We already know that social distancing will be one of the biggest tools in minimising spread and the impact of COVID-19, on both our healthcare systems and our collective wellbeing. But no one solution is likely to work on its own. As the global statistics are indicating, countries that employ a multi-pronged approach to the virus appear to be managing the outbreak comparatively well. Testing efficiently and effectively is certainly playing a key role. As the Director General of the World Health Organization has stressed, “You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test.”
As such, there are three essential factors we should be considering in the fight against COVID-19: the speed, locality and scalability of testing, and how these might apply in our Australian setting.
1. The speed of testing.
It’s no secret that time is of the essence as COVID-19 spreads exponentially throughout the population. The faster we can test, the better placed we are to contact trace, isolate and treat. Subsequent analysis of the Ebola epidemic of 2013-16 suggested that if 60% of patients could have been diagnosed within 1 day instead of 5 days, the attack rate would have dropped from 80* to almost 0%.
For the current pandemic, we can already compare the testing policies of different countries and how these policies are translating to infection and fatality statistics. It seems that several countries in Asia have taken lessons from previous SARS-CoV and MERS-CoV outbreaks and prepared accordingly. South Korea has rapidly employed extensive and regular testing, for example, together with technological tracking and contact tracing of confirmed cases. Test results are available within hours and 300,000 tests have been completed as of 23 March, at a per-capita rate that is 40 times that of the United States. Such a speedy response appears to be successfully flattening the country’s curve so far.
Of course, effective RNA testing depends on the quality of tests and the speed of the qPCR system. The reason we currently have experienced such strong demand for our Magnetic Induction Cycler, known as Mic, is because it enables accurate and fast results with 35 cycles possible in under 25 minutes. Efficient equipment could prove invaluable in the rapid deployment of testing capabilities, especially when it can be used straight out of the box.
2. The ability to carry out decentralised testing.
Australia’s geographical size works both for us and against us. While this enables our smaller communities to stay isolated which can minimise spread – at least initially – it can also make testing more difficult. One infected person could interact with a large percentage of a regional or remote population for 5-14 days without showing symptoms – leading to a sudden demand for local healthcare services that can often be stretched thin at the best of times. There’s also the concern that remote and regional populations have higher disease burden rates and poorer health outcomes than city counterpartswhich could leave them particularly vulnerable to the symptoms of COVID-19.
Testing for COVID-19 in Australia has largely been carried out at a number of hospitals and private labs to date, however decentralised testing would support Australia’s Indigenous, regional and remote communities in the case of localised outbreaks. Smaller, faster and more accurate qPCR machines are ideal for setting up more localised testing facilities without sacrificing larger equipment from major testing centres. Data can be sent remotely and in real-time to support the national modelling and action plan, so that targeted action can be carried out as needed.
Here at Bio Molecular Systems, Mic has even attracted a great deal of interest in recent weeks from oil and gas sites and mining companies who wish to localise testing for their employees.
3. The ability to scale testing as needed.
A key part of the Australian Government’s Emergency Response Plan for COVID-19 involves employing ‘a flexible approach that can be scaled and varied to meet the needs experienced at the time’. It’s recommended that the diverse cities, states, territories and regions within Australia adapt their approach to where outbreaks are occurring, in order to deploy testing and healthcare resources where they’re most needed. Once again, geographical distances can make it more difficult to share and transport essential equipment such as PCR lab equipment and ventilators. Ideally, testing and treatment equipment would be scalable to suit the localised circumstances so that systems can be scaled up or down depending on need. This would enable groups or regions to share resources with one another, depending on where an outbreak might be situated.
It’s this demand for scalable diagnostics that makes Mic so useful. Each cycler has a small footprint and up to 10 Mics can be connected to a single workstation for analysis. Because Mic’s magnetic induction operation provides thermal and optical consistency, the user can reproduce the same results across various instruments as well as across various runs. Data therefore looks like it was all generated from a single qPCR machine. What this setup offers is a superbly scalable qPCR system that enables smaller and faster runs, can process many samples simultaneously when demand is high and can be scaled down into individual units should any neighbouring regions require extra testing capability at short notice. This type of nimble and flexible lab automation could transform the way outbreaks are managed now and in the future. We’re proud to have over 2,500 of our qPCR magnetic induction cyclers already out in the field, supporting those in diagnostics and research.
Only time will tell how and when we will truly see the end of the COVID-19 pandemic, and all evidence points to the fact that it’s about to get far worse before it improves. One thing is clear – efficient, adaptable and effective testing is sure to be a powerful weapon in the fight as the world’s best minds develop potential vaccines, treatments and strategies.
References & Footnotes