In the context of the coronavirus disease (COVID-19), the EBMT has set up this section to provide you with an array of useful information and resources.
Message from EBMT President 15/06/2020
Dear EBMT members, colleagues and friends,
The COVID-19 pandemic is impacting our professional and personal life as well as the intertwined healthcare systems and economies of EBMT member countries in a way unlike anything any of us have experienced. Despite lower numbers of new infections with SARS-CoV-2 in Europe and in other parts of the world, and the re-opening of borders, schools, restaurants and cafés, we are all struggling to come to terms with a new normality which is so different to anything we anticipated at the start of 2020.
A message from John Murray & Michelle Kenyon to EBMT nurses
Dear EBMT Nurses,
In June 2019, the EBMT Nurses Group decided to mark the WHO ‘2020 International Year of the Nurse’ by choosing this as a theme for our annual programme in Madrid.
The WHO website describes the vital role nurses and midwives play in providing health services. The WHO recognizes that we, as nurses, make a critical contribution to global health, provide essential health services, often work in challenging circumstances and are there to provide care at each and every step of life.
Never has this been more true than now.
In 2020, we all face the unprecedented challenge of Covid-19. The impact of this challenge is far reaching. We are experiencing it personally and professionally, as individuals, within our family lives, within the Haematology and Transplant teams and services we work and with our patients and their families.
Taking time to reflect underpins our practice and is as important now as ever. Take a step back, pause and think about how valued you are as a person and how valuable your role is in the care of your patients. Haematology and Transplant nurses are exceptional people with exceptional skills. Every day, we are adapting to meet the needs of our patients and to support our colleagues.
Many of us are working differently and are adapting our skills and roles to the demands of our changing environment. We are working to support each other in Haematology and Transplant as well as working outside our usual roles and specialities to care for patients in respiratory wards and intensive care.
Teamwork and communication are critical to all of us facing the pandemic and are valuable tools to help us bring comfort to those who are without family or friends at such a difficult stage of their lives and importantly to each other.
Finally, a reminder that self-care is essential and without it we become less able to provide care. Remember to take some time each day for you.
As nurses, we have never been more challenged.
Stay safe, stay well and stay strong
John Murray and Michelle Kenyon
Don't hesitate to share your stories with us using the #strongertogether hashtag and tag @TheEBMT_Nurses for a retweet.
A message from the Patient Advocacy Committee
"To all the Haematologists and Nurses,
The patients and carers we represent are all so grateful for how hard you work to support and care for BMT patients and donors. In this time of unprecedented difficulty, we want to express our gratitude and to send a special warm thank you for all the work you are doing and will be challenged to do in the coming months."
On behalf of all BMT patients, carers and donors,
The EBMT Patient Advocacy Committee
Bregje Verhoeven, Guy Bouguet, Lola Manterola, Sarah Hutton
A message from the ALWP and Scientific Council Chair
COVID-19 has been a challenge like no other. As transplant health care professionals, we are used to seeing a lot of critical illnesses and complications in patients with advanced and refractory diseases. However, when thinking of COVID-19, we can feel around us, a constant self-questioning as to how we can help our patients during this difficult period.
During this crisis, the Acute Leukemia Working Party (ALWP) members and staff maintained their activities using digital tools. This is part of our continuous commitment to quality of care, modern education and therapeutic innovations. Of note, acute leukemia (AL) patients who suffer from a profound and long-lasting humoral and cellular immune deficiency, may benefit from tailored recommendations. Moreover, AL patients under intensive chemotherapy are at a high risk of requiring ICU care, and of mortality in case of complications. Therefore, special attention should be paid to this specific population during the ongoing COVID-19 outbreak.
With this background, the ALWP developed some important recommendations (see below on this page) to help AL patients’ management in the current situation. The aims are to minimize the requirement for ICU admission, without compromising the patient’s chance of being adequately treated.
Take care and please stay safe.
Due to fast spreading of SARS-CoV-2 a panel of experts of EBMT recommends the following guidelines for transplant units, recipients, and donors of hematopoietic cells. These guidelines will be updated when new information is obtained about COVID-19 epidemiology and clinical outcome.
Prospective survey on impact of COVID-19 on stem cell transplant recipients
The impact of the new coronavirus SARS-CoV 2 on immunosuppressed patients such as stem cell transplant recipients is currently unknown. The Infectious Diseases Working Party of the EBMT therefore invites you to participate in a prospective survey about the impact of covid-19 on patients having undergone stem cell transplantation.
The survey is in two steps:
- Please, fill in the registration form for each patient diagnosed with covid-19 at your center and submit the completed form to the EBMT IDWP Data office. The form is protected with a password: covid_idwp
- We will then send you a more detailed form asking for more details of the clinical course and outcome of covid-19
We will thereafter merge the information with the MED-A form to get the basic patient information.
We believe this is an important survey to rapidly collect information about this new virus associated disease and hope you and your center are willing to participate.
For any question about this survey, please email email@example.com
If you do not wish to participate, please let us know as well.
Update on JACIE activities in the context of the COVID-19 outbreak
JACIE continues to monitor the situation in relation to being able to perform on-site inspections. In the immediate term, it is clear that this is generally impractical although we are aware that the situation is not identical in all countries. We have recently started to reach out to inspectors and our network of national representatives to assess conditions in those countries were centres are preparing for accreditation. Furthermore, we are working on the basis of being able to resume at least some activity in the autumn and to give ourselves and our users a ‘horizon’ on which to fix. Needless to say, the safety of our volunteer inspectors is our priority and their willingness and availability will be key to being able to form teams and agree dates with the centres. For that reason, we kindly ask centres for flexibility and patience in this complex task of reactivation and to support the inspectors with all necessary safety measures.
In the meantime, the JACIE team based in Spain has maintained services by working from home since mid-March and can be contacted by email. Unfortunately, we cannot be telephoned directly but a videocall can be scheduled on request to firstname.lastname@example.org. Also note that any post sent to the JACIE team has not been collected since mid-March and so any urgent deliveries should be checked with the Coordinators directly before sending. Hopefully the situation will start to improve from mid-May onwards.
FAQ COVID-19 and implications for accreditation processes
Our inspection was scheduled and then cancelled when COVID-19 interrupted normal services. When will our inspection be rescheduled?
We will not be scheduling on-site inspections until it is safe to return to on-site visits. JACIE continues to monitor the situation and we have recently started to reach out to inspectors and our network of national representatives to assess conditions in those countries where centres are preparing for accreditation. We are working on the basis of being able to resume at least some activity in the autumn and to give ourselves and our users a ‘horizon’ on which to fix. Needless to say, the safety of our volunteer inspectors is our priority and their willingness to travel and availability will be key to being able to form teams and agree dates with the centres. For that reason, we kindly ask centres for flexibility and patience in this complex task of reactivation and to support the inspectors with all necessary safety measures.
In the case of those cancelled inspections, JACIE will make every effort to assign the same inspection team as inspectors will have already made preparations for the on-site visit.
We are in the pre-inspection phase of the accreditation process. What should we do?
Centres should continue to submit documents and maintain correspondence with their assigned Accreditation Coordinator. Accreditation Coordinators are available by email or teleconference (on request) to assist you. JACIE understands that the situation will affect centres’ preparations and can offer flexibility with regard to timelines so please notify your Coordinator when you anticipate delays.
Note that where processes take longer than expected, centres may be asked to update information provided earlier and to provide any updated versions of documentation in order for inspectors to have the most recent information and related files.
What happens if our accreditation expires?
Centres whose accreditation expired after 31 March 2020 automatically received a 12-month extension of this accreditation cycle and were notified in early April by email.
Accreditations that had already expired before 1 April 2020 were not extended. Those centres that have submitted an application for accreditation are listed as "In Process" in a separate list from the Accredited centres. This is referred to as "coverage", a term limited to acknowledging that a given centre is in the accreditation process without having yet achieved accreditation. A letter to this effect can be requested by the centre by writing to email@example.com.
The JACIE website is the official source of the lists of Accredited Centres and Centres in Process. See www.ebmt.org/jacie-accredited-centres for details. In some cases, a centre may appear in both lists because their most recent accreditation is still in force AND they have submitted an application to renew their accreditation e.g. accreditation expiring in December 2020 and application for reaccreditation submitted in December 2019. It is up to the centre if they wish to proceed with their new application. In any case, JACIE encourages early applications for reaccreditation (at least 12 months before expiry and earlier if possible) to avoid or minimise gaps between accreditations.
Centres with expired accreditation awards are not listed. A letter confirmed previous accreditation awards can be provided upon request.
Due to the pandemic, we have had to make temporary changes to our set-up and processes. What do we need to report to JACIE?
JACIE is aware that centres may have to move patients or change services temporarily due to the current extraordinary circumstances. These changes do not require immediate reporting nor JACIE approval. Nonetheless, such changes occurring in centres currently accredited should be reported to JACIE as soon as possible using the Changes affecting Accreditation Report document found at https://www.ebmt.org/ebmt/documents/changes-affecting-accreditation-report. These reports will be provided to inspectors at the next inspection.
Centres should apply quality management principles to these changes including a risk assessment with appropriate mitigation of any identified risks to the extent possible. By definition, these changes represent deviations from normal procedures and practice and so should follow internal processes for planning and approving or for reporting and documenting when unplanned. Standards B/C/D4.12 and B/CM/C/D5.7 apply.
Regarding changes to patient care, centres are directed to the EBMT COVID-19 resources page where guidance and recommendations by EBMT and other organisations are collated. See www.ebmt.org/covid-19-and-bmt
I am already accredited. When should I receive my certificate ?
Due to the COVID-19 pandemic, activities in the JACIE office have been affected. It is not currently possible to print the certificates on our official stamped paper. This is expected to be resolved in the coming weeks when staff can return to the office. A PDF accreditation letter will be provided by email in the meantime. Please contact your Accreditation Coordinator with all requests.
My centre has been already inspected and we are waiting for the inspection report. How can we demonstrate we applied for re-accreditation?
The COVID-19 has impacted the activity of our inspectors and the Office, which may lead to delays in the inspection reports. Centres can ask for a letter from JACIE stating that the centre is in process of being JACIE accredited.
For any queries please contact: firstname.lastname@example.org
My centre has to go through the Interim Audit (IA) this year. Are interim audits being postponed?
If your centre is due to send the IA documents in 2020, the process will remain as scheduled. As the audit is only document-based, centres can still present documentation focused on quality management aspects. The JACIE office will send them to the inspectors for review.
Be kindly reminded that your interim audit is due in the same month you obtained the accreditation. If your centre requires some extra time to gather the documents please contact email@example.com, We can extend the deadline for a month if required.
The required documents can be found here:
Novel coronavirus additional information
The following resources are being updated regularly with timely information:
International & European authorities
- World Health Organisation (WHO)
- Centers for Disease Control and Prevention (CDC)
- European Centre for Disease Prevention and Control (ECDC)
- The European Commission has clarified that Substances of Human Origin (SoHO) are considered to be essential goods/services for which free circulation within the EU is crucial
- European Network for Health Technology Assessment (EUnetHTA)
- The ECDC has published a guidance document on COVID-19 and SoHO
- American Society for Transplantation and Cellular Therapy (ASTCT)
- Amercian Society of Hematology (ASH)
American Society of Clinical Oncology (ASCO)
- National Comprehensive Cancer Network (NCCN)
- European Hematology Association (EHA)
- British Society of Blood and Marrow Transplantation and Cellular Therapy (BSBMTCT): recommendations for COVID Adult BMT
- Grupo Español de Transplante Hematopoyético y Terapia Celular (GETH)
- Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)
- Anthony Nolan: Coronavirus and your stem cell transplant
- World Marrow Donor Association (WMDA)
- National Institute for Health and Care Excellence (NICE): Rapid NICE Guideline for COVID-19 in HSCT
- The Lancet COVID-19 resource centre
- The New England Journal of Medicine: A collection of articles and other resources on the Coronavirus (Covid-19) outbreak, including clinical reports, management guidelines, and commentary.