Biosafety Risk Assessment of a Routine Diagnostic Laboratory During the Coronavirus Disease 2019 Pandemic

Background: In this study, we aimed to perform a biosafety risk assessment to determine measures to be taken against coronavirus disease 2019 (COVID-19) in the routine diagnostic parasitology laboratory of a tertiary health care center. Methods: The risk assessment template included in the supplement of the interim guidance of "WHO Laboratory Biosafety Guidance Related to COVID-19" was used for the risk assessment. Risk assessments were carried out for the "diagnosis of protozoan diseases in respiratory tract samples" and "diagnosis of intestinal parasitic diseases" processes. Initial risk of the laboratory activities was determined before additional risk control measures and overall initial risk was estimated for each process. Overall residual risk of the laboratory activities after risk control measures was estimated for each process. Results: Overall initial risk for both processes was "very high." Fresh microscopic examination steps in both processes and concentration steps for "diagnosis of intestinal parasite diseases" were discontinued. All aerosol-generating steps were moved into a class-IIA biological safety cabinet. Overall residual risk was "medium" for both processes. Conclusion: This study serves as an example for clinical laboratories regarding how the risk assessment approach in guidelines can be transferred to daily practice.