US scientists warn: We have the technology to test millions of people for corona every day. Why don’t we do it? “30. April 2020
US scientists warn: We have the technology to test millions of people for corona every day. Why don’t we do it? ”
New York, April 29, 2020
There is broad agreement that the only way to safely reopen the economy is by a massive increase in corona tests. This would require millions of people to be tested every day in the United States because of the Covid 19 pandemic. This is the only way to effectively track the virus and then contain it.
“The country only tested around 210,000 people a day last week,” criticize leading scientists at MIT. In addition, the pace is not increasing fast enough to reach millions. New legislation made $ 25 billion available for testing a few days ago. Nevertheless, “there is growing concern that the tests may not be scaled in time to make a difference.” The scientists emphasize: “We believe that it is possible.”
The scientific community today has the technological skills to test anyone who needs it. “The required level can be achieved by leveraging the fruits of the last decade of innovation in biology, including the dizzying advances in DNA sequencing, genetic engineering, industrial automation, and advanced computation.”
Mass screening tests may have different requirements and characteristics than the tests that are currently performed in clinical laboratories and approved by the Food and Drug Administration. What could a solution look like?
“It has to be scalable. That means tens of thousands or hundreds of thousands of tests per day and facility or home tests. It has to be sensitive to early stages of infection and recognize the actual virus instead of immunizing it. And there is less need to be tied to health insurance and government regulations to enable quick and comprehensive testing, contact tracking, and isolation. These differences do not mean lower standards. In fact, screening on this scale requires stringent security, accuracy, and reliability requirements.
The life sciences community is up to the challenge. We use our labs to develop new centralized home methods that address bottlenecks that prevent tests from reaching global scale. This community is moving fast, with common goals and a commitment to open collaboration. There are several promising routes as a result of these efforts.
Some rely on DNA sequencing tools that have improved millions of times since the human genome project was completed almost 20 years ago. Not only can these tools now read trillions of base pairs of human DNA every day, but they can also be easily reused to test the presence of coronaviruses on a large scale using tools that already exist across the country. Some methods, such as SHERLOCK and DETECTR, use CRISPR DNA and RNA recognition tools to enable fast, distributed testing in doctors’ offices and other locations. Other efforts are to remove critical bottlenecks such as sample cleaning to make existing approaches more scalable. ”
There are additional options, and the US has to bet on several of them at the same time. Some of these bets may fail, but the severity of the moment requires us to try. Chances are that we will need more than one of them ”.
Finally, the scientists point out that “just as important as the diagnostic technology itself”, they need to “drive innovation in all phases of the test process, including sampling, regulation, logistics, manufacturing, sales, scale-up, data infrastructure and billing. These are solvable problems. The solutions can sometimes deviate from the current conventions for clinical tests, but these are not conventional times ”.
As important as the diagnostic technology itself is the need to fuel innovation at all stages of the testing process, including sample collection, regulation, logistics, manufacturing, distribution, scale-up, data infrastructure, and billing. These are solvable problems. The solutions may sometimes differ from current clinical testing conventions, but these are not conventional times.
Maybe cotton swabs or saliva can be used for collection rather than traditional nasopharyngeal swabs, which are in critically short supply. Maybe mass screening tests don’t have to have the tested person’s name and date on every collection tube but could instead include a bar code that you snap a picture of with your phone. Maybe these tests can be self-administered at home or work rather than conducted by trained professionals in clinical settings. Maybe samples from low-risk, asymptomatic people can be pooled together for initial testing and further screened only in the event of a positive result. This would allow many more samples to be analyzed at once.
State or federal regulatory agencies could make these adjustments to conventional practices more easily if they were willing to treat mass screening for bringing people back to work differently from the testing used in clinical settings. In addition, mass screening efforts will require unconventional partnerships with private companies, nonprofits, universities, and government agencies to support the logistics, collection, manufacturing, scale-up, and data infrastructure to make such a system possible. All this can be done, and some of it is already starting to be done—but we must not lose hope.
The United States’ capabilities in the life sciences and information technology are unmatched in the world. The time is now to rapidly build a massively scaled screening program that will save lives while allowing us to reopen our economy and keep it open. This can be done, but it will require urgency and determination to make multiple, simultaneous bets on infrastructure, regulation, and technology, as well as collaboration to put it all together.
We have united before to face far greater challenges as a nation, and we can do so again.
Sri Kosuri is cofounder and CEO of Octant and an associate professor in the Department of Chemistry and Biochemistry at UCLA. Feng Zhang is the James and Patricia Poitras Professor of Neuroscience at MIT’s McGovern Institute, a core member of the Broad Institute, a Howard Hughes Medical Institute Investigator, and cofounder of Sherlock Biosciences. Jason Kelly is cofounder and CEO of Ginkgo Bioworks. Jay Shendure is a Howard Hughes Medical Institute Investigator at the University of Washington School of Medicine and scientific director of the Brotman Baty Institute.