The Atlanta Journal-Constitution

Pilot project would use blood from around globe to create an immense surveillan­ce system. Is is possible to build an early warning system for viruses?

- Veronique Greenwood

B ack in the summer, Dr. Michael Mina made a deal with a cold storage company.

With many of its restaurant clients closed down, the firm had freezers to spare.

And Mina, an epidemiolo­gist at the Harvard T.H. Chan School of Public Health, had a half-million vials of plasma from human blood coming to his lab from across the country, samples dating back to the carefree days of January 2020.

The vials, now in three hulking freezers outside Mina’s lab, are at the center of a pilot project for what he and his collaborat­ors call the Global Immunologi­cal Observator­y.

They envision an immense surveillan­ce system that can check blood from all over the world for the presence of antibodies to hundreds of viruses at once. That way, when the next pandemic washes over us, scientists will have detailed, real-time informatio­n on how many people have been infected by the virus and how their bodies responded.

It might even offer some early notice, like a tornado warning.

Although this monitoring system will not be able to detect new viruses or variants directly, it could show when large numbers of people start acquiring immunity to a particular kind of virus.

Here is how it works:

The human immune system keeps a record of pathogens it has met before, in the form of antibodies that fight against them and then stick around for life. By testing for these antibodies, scientists can get a snapshot of which flu viruses you have had, what that rhinovirus was that breezed through you last fall, even whether you had a respirator­y syncytial virus as a child.

Even if an infection never made you sick, it would still be picked up by this diagnostic method, called serologica­l testing.

“We’re all like little recorders,” keeping track of viruses without realizing it, Mina said.

Spotting patterns

This type of readout from the immune system is different from a test that looks for an active viral infection.

The immune system starts to produce antibodies one to two weeks after an infection begins, so the process, known as serology, is retrospect­ive, looking back at what you have caught.

With a large database of samples and clinical details, scientists can begin to see patterns emerge in how the immune system responds in some- one with no symp- toms compared to someone struggling to clear the virus.

Serology can also reveal before an outbreak starts whether a population has robust immunity to a given virus, or if it is dangerousl­y low.

“You want to understand what has happened in a population, and how prepared that population is for future attacks of a particular pathogen,” said Derek Cummings, an epidemiolo­gist at the University of Florida.

The approach could also detect events in the viral ecosystem that otherwise go unnoticed.

For example, the 2015 Zika outbreak was detected by doctors in Brazil who noticed a cluster of babies with abnormally small heads, born seven to nine months after their mothers were infected. “A serologica­l observator­y could conceivabl­y have picked this up before then,” Cummings said.

Serologica­l surveys are oftensmall and difficult to set up, since they require drawing blood from volunteers. But for several years Mina and his colleagues have been discussing the idea of a large and automated surveillan­ce system using leftover samples from routine lab tests.

“Had we had it set up in 2019, then when this virus hit the U.S., we would have had ready access to data that would have allowed us to see it circulatin­g in New York City, for example, without doing anything different,” Mina said.

Although the observator­y would not have been able to identify the new coronaviru­s, it would have revealed an unusually high number of infections from the coronaviru­s family, which includes those that cause common colds.

It might also have shown that the new coronaviru­s was interactin­g with patients’ immune systems in unexpected ways, resulting in telltale markers in the blood.

That would have been a signal to start genetic sequencing of patient samples, to identify the culprit.

A powerful investment

The observator­y would require agreements with hospitals, blood banks and other sources of blood, as well as a system for acquiring consent from patients and donors.

It also faces the problem of financing, noted Alex Greninger, a virologist at the University of Washington.

Mina estimated that the observator­y would cost about $100 million to get off the ground.

A pathogen observator­y, he said, is like a weather forecastin­g system that draws on vast numbers of buoys and sensors around the globe, passively reporting on events where and when they arise.

The predictive power of serology is worth the investment, said Jessica Metcalf, an epidemiolo­gist at Princeton and one of the observator­y team members.

A few years ago, she and her collaborat­ors found in a smaller survey that immunity to measles was ominously low in Madagascar. Indeed, in 2018 an outbreak took hold, killing more than 10,000 children.

Now, the half-million plasma samples in Mina’s freezers, collected by a plasma donation company from sites across the country last year, are starting to undergo serologica­l tests focused on the new coronaviru­s, funded by a $2 million grant from Open Philanthro­py.

The team hopes to use this data to show how the virus flowed into the United States, week by week, and how immunity to COVID-19 has grown and changed.

They also hope it will spark interest in using serology to illuminate the movement of many more viruses.

 ??  ?? Each week, as part of our solutionso­riented focus, the AJC partners with the Solutions Journalism Network, a nonprofit organizati­on dedicated to rigorous reporting about social problems.
Each week, as part of our solutionso­riented focus, the AJC partners with the Solutions Journalism Network, a nonprofit organizati­on dedicated to rigorous reporting about social problems.
 ?? KAYANA SZYMCZAK/THE NEW YORK TIMES ?? Freezers contain a half-million vials of plasma outside the lab of Dr. Michael Mina, an epidemiolo­gist at the Harvard T.H. Chan School of Public Health, in Boston. Scientists want to build a warning system for virus outbreaks.
KAYANA SZYMCZAK/THE NEW YORK TIMES Freezers contain a half-million vials of plasma outside the lab of Dr. Michael Mina, an epidemiolo­gist at the Harvard T.H. Chan School of Public Health, in Boston. Scientists want to build a warning system for virus outbreaks.

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