EyeWorld Asia-Pacific June 2021 Issue

FEATURE 6 EWAP JUNE 2021 by Erik Hellier, CEBT Eye banking challenges in the COVID era: Adapt and Overcome E rik Hellier, CEBT, Global Development Director of Eversight, an organization whose mission is to “restore sight and prevent blindness through the healing power of donation, transplantation, and research,” spoke at an APACRS and Asia Cornea Society (ACS) Webinar held on 10 December 2020 on the topic of “Corneal Conundrums during COVID-19.” He discussed how Eversight “adapted and overcame” the challenges presented by the COVID-19 pandemic. How we got here The WHO first reported COVID-19 on 31 December 2019, calling the first case “mysterious pneumonia.” The world soon after learned of the novel coronavirus and COVID-19. The WHO declared the outbreak a Public Health Emergency of International Concern on 30 January 2020; by February 2020, when the WHO named the virus “severe acute respiratory coronavirus 2 (SARS-C-V-2),” several countries had begun lockdown. According to Mr. Hellier, the United States had not yet responded to the “budding pandemic.” On 11 March 2020, the WHO declared the outbreak a pandemic. That month, the U.S. began establishing lockdown protocols on a state-by-state basis. For eye banks, tissue supplies immediately became Contact information Hellier: ehellier@eversightvision.org On 10 December 2020, the APACRS and Asia Cornea Society (ACS), in collaboration with the Association of Eye Banks of Asia (AEBA), conducted a webinar on “Corneal Conundrums During COVID-19.” This article is based on the talk given by Erik Hellier, CBET, Global Development Director, Eversight, on “Eye banking challenges in COVID era: Adapt and Overcome.” scarcer; most U.S. states and countries shut down elective procedures—including non- urgent corneal transplants. But by June and July of 2020, Mr. Hellier said that cornea transplants had resumed in the U.S. Facility volumes ranged from nearly 100% to 120% to catch up; countries with better access to healthcare and that were better able to implement physical distancing reopened around this time. Several countries did not reopen elective cornea procedures until later in the year, with countries that had trouble containing COVID-19 spread not opening until August, but by November and December 2020, most countries were operating at near normal transplant levels or above. “We always knew that eye banking is very different than a manufacturing business but this really emphasized that point,” Mr. Hellier said. He indicated how eye banking is subject to public health issues—screening protocols exist in eye banking in ways they do not in manufacturing and the donor pool is uncontrollable the way other industries’ resources are. Mr. Hellier said that Eversight operates “as stewards of a gift, not a business to make money.” “It’s genuinely to be a link in the chain to get the tissue from one person into the surgeon’s hands capable of transplanting it into another,” he said. At the time of this writing, eye banking in the U.S. has recovered, “but we are far from out of the woods,” he said. With the many countries in the world now struggling to contain a new wave of COVID, the numbers continue to rise in the U.S. As that happens, tissue supply could become an issue due to COVID-19 rule outs and potential staff exposure and infection. The effects, Mr. Hellier said, could be felt through first half of 2021. “What do you do?” asked Mr. Hellier. “You have to adapt and overcome.” Adapt Eversight started adapting to the situation early, beginning scenario planning in February 2020—well before COVID-19 was declared a pandemic. This extra time proved invaluable, and Eversight were able to make multiple action plans that made implementation easier— “not to be confused with being easy,” Mr. Hellier said. “It was still an enormous shock to the system. But the shock was mitigated by the preparation.” Unusually, Mr. Hellier said, U.S. eye banks received payroll protection program funds— government loans that could become a grant. This allowed U.S. eye banking to stay afloat. Since infection prevention has always been a priority for eye banking, with the proven double povidone-iodine (PVP-I) antiseptic soak already implemented in 2019, they were already practicing increased precautions to mitigate disease transmission risk. Clinically, Eversight responded Erik Hellier, CEBT, USA Director, Global Development - Eversight Association of Eye Banks of Asia (AEBA)