogens, may also have deleterious effects on your valuable research instruments. Also, it is important to note that most branded disinfectant products we encounter are only recommended for use on hard surfaces, not porous materials or fabric. If you intend to use a product other than one we recommend, be sure that it is EPA listed as effective against COVID-19, that the manufacturer specifies that the product is suitable for use on fabric if you intend to use it on upholstered furniture or head-caps, and that you abide by the exposure time from EPA List N (linked above) for effectiveness against COVID-19.

Can I use unbranded alcohol, hydrogen peroxide, or bleach to disinfect?

We are not infection control experts nor chemists, so we are unable to make specific recommendations about exposure times or concentrations of other widely available unbranded chemicals that are not backed by any manufacturer claims. We can only say what the effect of certain chemicals is likely to be on the electrodes and caps.

  1. 3-5% hydrogen peroxide would be safe to use on caps and electrodes, but this chart indicates that at higher concentrations you may expect the acrylic housings of the active electrodes to suffer some discoloration, and that may also shorten their useful life.
  2. 10% isopropyl alcohol is also safe for use with the caps and electrodes. We have not tested higher concentrations, but it is our understanding that 70% is the recommended concentration for disinfection. We have no reason to believe that 70% would cause problems with the electrode contacts, but we have seen evidence that alcohols tend to dry-out and degrade the flexibility of plastics, including wire insulation. In the long run this will lead to cracking, moisture ingress, corrosion, and failure.
  3. Household bleach containing sodium hypochlorite can be used on head-caps, electrodes, optodes, and other sensitive equipment, but there will be some consequences. Bleach tends to take the color out of the fabric caps over time. It may also result in darkening of electrode pellets. This darkening relates to the deposition of Chloride on the electrodes, which is not harmful, but it may lead to ionic imbalance between electrodes that are used and disinfected often compared to new electrodes or electrodes used less often. To alleviate the imbalance, soak new electrodes in a salt-water bath (tap water with non-iodized table salt) with well-used electrodes for 10 minutes before their first use.