COVID-19: Maybe we could get to where we need to be in testing

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Additional testing capabilities augur well for Canada’s re-emergence from the economic deadlock due to the pandemic.

With more than 1,030 confirmed coronavirus cases in Ottawa now, including 42 deaths – with the two measures still growing – this may not be the time to be optimistic.

However, after conversations with a leading microbiologist and a determined entrepreneur on Friday, it is hard not to feel a little more comfortable about how this pandemic will ultimately unfold.

Marc Desjardins is the head and regional head of the microbiology division of the Eastern Ontario Regional Microbiology Laboratory, which serves 16 hospitals in the Pembroke area of ​​Cornwall. In the past few weeks, the laboratory has tripled its ability to perform COVID-19 tests to 1,132 per day. This represents about half of the tests performed in the greater Ottawa area, including the provincial laboratory and the bio-test laboratory.

“We can accept the quantity of tests to be performed,” said Desjardins, adding that his regional laboratory was operating at 50 to 60% of its capacity.

Archive photo of Marc Desjardins, chief and regional head of the microbiology division of the Eastern Ontario Regional Microbiology Laboratory.

University of Ottawa

Its biggest obstacle is the availability of specialized swabs used to collect samples of the virus. “Right now, swabs are a limiting factor,” said Desjardins, referring to the increase in the number of tests performed in hospitals and local assessment centers such as the Brewer Park arena.

Copan, the world’s leading supplier of swabs, is headquartered in the Italian region of Lombardy. There are also half a dozen other manufacturers on the Health Canada approved list, but all are experiencing shortages. Despite this, laboratories across the country have managed to procure enough supplies to almost double the number of daily tests compared to last month.

Paul Lem, CEO and founder of Spartan Bioscience, has no problem with swabs. His problem is that it just can’t grow fast enough. In recent weeks, Lem has obtained orders for more than two million COVID-19 test cartridges from Ontario, Quebec, Alberta and the federal government. Along the way, he obtained Health Canada approval for his technology and reached an agreement with a high-volume contract manufacturer in Toronto. This will allow it to increase production of Spartan test kits to several hundred thousand per week by July. The capacity would increase from there.

“There are only five of us in the world making portable test kits,” said Lem, “and we’re all overwhelmed. “

Nor does there seem to be an end to the demand for his company’s DNA analyzer, dubbed the Spartan Cube. Unless there are unexpected technical problems, governments will purchase whatever Spartan can do for the foreseeable future. After that, Lem intends to start selling COVID-19 test kits to companies and possibly export. Lem does not anticipate a problem with the supply of swabs, which are manufactured by contract manufacturers locally – L-D Tool & Die – as well as in Toronto. The swabs are customized for the Cube and incompatible with other test kits.

Paul Lem, CEO of Spartan Bioscience Inc. in Ottawa.

Julie Oliver /

Postmedia

The additional testing capacity bodes well for Canada’s re-emergence from economic deadlock, a transition that will depend heavily on accurate COVID-19 testing to identify and isolate those who have the virus. The tests will be combined with contact tracing and continuous social distancing if necessary.

But, even with the recent push to increase testing capacity, will it be enough to give us enough knowledge about this elusive virus?

Theresa Tam, Chief Public Health Officer of Canada, said this week that the national target should be around 60,000 tests a day, about triple what it is today. This would include the full range of laboratory and point-of-care tests for COVID-19 to serological tests that look for antibodies in the blood. This goal seems to be a stretch for the country, certainly in the coming months. But the bottlenecks of the key ingredients should finally be resolved, unless the spread of the virus really gets out of control in the United States.

On the positive side, the Ottawa Valley’s testing capacity is already in line with the Tam target per capita, which bodes well.

An increase in national capacity to 60,000 tests per day is a reasonable benchmark, according to a recent study by researchers at Harvard University, published earlier this month by Science newspaper. The study offers a fascinating insight into how the virus will behave in the coming months, depending on the type of testing and social distancing we do.

The researchers, led by Stephen Kissler and Christine Tedijan, studied two coronaviruses that were “close genetic cousins” of SARS-CoV-2, the virus that causes COVID-19, and tracked their behavior for several seasons.

https://science.sciencemag.org/content/sci/early/2020/04/14/science.abb5793.full.pdf

The study concluded that there should be “continuous and extensive surveillance” of the American population to assess the physical distance needed in the short term and to prevent outbreaks in the longer term. The researchers envisioned multiple periods of physical distancing as the population gradually developed their immunity.

Analyzing the research, Harvard Professor Ashish Jha concluded that the United States should at least triple the number of tests to more than 500,000 per day, which would be approximately 57,000 per day in Canada. This would include testing for the virus and the antibodies.

The authors also expressed the hope that if serological tests revealed that many more people than expected had been infected but had no symptoms, periods of physical distancing could be reduced. It will depend on whether those who test positive for the virus – whether or not they have symptoms – develop immunity and for how long.

Again, this reinforces the importance of testing.

Health Canada has approved 14 companies, including Spartan Bioscience and its American rivals Cephied and Abbott Laboratories, for COVID-19 testing under emergency authorization. No company has yet been approved for serologic testing, although about a dozen have applied. Spartan is not one of them – its products only support DNA testing. However, the Desjardins laboratory is working on a solution to test COVID-19 antibodies. The United States Federal Drug Administration has approved more than 60 test kit manufacturers under its emergency use authorization, four of which specialize in antibody testing.

Testing alone will not fully reopen provincial economies. Another key to containing the spread of the virus is the employment of a small army of workers to trace the contacts of people who test positive. When Wuhan – the epicenter of origin of the coronavirus – was taken into custody in January, he assigned more than 9,000 people to the labor-intensive task of following the spread. It’s about one in 1,000 people.

A Swiss doctor holds a swab kit made by Copan, who is based in the hard-hit Lombardy region of Italy.

DENIS BALIBOUSE /

REUTERS

Coincidentally, Ottawa Public Health says it has between 55 and 115 workers involved in case and contact management: similar to the intensity of Wuhan, although it is unclear whether the data is comparable .

The more data health agencies compile across Canada, the more we will know how the virus circulates and whether certain regions of the country actually develop significant immunity.

Certainly the provinces have been affected in different ways. The influence of Quebec’s spring break in early March – two weeks earlier than in most other provinces – is well known. The return of hundreds of thousands of snowbirds from the southern United States later in March likely also contributed to the spread of the virus, particularly in Ontario and Quebec and, to a lesser extent, in Alberta.

BEFORE CHRIST. witnessed an early coronavirus outbreak across the border in Washington State, so its residents may have been more cautious earlier. Certainly in British Columbia – along with Saskatchewan, Manitoba and New Brunswick – have the lowest incidences of COVID-19 per capita and are closest to reopening parts of their economies.

Even so, it is not surprising that many Canadians are still nervous about reopening provincial economies. The coronavirus that causes COVID-19 has from the start shown a disturbing capacity to surprise us in a negative way. And there are many things that we still don’t know. Marc Desjardins and Paul Lem are doing their part to change that.

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