Development and Implementation of a Phased Framework for Collecting the COVID-19 Virus Material at a Medical University

Abstract

As national leaders in infectious disease outbreaks, the University of Nebraska Medical Center (UNMC) and its hospital partner Nebraska Medicine monitored and treated COVID-19 patients, starting with evacuees from Wuhan, China in February 2020. To document UNMC’s institutional response to the COVID-19 pandemic, and future outbreaks or pandemics, UNMC’s McGoogan Health Sciences Library Special Collections and Archives (SCA) Department faculty quickly established an archival collecting strategy to create a broad documentation package with multiple collecting phases. The initial phase included a contemporaneous response for digital collecting, timeline creation, and community collecting, followed by later collecting of personal papers, artifacts, and oral histories from key players who are also front-line workers. The combined collecting approach ensured early digital content preservation, captured public momentum, and provided the structure for longer-term collecting, after time for healing and relationship-building with prospective donors.

Background

The University of Nebraska Medical Center (UNMC), along with its clinical partner Nebraska Medicine are national leaders in infectious disease research and education. The campus supports centers and clinical operations that train healthcare providers to diagnose, manage, and treat emerging, highly infectious diseases. UNMC’s federally funded National Center for Health Security and Biopreparedness houses The National Quarantine Unit. In this twenty-bed unit, staff watch patients for infectious disease signs, including those Americans exposed to the 2019 novel coronavirus^1,2 early in the outbreak. Infectious disease clinical operations comprise a ten-bed Biocontainment Unit, where the staff treat patients with infectious diseases, such as recent cases of the Ebola virus and the COVID-19 virus. The campus also houses the Nebraska Public Health Laboratory, a biosafety level 3 lab serving the state of Nebraska.

UNMC and Nebraska Medicine played an early, critical role in monitoring, treating, and researching the coronavirus. Faculty and staff treated initial patients with the COVID-19 virus in the United States. ³ They enrolled the first patient in the National Institutes of Health (NIH) clinical trials for the therapeutic drug Remdesivir. ⁴ Employees developed faster, more accurate laboratory testing, ⁵ pioneered a technique to sterilize and reuse personal protective equipment (PPE), ⁶ published early studies on virus transmission patterns in clinical settings, ⁷ and set safety guidelines in close-contact settings like meatpacking plants. ⁸

Expanding the Archival Scope at a Critical, Yet Sensitive Time

Infectious disease and public health security are clinical and research assets of UNMC and Nebraska Medicine, yet the scope of McGoogan Health Sciences Library’s archival collection does not represent these strengths. The current archival collection on infectious disease and outbreak response is not robust enough to support research or exhibitions. Archival collections show few past significant campus events, such as the campus role in fighting Ebola virus outbreaks. In part, records transfer to the archive through traditional channels, such as retirement, may not yield plentiful material on the subject. Prior SCA staff did not actively collect archival material.

Given the role the UNMC faculty had in combatting disease, it was logical to pursue active collecting to gain more material for the archive. Developing this collection strength remained a back-burner project until the coronavirus arrived. In early February 2020, upon news that UNMC and Nebraska Medicine would receive coronavirus patients from Wuhan, China, and the Diamond Princess cruise ship, the SCA department could not miss another opportunity to document the campus role in treating an international viral disease outbreak and developed a collecting framework in response. The original project goal was to archive the pre-pandemic treatment and containment of the coronavirus on campus. In a few weeks, virus containment failed on an international scale, and the collecting scope expanded to capture the medical university’s role in responding to the coronavirus on both a national and local scale while still conducting operations during a pandemic.

Planning to collect archival material at a medical university during a pandemic was challenging. Many sources able to contribute valuable stories on the topic were front-line workers and were too busy to approach. SCA staff stayed aware of, and sensitive to, the trauma these workers may experience while treating patients. The collecting framework needed to adjust to the expanded scope. It also required staff to collect in real-time without approaching the campus community. Disease outbreaks are not short, single incident crises lasting hours. Neither are they long-term events. Their footprint in the archival record is small, and opportunities for documentation are short and unpredictable. Uncertain times need a flexible collecting timeframe. The framework started with the active collecting of digital material and later shifted to collecting other archival material. With the facilities on campus and the faculty experience, UNMC and Nebraska Medicine will respond to future infectious diseases. The SCA department will refer to this framework, objectives, methods, and outcomes when planning to collect archival material during future outbreaks as well.

Rapid Planning

The SCA department staff met with senior library administration in early February 2020 to discuss the collecting strategy and brainstorm key departments and potential vital voices. The collecting strategy’s scope comprised representation from students, faculty, staff, and health care workers. Potential archival acquisition material included social media, news articles, official university or hospital statements, media footage, personal papers, oral histories, administrative documents, artifacts, and images.

In this sensitive collecting context, a phased collecting strategy was useful. Phase one strategy was to collect digital archival material available without actively disrupting busy people. Phase two included active collecting of archival material that requires approaching individuals for material donations or oral histories. The second phase will occur in an interim period after phase one, but not far into the future. This phase is passively active and requires relationship building, listening, and waiting. Senior library administrators will decide the right time to approach people for these materials. The potential donors may never want to talk about their experience or donate their material. Some key players work on a national scale and may have other plans for their stories or materials. Phase three will grow the collection through passive receipt of donated material at the end of the records life cycle.

Phase One: Roll-Out

The phase one plan for collecting digital material included Twitter posts, official emails and documents, public relations footage, news stories, and web media. Given the prolific use of Twitter as a quick communication tool, it was essential to include in the archival record. The SCA department did not have an established method to capture social media or other digital content, or quick funding to buy a social media archiving service. Because of its open-source, fast employment, and proven results, Documenting the Now’s Twarc tool ⁹ was a natural choice for capturing Twitter posts. Twarc was easy to install when following the instructions outlined in the University of Virginia’s Digital Collecting Toolkit ¹⁰ The library’s new digital technologies librarian Brian Maass assisted with code and file paths. Using this tool required weekly input of the hashtags and handles identified in the collecting plan, and adjustments as UNMC and Nebraska Medicine expanded their role during the pandemic.

This coronavirus brought local and national media attention to UNMC and Nebraska Medicine. UNMC’s Department of Strategic Communications staff digitally transferred files to the SCA department, including footage of press conferences, interviews with experts, in-depth stories, and instructional videos created for medical workers. SCA staff captured and stored local and national news articles, official campus COVID-19 virus-related communications, infographics, and manuals as pdfs. Communication and events changed so often that the SCA department staff used these files to create and update a timeline documenting the event fluctuations and UNMC and Nebraska Medicine’s response to these changes. The timeline provided points of access for archival research within the pandemic variations.

Once the coronavirus affected the entire country, community collecting became a widespread initiative among special collections departments. A UNMC professor approached the library to collect donations that originated as a class project. The SCA department added community collecting to the collecting scope, and Carrie Meyer, department head, created a submission form on the library’s website. Coordinated community collecting with Nebraska history institutions followed. The institutions generated a joint news release, directing regional readers to donate material according to their location and best fit within the participating institutional scopes. The UNMC and Nebraska Medicine community collecting scope included projects, art, and writings generated by our university faculty, staff, and students. To help their campus community when UNMC switched to remote learning and canceled clinical practice, several UNMC student groups filled their time with service projects. Students found childcare for faculty in need after schools closed, created PPE, and decorated residential care facilities, among other volunteer activities. The students documented their COVID-19 virus projects on their student group websites. Larissa Krayer, the SCA department’s digital archivist, captured the student sites using Web Recorder.

Planned Phase Two

The phase two collecting plan includes requests for donations from key players and other faculty, staff, and students. Physical and digital material, personal papers, artifacts, and oral histories, among other tangible items, are on the list of material the SCA department is interested in acquiring. The timeframe for phase two implementation is unknown, but it will start when the COVID-19 virus is no longer a consumer of campus and hospital resources. Library administration with higher-level insight into the campus pulse and a better perspective on timing will advise on the start of phase two. In the interim, preparation for phase two includes continual monitoring of the campus COVID-19 response, documenting the roles of persons involved in the response, observing new or changing research, and compiling lists of potential physical material to collect. This groundwork directs collecting efforts for phase two by providing the documented context of events, individuals’ roles, and the desired physical material. Library staff continues to establish relationships across campus, including those individuals involved with the campus and hospital response to the COVID-19 virus. These associations will help decide if an approach will be welcome, and SCA staff will receive rejected requests for material donation with understanding and compassion.

Early Reflections at the Six Month Mark

It would have been ideal to trial this framework on a brief outbreak, not an enduring pandemic. However, infectious diseases are unpredictable, and the phased approach is useful during an uncertain timeframe. Documenting the coronavirus response on campus is time-consuming. During the past six months, specific days or weeks required more time to watch the pandemic response than others did, but all weeks have some archival activity. It is crucial to receive administrative support for the time to archive a significant campus event. When justifying resource allocation in these conversations, emphasis on the collection capturing campus decision-making and actions is helpful in this case. Measuring external researcher interest is difficult at this early stage. However, the collection is beneficial for in-house research and is invaluable for documenting the campus’s response to this historic event.

Digital archiving service may be a laborsaving choice if the budget allows. Twarc is open-source and available with no fees but requires dedicated time from staff for tweet capture and archival work. One goal of digital capture efforts was to estimate storage space requirements for a future pandemic or outbreak collecting during phase one. Now, it is clear that the duration, and thus storage space and costs, will differ in each situation.

This framework will apply to future outbreaks or pandemics that arrive on campus. Frameworks, like any document, need review and update. Technology, staff allocation, and key players in infectious disease and public health will change. It may be worth revisiting and updating the framework annually, as part of standard policy or a disaster preparedness review.

Conclusion

The SCA department staff documented the infectious disease and public health strength unique to the medical university early in what became defining historical events on an international scale. Actively archiving the campus response to disease epidemics has built an archival scope strength around the topic and ensured material arrived in the archive when The COVID-19 disease outbreak occurred. The multiple phase collecting approach has provided for archiving from a respectful distance and guaranteed initial digital content and context. The framework has allowed staff to adjust collecting methods and tools during an extended event and provided the structure and administrative support for longer-term collecting, after time for healing and relationship building with prospective donors.