IRB Work During a Pandemic: Remember Your Values

During the first and second week of March 2020, my department director and I spent hours in meetings. Not only were we grappling with our own personal fears and uncertainties as the COVID-19 pandemic continued to spread across the globe but we were also attempting to define the limits of our ethical obligations to our staff, our institution, and our community. We knew that our entire department was able to function remotely. At the same time, higher-level leadership was reluctant to permit such a dramatic shift, especially when some employees were not able to work remotely. But with each passing day in early March, my office was increasingly inhabited by staff members on the verge of tears. Some even considered quitting because these (mostly women) truly felt their lives were at stake for the purpose of being physically present in the office.

Our department forms the core of the Human Research Protection Program (HRPP) within one of the hardest hit hospitals and academic medical centers in New York City. Ninety-five percent of the research we oversee is biomedical. We work with populations diagnosed with diabetes, asthma, cancer, HIV, substance abuse disorders, and addiction among others, and manage trials involving investigational drugs and devices funded by federal grants, industry sponsors, and internal funds. Many of our patients are some of the most vulnerable: families living at or below the federal poverty line, undocumented individuals, families without easy access to fresh, nutritious food, and communities struggling with systemic racism and severe financial stressors.

New York City residents not only live on top of one another; we also work on top of one another. Our staff share small spaces, and many of these spaces have no windows. Our staff rides subways and public buses to get to work and, in doing so, share tight spaces with hundreds of people.

We HRPP folks are compliant by nature. We want to do the right thing. And we want to follow the rules and the laws. We spend our days explaining to other people how to follow those laws while also upholding ethical principles that sometimes extend beyond the minimum requirements specified in the regulations. When the pandemic's arrival in NYC had been confirmed on March 1^st, and as this virus spread like wildfire throughout our metropolitan area, no dilemma was more pronounced for me than the tension between "following the rules" and "doing the right thing." Expectation and responsibility; law and ethics; written law and the intent of such laws. And to whom did I owe my loyalty? The organization as a whole that expected me to remain physically present at work? Or to my staff who couldn't focus on their work because of their rapidly deteriorating emotional states and increasing stress levels?

On Thursday, March 12^th, shortly after another conversation during which my director and I questioned whether we could, as managers, ethically continue to require our staff to be physically present, I stood alone in my office distractedly eyeing my plants to determine which I would let die. I assumed I would not be back for quite some time and couldn't carry them all home. I left that evening and, fortunately, was informed by our organization's leadership the following Monday that remote work was now permissible for those able to perform their job duties from home. I felt a sigh of relief that earlier that week, New York City had issued guidelines asking citizens to avoid densely packed subways, buses, and trains, and that the governor had closed state and city colleges and universities. Suddenly, the decision-making had shifted to the state and the city. I no longer felt responsible, as a supervisor, for putting people at risk.

The next several months were, by far, the most challenging period in my professional career. Between March and June, our entire department worked seven days per week, often 10–12 hours per day and late into the evenings. Prior to the pandemic, only about half of our staff worked directly as IRB staff. During this period the number of staff required...