The issue in tracking the spread of the SARS-CoV-2 virus throughout the population is that the two tests being suggested are, an untested antibody test, providing best results 21-28 days after showing symptoms of the COVID-19 disease, or a manpower, technology, reagent and skills intensive PCR test looking for active virus a period of time post infection.
A percentage of the population remains asymptomatic as they carry the virus but can transmit it.
The PCR tests are and will always be resource limited. Those infected with the SARS-CoV-2 virus may be infective for a period before the PCR tests will identify active infection. The test is only accurate at the moment of time the swab was taken and there is nothing to stop someone not infected at the time of test being subsequently infected at any time after the test. The reagents needed for the test are in a short supply across the globe and testing facilities are becoming overwhelmed.
Current “mass” screening capability used in several countries uses thermal cameras looking for people with elevated temperatures. However, it will not identify asymptomatic carriers and only detects one symptomatic indicator.
What is needed are a series of complimentary tests able to identify an infection and immune system activation as early as possible so that infected persons can isolate as early as possible to reduce cross infection risk, once isolated then individuals can be tested for specific viruses such as SAR-CoV-2 and then for antibodies.
Tests should be simple and cost effective enough to allow individuals to be tested as often as is deemed necessary. For example, healthcare staff on arrival at work and on leaving work each day. There is currently insufficient PCR capability to do this and it is unlikely there ever will be. PCR tests are relatively expensive.
Research post the original SARS epidemic believed to have emerged in 2002 identified the utility of a viral infection marker produced by the body as part of a stimulated immune response. The marker is called Neopterin. There are numerous scientific papers outlining the utility of this chemical marker including:
The immune system being activated and releasing Neopterin is not specific to SARS-CoV-2, however it is an early warning system that something is going on; currently there is no test that does this.
Professor Colin Self, an Emeritus professor with Newcastle University and recognised leading testing scientist as developed a simple revolutionary test that could be used for that early warning capability utilising the detection of Neopterin in saliva.
The base technology used for the test has been developed over many years of research under Framework 7 and Horizon 2020 funded research projects. It can be used to detect any small molecule where a specific antibody for that molecule can be found. It is simple positive read out test, that gives results in less than 2 minutes.
As an antibody is specific to a particular chemical structure, this methodology is extremely accurate. Professor Self has a very pure cell line producing antibodies to Neopterin. The use of saliva, the positive read out if neopterin is present and the speed of testing allows self-testing and self-reading of the result. Each test if produced in volume batches, only costs a few pounds.
Imagine everyone being able to test themselves several times a day and if positive the more expensive PCR tests can be used in a targeted way to track SARS-CoV-2, if negative you know you do not have an immune stimulating infection.
Professor Self has told me that whilst his test is in storage as his research grants have finished, he has identified a qualified team with availability, facilities to produce a production standard test in approximately 6 weeks and then the manufacturing process to produce 10’s of thousands of test strips per day or potentially significantly more would be easily achievable. His tests don’t need special reagents, he can grow volumes of the relevant antibodies quickly, large numbers of test strips can be manufactured easily.
A video of the test being used in real time is below:
The presence of small molecular weight analyte (Neopterin) gives rise to a positive line appearing out of a clear white background. Intuitively, the more line is seen the more Neopterin is present.
The cassette dipstick on the left receives neopterin-free buffer, whereas the cassette dipstick on the right receives buffer containing the small molecular weight analyte.
During the, real-time run, both cassette dipsticks display a positive control line towards the top of the window to show the devices have been used correctly. Only the cassette receiving a positive sample shows a positive test line, towards the bottom of the window.
This occurs very quickly. The fact that the positive sample is indeed positive can be seen by eye within a matter of seconds, allowing immediate action to be taken if necessary. Further development of the sticks over two minutes, allows the control line to stabilise and a quantitative determination of the concentration of the analyte.
All Professor Self needs is help taking this ground-breaking test to production. It could enable better control of pandemic conditions.
A war which is unrestricted in terms of the weapons used, the territory or combatants involved, or the objectives pursued, especially one in which the accepted rules of war are disregarded is the definition of ‘Total War’ in the Oxford Dictionary. The global fight against the invading army of microscopic virus particles is without doubt a total war. The fight against SARS-CoV-2 can be defined in no other way than World War 3.
The enemy front line in this conflict are those directly affected by it, those wilding the weapon of mass destruction that is the virus, it is the people, all the people of planet earth as anyone could be carrying it, anyone could spread it, anyone could catch it, anyone can die from it.
The SARS-CoV-2 weapon is the COVID-19 disease it causes, and the effectiveness of that weapon is enhanced by the ability of the virus to move silently, undetected through the population, killing only a very few, but generating fear in many and disrupting if not destroying what was normality.
The deep battle fighting the viral enemy has two distinct elements, firstly the political battle, bringing in restrictions to ensure social distancing, allocating resources to ensure those fighting the close battle have what they need and the second element is scientific research, trying to find a better testing regime for the virus and a vaccine for the disease. The tacticians and planners are our chief scientists, chief medical staffs and financial planners. They are preparing the ground for those fighting the close battle.
The close battle is being fought by our doctors, nurses and paramedics; in military terms they are the F echelon, the fighting echelon. Of course, they need support and that support is provided by the laboratory staff, the other health care staff including porters, cleaners, volunteers, military personnel and more; they are the B echelon, the vital element keeping the f-echelon able to focus on the task in hand, fighting the disease, COVID-19 caused by the virus, the global enemy.
Corona viruses have caused conflict before this century, three coronaviruses have crossed the species barrier to cause deadly pneumonia in humans: severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. However, SARS-CoV and MERS-CoV only caused limited wars unlike the new deadly SARS-CoV-2 that has plunged the world into the new total war, that is our third World War.
The potential for a global conflict against a viral attacker is nothing new. Bill Gates said at the 2017 Munich Security Conference, “We ignore the link between health security and international security at our peril.” He concluded his talk by saying “When the next pandemic strikes, it could be another catastrophe in the annals of the human race. Or it could be something else altogether. An extraordinary triumph of human will. A moment when we prove yet again that, together, we are capable of taking on the world’s biggest challenges to create a safer, healthier, more stable world.”
We are seeing national and international industries change their focus and deliver vital war equipment; Dyson, JCB and Mercedes F1 delivering ventilators, airline staff delivering medical support, people from all walks of life helping supermarkets, delivery companies, charities and so many other initiatives. Our industry is on a total war footing.
We are seeing in a limited way at the moment but have no doubt it has the potential to increase, the use of deception, fake news and propaganda. This is where our responsible national media have moved to a total war footing, fact checking, broadcasting public information broadcasts and more.
What we have to realise is we can’t target the enemy directly this way like Sun Tsu espoused in the 6th century when he said, “All warfare is based on deception. Hence, when we are able to attack, we must seem unable; when using our forces, we must appear inactive; when we are near, we must make the enemy believe we are far away; when far away, we must make him believe we are near.” However, those comments could fit perfectly with the need for social distancing. But the lesson from this is we shouldn’t open a second front, exploitable by the virus by fighting amongst ourselves. This is a time for all to come together to fight a common enemy and put human differences to one side.
The US surgeon general, Jerome Adams told Chuck Todd on NBC’s “Meet the Press.”, “the next week is going to be our Pearl Harbor moment.”
Her Majesty the Queen continued the wartime analogy when she said in her rousing speech watched across the globe: “I am speaking to you at what I know is an increasingly challenging time.
“A time of disruption in the life of our country: a disruption that has brought grief to some, financial difficulties to many, and enormous changes to the daily lives of us all.”
“It reminds me of the very first broadcast I made, in 1940, helped by my sister. We, as children, spoke from here at Windsor to children who had been evacuated from their homes and sent away for their own safety.”
“Today, once again, many will feel a painful sense of separation from their loved ones.”
“But now, as then, we know, deep down, that it is the right thing to do.”
“While we have faced challenges before, this one is different.”
“This time we join with all nations across the globe in a common endeavour, using the great advances of science and our instinctive compassion to heal.”
“We will succeed – and that success will belong to every one of us.”
“We should take comfort that while we may have more still to endure, better days will return: we will be with our friends again; we will be with our families again; we will meet again.”
Invoking the emotion generated by our last global conflict. Her Majesty has clearly made the link to the current global conflict, World War 3, battling a virus, SARS-Cov-2. Ma’am, we will meet again.