Apart from vaccine, research on drugs should be expedited

Dr Priya Abraham, who heads the National Institute of Virology in Pune, and her team have successfully isolated the SARS-CoV-2 virus, enabling scientists to work on vaccine candidates and drug research. It will also help evaluate rapid diagnostic kits. In an exclusive interview with THE WEEK, Abraham spoke about her team’s expertise in testing and stressed on the need to ramp up efforts to deal with the ongoing crisis.

Excerpts:

India is the fifth country to have isolated the SARS-COV2 virus. What are the implications of this achievement?

Coronaviruses in general are not very easy to propagate in culture, but we have managed to do it. We now have isolates of the SARS-CoV-2. While we continue to focus on testing, which is our major mandate, the implications of isolating the virus are huge and are crucial at this point. By isolating the virus, the next step would be testing in-vitro for susceptibility to drugs, future vaccine development and development of diagnostic assays including point of care assays.

Please explain the process behind the isolation of the virus.

Viruses need living organisms to grow in. In our lab, we first isolated the virus from the throat swabs of eight of 16 virus positive patients in artificial cell lines. Within 24 hours, we started to observe some changes in the cells. This is called cytopathic effect (CPE: changes caused by the virus when it grows in cell lines). By day three, we noticed that the virus titre had increased, and by day four, the virus titre increased even further. The challenge at this stage was—there is a virus, but can we confirm that it is SARS-CoV-2 ? We did it. We did a whole genome sequencing of the virus genome from the culture supernatant of the cell lines showing CPE and found that this was indeed the SARS-CoV-2. Using the culture supernatant from the infected cell lines, we were also able to visualise the virus in our electron microscope.

Experts across the world are saying that the virus is nothing like what they have seen before.

The outbreak and its spread were truly unprecedented. At the time of SARS, the world saw about 8,000 cases, but in this case, we have already seen over 1,84,976 cases and 7,500 deaths. When reports from China were emerging on the atypical pneumonia in mid-December, I told my team that we needed to keep our ears to the ground. We started performing “mock runs” using “pan”corona virus primers in the hope that we may pick up this novel agent. By early January, it was clear that this was a coronavirus strain that the world had not seen before. Now, it is crucial that apart from the vaccine, the research on drug development is expedited. With the identification of such a drug, mortality can be decreased. Following the isolation of the virus here in ICMR-NIV, we can help towards that effort. We will be able to test activity of the candidate drugs now.

Do you think India is prepared to take on Covid-19?

A/ The preparedness is there, but we will need to ramp up our efforts. My worry is about our population density which can favour the spread of the virus. We will need to increase our testing capacity, too. As of [March 18], we have equipped 67 laboratories for the job and this number can be increased. For each sample, we have also been testing for 18 other respiratory pathogens such as the influenza viruses. The experience of our national influenza testing centre, a WHO regional laboratory, has helped us tremendously. We are evaluating at least 10 other commercial candidates for the assays [tests]. We are also helping an indigenous company to make a point-of-care assay for SARS-CoV-2.

The preparedness is there, but we will need to ramp up our efforts. 

My worry is about our population density which can favour the spread of the virus.

Do we have enough testing kits?

In the recent past, we ordered probes for 1 lakh testing reactions [testing kits need a primer and a probe; primers are short synthesised DNA fragments, designed to find and bind to specific segments of the viral genome, and probes are fluorescent-labelled DNA oligonucleotides, designed to bind downstream of one of the primers and to give a fluorescent signal during the test], and now we have ordered an additional lakh. We are also helping an indigenous company to make a point-of-care assay for SARS-CoV-2. There are other point-of-care assays that test for viral antigen and antibody. The antibody test will be a blood test. Antibody-based tests may be useful later in the course of infection since they will require the immune response of the body getting triggered. These will be helpful to check on those who have recovered from the infection.

Our job is to give an objective report on the specificity and sensitivity of these kits. The idea is to have point-of-care or near-point-of-care tests validated so that in the coming days, [tests] can be [done] in smaller labs and even at airports and other screening facilities.

The NIV has also sent scientists to Iran.

Yes, a handful of our staff were in Iran and have just returned. The commitment of that team and their families is commendable.

The team here in NIV has been putting in endless hours, and as their leader, I have to ensure that they are motivated, supported and cared for.

Does NIV have enough manpower and resources, given the frequency of viral outbreaks?

NIV has always risen to the occasion in the past. In this outbreak, too, the SARS-CoV-2 team has been working round the clock since the outbreak hit India. We have also had a key role in empowering several virus research diagnostic laboratories across the country to start testing. However, there is a need for more trained virologists, especially those with clinical experience. Pure scientists and physician scientists complement each other to meet challenges such as this.