Eric Brown is a professor of biochemistry and biomedical sciences at the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University in Hamilton.
COVID-19 is an invisible enemy. While we weren’t prepared for this pandemic and researchers around the world are racing to develop a vaccine for it, we have learned an important lesson: testing is critical if we are to defeat this virus and prepare for any future pandemic.
New forms of rapid, non-invasive, saliva-based tests, ones that can be administered with speed and ease by anyone, could test COVID-19 into oblivion with widespread use. This is not science fiction. There are many such tests in the making.
Research has shown that about 40 per cent of patients infected are asymptomatic, which is in large part responsible for the astonishing spread of the virus. Testing saliva samples from every Canadian on a routine basis would reduce the reproductive number of the virus – the number of people one might, on average, infect – as we quickly identify, isolate and care for the infected. The result would be a dramatic decline in infections, sickness and death.
While there is growing optimism a COVID-19 vaccine will be effective, there are no guarantees. We could be expecting a miracle that may never come. We need only consider the AIDS epidemic, which first emerged nearly 40 years ago. It took more than a decade to get effective therapies for HIV patients, and there is still no vaccine today.
The United States has set a target for a COVID-19 vaccine by year-end, and 10,000,000 doses of a Canadian-made vaccine are projected to be available for March, 2021. This is a long time to wait, but it is also very ambitious, indeed unprecedented, in terms of the time required for vaccine development. There may be delays, setbacks and outright failures in clinical trials.
At the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University, we are researching new therapies, diagnostics and vaccines. We recognize what a game-changer daily COVID-19 testing could be to the workplace, to education and to the wider community. With this in mind, we are embarking on new research to study saliva-based testing. We want to understand the logistics of such an effort, how it might facilitate a return to normalcy and how we might scale this quickly for our entire university and even larger communities.
Consider what we are seeing in professional sports. COVID-19 testing conducted every day on asymptomatic players and staff has made it possible to watch the the NHL playoffs and to follow the Toronto Raptors as they attempt to defend their NBA title.
Recently, the U.S. Food and Drug Administration granted emergency approval of a saliva diagnostic test developed by the Yale School of Public Health in partnership with the NBA and first trialed within the NBA bubble. This is a lab-based test designed for widespread public screening using saliva instead of the dreaded deep nasal swab.
Analyzing saliva samples can solve many lingering issues related to nasal swab testing, which is expensive, unpleasant and requires trained medical professionals who are at risk from a procedure that often induces coughing and sneezing.
It can eliminate problems within the supply chain too, including costly, hard-to-source swabs, sample storage and testing liquids. Certainly one of the most promising aspects is that saliva sampling can be self-administered at a fraction of the cost of conventional swab testing.
A saliva-based lab test is the first hurdle. The next step is to develop a test that doesn’t require a lab, and this, too, is within reach.
Daily at-home testing would be a game-changer. Imagine spitting into a tube or onto a piece of treated paper, and monitoring to see if it turns colour: green means go to school or work, red means isolate and engage with the health-care system.
Students could go to school, employees could return to the workplace and health-care workers could do their jobs with security and without worry, bringing normalcy to health care, education and the economy.
But critics argue that at-home tests are risky. Health Canada has been wary, initially ruling them out due to accuracy concerns, but later reversing its stance and agreeing to review applications for home tests. New COVID-19 testing technology could be a breakthrough for this pandemic, so it’s important that Health Canada is open to it.
No question, new testing technology is also a wise investment for the future. COVID-19 may be a dress rehearsal for another even more deadly pandemic, and we will be better prepared to respond quickly, averting the madness of 2020.
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