Outbreaks of infectious diseases continue to occur however, the recent outbreak of COVID – 19 has introduced a heightened need for Microbial Risk Assessment in organizations. Before COVID 19, Influenza, SARS, and other agents also required to be assessed for risk. We need to evaluate the risk to prevent the infectious disease from spreading to other people via media like air, water or soil etc. Coming to the scenario of COVID-19, it’s still a debatable topic on means of its transmission either via air, animals. Contact via human to human has been an established fact. Some general routes of entry in case of microorganisms are like Nasal discharges, droplets etc, with Respiratory or eye route of entry.
In the past we were using the indicator organisms to establish hygienic quality and disinfection potential like for example E. Coli in potable drinking water. Microbial risk assessment differs from Chemical risk assessment in that an individual who become infected can continue to infect additional individuals like secondary or tertiary channels
Since there are plans for reopening the lockout or organizations deliberating on starting critical operations, we can carry out Risk assessment to estimate the consequences from a planned or actual exposure to a infectious agents. For example, a person infected with an infectious agent has been found among the group of people or there are infectious agents in the air which have been released. What is the anticipated danger to the people? Even more complex scenario is if the risk for a set of events or sites must be estimated.
Before I provide software tools, I would like to cover few Epidemiological concepts of microbial risk. For COVID – 19, the dose response, exposure magnitudes are almost incomplete and its beyond the current blog to understand the potential error or so on. Its incubation time is around 7 – 14 days. Same is the case for secondary cases, individual vs population risk. To properly identify a case all the sequences of steps in a disease identification needs to follow like person seeking medical support, laboratory ability to test disease detection, etc. In case of disease detection, one needs to know that a person can be asymptomatic or symptomatic.
Now coming to the topic of virulence it depends on microorganism ability to adhere to certain cells, produce toxins or attack immune system etc. Host conditions are also play a critical role in the disease like age, alcoholism, chronic diseases, immune system, double infection etc. In case of COVID-19 based on history till now its reports say it impacts people with Heart diseases, Diabetes and can be aggravated by any activity which weakens the immunity like excessive drinking or smoking. Clinical conditions of infected persons include cough, fever and difficulty in breathing.
We can make use of software tools to carry out the quantitative risk assessment. In the following paragraphs I would like to highlight key software tools and approach using ERP tools which can be helpful. ERP / Non-ERP tools have ability to carry out Risk Assessment of agents and couple with Occupational Health for necessary medical examinations. Most of the software tools for Risk Assessment have framework for carrying out the risk assessment of chemicals, biological agents. Which consist of Hazard Identification, Risk Assessment, Similar Exposure Groups, Risk Matrix and control measures, which can be further evaluated to match to the case of COVID-19 type of risk assessment.
National Academy’s four step approach can be implemented for microbial risk assessment. Hazard identification, Dose – Response assessment, Exposure assessment, Risk Characterization and Risk management are part of the process. Overall risk assessment includes risk assessment, risk management and risk communication. The analysis can be quantitative or qualitative. Risk assessment identifies the qualitative or quantitative characterization, Risk Management includes identifying or weighing alternatives or control selection etc. and finally risk communication is about communicating to public or government agencies.
The sampling scenario or medical examinations can be used for maintaining the analytic values of the virus for example assays in mammalian cell culture with PFU where morphological changes or in case of COVID-19 source tracking like RNA / antibody is the criterion for some test kits. Then comes the exposure assessment where different numerical techniques can be used assess the exposure like determination of amount or number of organisms that correspond to a single exposure or total number of organisms. Now coming to the scenario of dose – response a relationship is established between level of microbial exposure and the likelihood of occurrence of adverse impact. As the actual risk of exposure is high in case of COVID-19, direct assessment can be performed. Different precautionary measures can be introduced to understand the impacts as well.
Risk Assessment module which when coupled tightly with tools like Occupational Health Modules will help organizations a lot to keep track of information. This type of assessment might not be a scenario during peak time of the outbreak where we are trying to minimize the risk and contain the infections, but will give a very good insight in coming months when outbreak subsides and companies might restart the processes and wants to have a framework for carrying out risk assessment.