Researchers around the world work on a fast, cheap COVID-19 test,
How can we know instantly who has COVID-19? Researchers work feverishly for answers
In late January, days before Chinese New Year, a group of British researchers who work for the Oxford Suzhou Centre for Advanced Research outside of Shanghai returned home from a country on high alert due to coronavirus.
By then, about 2,000 cases had been confirmed in China and travel restrictions were in place for numerous cities in the Hubei province, the epicentre of the outbreak.
As the researchers passed through airports in the U.K., though, there was one thing that stood out.
They said there “was absolutely no check at the airport whatsoever,” says Zhanfeng Cui, an engineer who is the director of the Suzhou centre. Cui had been in Britain since the middle of December.
Stuck there, and unable to return to the centre — the only research facility that Oxford University has outside the U.K. — Cui says his group tried to determine how they could help.
“We thought, what can we do? We need to do something.”
For them, the most pressing need was a test that could produce results fast enough that it could be used while a traveller waited. Based on the results, a person could either be allowed in the country or put into isolation.
On March 18, Oxford announced a team led by Cui and Prof. Wei Huang had created a test that can detect viral RNA and RNA fragments — which typically show up three or four days after exposure — in swab samples within 30 minutes. The test equipment is portable and the results can be read with the naked eye.
Early results from Oxford showed the test correctly identified 16 samples — eight negative and eight positive — for the virus, taken from real clinical samples at Shenzhen Luohu People’s Hospital in China. The team is working on a larger trial to validate the results.
Cui wants to make the technology available, for a small licensing fee, to manufacturers in countries around the world, which could happen in weeks if the trial is successful.
“Basically, under the current global situation, I think money, making profit, is the last thing on people’s minds,” says Cui. “We want to make it as widely accessible as possible. Every country has different regulatory approvals. Every country needs this type of test.”
The focus is to get the test, if it works, to medical professionals.
Many jurisdictions around the world are opting for some kind of test like Cui’s that can produce fast results to check the spread of the virus.
Cui has had interest from about 15 countries, including Canada.
Australia is rolling out a pinprick test this week that looks for antibodies in blood, which typically appear about six days after exposure. The test was fasttracked for regulatory approval there and will be administered by family doctors, nurses and emergency rooms.
And the U.K. purchased 3.5 million home test kits that use a finger-prick blood test to determine — in 15 minutes — if antibodies are present. But health advisers there say they need to ensure the tests are reliable before they sell them on Amazon, according to news reports.
The danger is that, if the kits aren’t precise enough, they could show false negatives or false positives, says Cynthia Carr, an epidemiologist who founded EPI Research in Winnipeg. Carr has no knowledge of these specific tests and is speaking generally.
“The quicker you get the results, the faster people can make sure that they don’t spread it, but fast is not more important than accurate,” cautions Carr. “You don’t want to scare people and you don’t want to tell people they don’t have a disease when they do.”
Ontario announced this week that it was purchasing fast-test kits from Spartan, an Ottawa-based company. The kits will be used to detect COVID-19 in nasal and throat swabs using an analyzer, a small machine about the size of a coffee cup. The province has ordered 900,000 kits but it hasn’t released how many analyzers it will purchase.
The analyzers can only process one test at a time, but they are portable and can be used in clinics, airports, remote communities and at borders.
The company is working closely with Health Canada so the test kits can be fast-tracked for approval, which means they could be out in weeks, says Spartan CEO Paul Lem.
Although some countries have scaled back on testing once there is community spread, many epidemiologists here believe testing is still key.
“It is now quite apparent that widespread testing is likely needed to control the virus,” says Dr. Jeff Kwong, a family doctor at Toronto Western as well as a professor at the University of Toronto’s Dalla Lana School of Public Health.
“Social distancing is really a stopgap measure because we aren’t able to do widespread testing and contact tracing,” says Kwong.
Ontario has a huge backlog of lab results and on Monday processed fewer than 3,200 lab tests, short of its goal of 5,000 a day. Conventional testing can take up to five hours in a hospital lab such as Mount Sinai’s, where 94 samples can be processed during that time, says Tony Mazzulli, the hospital’s microbiologist-in-chief.
The province has been slow to expand testing to labs at private companies and universities.
New York state was able to expand its capacity because it moved early to open testing to public and private labs, as soon as it received FDA approval March 13, says Jonah Bruno, director of public information for the New York State Department of Health.
More than 12,000 tests were processed one day last week in New York, which has a population of 19.5 million, about one-third more than Ontario.
Partnerships with private labs have also let South Korea do widespread testing, which has been credited with slowing down the spread of the virus there, although there are still thousands infected in the country.
The country has drive-through testing and people are texted or emailed the lab results the next day.
“If we could have expanded testing and done comprehensive contact tracing” at the outset, says Kwong, “we may have been able to avert many of the cases that we are seeing today and will see in the next week.”
What role rapid testing will have on the pandemic will play out in the next few weeks.
Cui is focused on getting his test out during that time frame so that it can be developed and improved in other countries. No single company could make enough test kits to meet global demand, he notes.
“Any test is good,” says Cui. “Right now, we’re staying home, but the question you always ask yourself is, ‘Did I get it? Did I get it?’ And this concern creates anxiety. If we have a test that you can do fairly quickly, then that’s great.”
His test is also much cheaper than a conventional one — about $35 Canadian covers the materials — although Cui says he wasn’t happy when he first heard the price. “I thought this was too expensive. I wanted to make it even cheaper,” he says, thinking that if he could ever develop it into a home test that it would be too much for a family of four or five.
“But I was told that at the moment the (conventional lab) test costs £300 (roughly $525 Canadian). So they tell me ours is much cheaper,” he says, laughing. “I’m an engineer. I just want to make it as cheap as possible, more accessible.”