COVID-19 Research and REALM

The REopening Archives, Libraries, and Museums (REALM) project has been in full motion since spring 2020. As the project charts the path forward into the new year and next phase of research, we are taking a moment to look back on the road we’ve traveled thus far. As REALM project director for OCLC, I’ve benefited from the guidance of the thoughtful, responsive, compassionate people who comprise the multi-organization project team, working groups, and executive project steering committee. The activities and results I describe in this article would not have been possible without their commitment to resilient archives, libraries, and museums; and to the safety of their staff and community members.

How did REALM come about?

At the end of March 2020, as the novel coronavirus was moving through the US in what was to be the first COVID-19 surge, the Institute of Museum and Libraries Services (IMLS) had just hosted a webinar on managing collections during an active pandemic. During the session, an epidemiologist and a health scientist from the US Centers for Disease Control provided guidance and covered topics such as creating or updating your institution’s emergency operations plan, staying in close communication with your local health department, and helping prevent spread of the virus by encouraging staff and visitors to practice frequent handwashing and social distancing. They also recommended frequent cleaning and disinfecting of high-touch surfaces with EPA-approved products, and to leave any room or item alone for 24 hours when there was possible contamination by someone infected. The interpretation of “high-touch” and “possible contamination” led many webinar attendees to wonder if well-trafficked public spaces and frequently handled collection and exhibit materials in libraries and museums fell into this category. Ensuing discussions led the IMLS to see the potential for a COVID-19 research project focusing on the operations, spaces, collections, and services specific to archives, libraries, and museums.

Who is involved in REALM?

On April 22, 2020, IMLS announced a partnership between the IMLS, the scientific research institute Battelle, and OCLC. Battelle has an extensive history doing research on emerging and infectious diseases such as Ebola, West Nile, influenza, and tuberculosis. OCLC’s research division has managed dozens of grant-funded projects and collaborates across a network of thousands of libraries throughout the world. To support the partnership and its decision-making, the IMLS also coordinated the formation of an executive project steering committee and working groups composed of representatives from member organizations, consortia, and individual institutions, as well as subject matter experts. By the end of May, the partnership had launched the REopening Archives, Libraries, and Museums, or REALM, project.

What is the scope of REALM?

The REALM project was designed to produce and distribute science-based information about how materials can be handled to mitigate exposure to coronavirus in staff and visitors of archives, libraries, and museums. A goal of the project is to better understand the virus in ways that will help inform local decision-making around operational practices and policies. The main questions that have shaped the project’s research activities are the following:

  • How is SARS-CoV-2, the virus that causes COVID-19, transmitted?
  • Are contaminated surfaces and materials contributing to COVID-19 infections?
  • What are effective prevention and decontamination tactics to mitigate transmission?

These questions were explored in two ways during the first two phases of the project: Systematic literature reviews and laboratory testing. In addition to the scientific research, the project is also collecting and reviewing relevant informational resources created by other organizations, and sharing illustrative examples of policies, practices, and procedures that archives, libraries, and museums have developed in response to the COVID-19 pandemic. The other main activity of the project is to create toolkit resources to synthesize the research into simplified language and imagery that can be used to support conversations with stakeholders and community members.

What is not in scope for the project is to develop one-size-fits-all recommendations or guidelines. Institutions vary significantly in their resources, settings, services, and priorities; and there is also a wide range of advisories and orders in place at local, state, and national levels. Therefore, each institution needs to develop policies and procedures in response to its local community needs and conditions and take into account pragmatic considerations of risk and available resources.

Staff and leadership of organizations are under a great deal of stress while trying to find and interpret credible information and make decisions in the middle of crisis. Naturally, individuals also want to know how best to protect their own health and the health of others. All of us working in the field are trying to do the “right” thing to reduce any risk to the staff and users who depend on services, facilities, and collections. In an atmosphere of urgency, uncertainty, and ambiguity, figuring out what is the best course of action can be very complicated. We have had to learn that during a public health crisis it is normal to have to make decisions based on incomplete or conflicting information. As the authors of the BMJ article Managing uncertainty in the COVID-19 era suggest, we are learning to “make sense of complex situations by acknowledging the complexity, admitting ignorance, exploring paradoxes, and reflecting collectively.”

What can we learn from the scientific literature on SARS-CoV-2?

The REALM project has published two systematic literature reviews thus far, one in June and another in October of 2020. These reports synthesize research on the virus that was published through mid-August. A third review is currently underway and will be published this winter.

We still do not know several things about SARS-CoV-2; this is important to recognize when discussing, considering, and making decisions about your institution’s and your community’s policies and procedures. For example, we don’t know how many virus particles an infected person leaves behind on an object through such actions as sneezing or coughing. Although research and some educated guesses exist, there is no definitive answer. Another unknown is how many virus particles you can pick up from an object, and whether that transference is contributing to infections. Also, scientists have not yet determined the human infectious dose for this virus: we don’t know how much of the virus you need to ingest to contract COVID-19.

The SARS-CoV-2 virus has shown to be quite infectious, as demonstrated by the speed in which it has surged across countries around the world. The primary form of transmission is now generally understood to be through contaminated water droplets expelled when people infected with COVID-19 sneeze, cough, sing, talk, and/or breathe. The practice of limiting close (less than six feet) or extended (more than 15 minutes) contact between people is intended to reduce the risk of this type of transmission.

Evidence has also suggested that another likely pathway for spreading the virus is by breathing air in which the virus is suspended after some sort of aerosolization event, such as a sneeze. Aerosols have received increased attention since the summer, and some researchers believe they may be a significant source of COVID-19 transmission. Others suggest that more study is needed before any conclusions are drawn.

While touching fomites, or objects contaminated by virus-containing droplets, was thought to be a significant pathway in the early months of the pandemic, this has been a difficult pathway to trace when there is so much direct people-to-people transmission also occurring. As concerns about airborne transmission have grown, less attention has been given to studying the role of fomites in the COVID-19 pandemic. The REALM lab testing on fomites has contributed to this area of scientific inquiry.

Environmental factors have been identified as influential in the spread of the SARS-CoV-2, though additional research is needed to understand the complexities of these variables’ impact. Higher humidity and temperatures show evidence of hastening the deactivation of the virus; lower humidity and temperatures slow the speed of deactivation, so the virus remains infectious for a longer period under these conditions. Fresh air free of pollutants reduces transmission of the virus more than “dirty” air does. Some evidence has suggested that inadequate HVAC systems and other air circulation mechanisms can contribute to viral spread if not configured to maximize air exchange to refresh indoor spaces frequently with clean air. However, until further research defines the risk of people contracting COVID-19 through airborne virus, the extent to which these systems contribute to infection is unclear.

The research that has emerged reinforces the effectiveness of certain low-cost, relatively easy prevention tactics, especially handwashing or hand sanitizing, physical distancing, and wearing a mask. When a room, surface, or object is suspected of being contaminated by a person infected with COVID-19, increased heat, and use of disinfectants identified by the EPA have been shown to be effective decontamination practices. Important considerations in evaluating any type of agent or treatment for use are described in various resources; the National Park Service (NPS), the Northeast Document Conservation Center (NEDCC), and the Canadian Conservation Institute (CCI) offer guidance on caring for collection items and exhibit spaces so as not to damage materials or the staff handling them. The REALM website points to these and other resources.

What are the findings from REALM lab testing?

The project is currently scoped to conduct ten tests. Six have been completed and their findings were published between June and November 2020. The seventh and eighth tests took place in December, and the remaining two tests will be defined and scheduled based on those results. 

Two types of tests are used to measure the presence of the virus. One detects genetic matter associated with the virus but does not distinguish between active (i.e., infectious) and inactive particles. The other measures the amount of active virus by mixing it into a test cell culture and noting whether the virus infects the cells. The Battelle research method for REALM measures infectious virus, but the tests are not able to determine whether the number of active particles present would be enough to infect a human being with COVID-19.

The first six tests examined five materials selected from recommendations provided by the REALM Steering Committee and working groups. Three tests focused on commonly circulated public library items, such as different types of books and DVDs. The other tests studied plastic materials, textiles, and hard surfaces respectively. Many of the materials were donated by the Columbus Metropolitan Library, the National Archives and Records Administration, and the Library of Congress. Other materials, such as some of the textiles, were purchased new from vendors.

The Battelle lab technicians cut each material into coupons and applied the infectious virus to the surface at a known concentration in a synthetic saliva solution. They put the coupons into a controlled environmental chamber in stacked and unstacked configurations. The first six tests were conducted in conditions that simulated a standard office environment of 68°F to 75°F (22 ± 2°C) and 30 to 50% relative humidity. At preselected timepoints, the scientists measured the quantity of active virus on the coupons to document its attenuation (or drop) over time. The timepoints for each test were selected with two concerns in mind: the desired outcome of seeing the virus fall below the detection limit within the test timespan; and the timeframe representing a practical quarantine period for materials suspected of contamination.

Quantitation Limit
The culture method cannot be used to measure a virus count below 26 particles. This is called the “limit of quantitation.” Below this point, researchers must look at the test coupons under a microscope and note the presence or absence of virus on each coupon visually. If virus is not observed on any of the coupons, the result is recorded as being below the limit of detection.

Results of the first six REALM tests are shown here. Quick summaries, full lab reports, and the raw data sets are available on the REALM website.

What is next for REALM?

Research is expected to continue for the first half of 2021; new factors to consider include the emergence of vaccines, the impact of the second deadly winter surge, impacts induced by sliding along a confusing continuum of “open” and “closed” for institutions and their communities, and expanding experience that decision makers are gaining in making risk assessments and contingency plans. The project will continue to host and attend virtual speaking engagements to share information and answer questions to allow and foster listening, learning, and adapting among all in the cultural heritage fields. WebJunction is hosting a REALM webinar on January 29, 2021; register for the live event or view the recording when it is added to the course catalog.

[This post is adapted from an article published in the January 2021 edition of AIC News (Vol. 46, No. 1), the member newsletter of the American Institute for Conservation of Historic & Artistic Works. Quick summaries, full lab reports, and the raw data sets are available on the REALM website at oc.lc/realm.]

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