Nicolas Vergauwe, chief executive officer of miDiagnostics, shares his thoughts on how the global diagnostic landscape should change in response to COVID-19.
The question of when and how to test those infected with COVID-19 has become of paramount importance as the pandemic has gained momentum across the world, with over four million cases reported to date. International governments are struggling to cope with the demand for increased testing capacity within already stretched healthcare systems. The industry has therefore been working tirelessly to develop and supply clinicians with novel tests to try and cope with the backlog.
Yet this difficulty in addressing testing capacity is prompting a more fundamental discussion on whether our diagnostics testing model is fit for purpose, especially to play a critical role in the early onset of a disease outbreak. As it stands, the current model focuses on sending collected samples to a set number of specialised facilities. Separating the testing centre from the place where the sample is collected introduces significant delays, which prohibits rapid isolation and outbreak containment. Furthermore, this means that if there are any logistical bottlenecks, we face an even longer wait for results. The discrepancies between different national systems has been well-documented, with South Korea and Germany praised for screening a large proportion of their populations in a short space of time, whilst others, notably the US, have been trailing behind.
So what if, instead of the firefighting we are doing now, we were given the tools that enabled us to anticipate the rapid spread of the next virus? Doing this requires two things: first, a testing system that can be used anywhere, at any time, by any person. Think of the speed at which an outbreak could be contained if testing capabilities were available, not only in all existing healthcare settings such as regional hospitals and physicians’ offices, but also at pharmacies and critical transportation hubs such as airports, train stations and at border controls. Second, you have to ensure that you can identify a potential pandemic-causing pathogen. To address this, you would need a screening system that can not only tell you whether the flu-like symptoms the patient is presenting with are actually the result of flu or not, but also if they have something more serious. In other words, you need to be able to analyse multiple pathogens at the same time in a single test, so called “multiplexing” or “syndromic testing.”
Furthermore, research suggests that individuals infected with COVID-19 who haven’t yet shown symptoms are at their most infectious just before these symptoms arise. If we were able to quickly and efficiently test those who could have possibly been infected, we could potentially limit the further spread and enable quicker containment.
At miDiagnostics we are working hard on a new type of test card that offer these multiplex test capabilities for various decentralised or remote settings, rapidly and at a low cost. An easily accessible sample is taken from a patient, such as a nasal swab or drops of blood, and loaded directly onto a test card. The test card contains a nano-fluidic processor on a silicon chip that takes care of all the sample processing, followed by read-out.
Our test differs from current decentralised rapid diagnostic tests, which can produce quick results during outbreaks, but which also requires a reconfirmation by a test performed in a lab. The low cost for each of our tests would also make them suitable for any type of health centre across the world, even those without access to expensive lab facilities. This is particularly important for COVID-19, which is not only hitting the Western world hard, but also countries that are already suffering under a variety of endemic and pandemic threats. The technology could also be used at transportation hubs or for use at a patient’s home.
The diagnostics industry has responded with impressive speed and ingenuity to COVID-19 and governments are working tirelessly to make the right decisions on how to contain its spread. Yet once this crisis has passed, there will be important questions to ask as to how we can adapt our healthcare systems to better anticipate such pandemics. At miDiagnostics we are convinced that we need to offer alternative technologies that go significantly beyond what is possible today to equip clinicians, healthcare workers and patients with accurate and speedy diagnostic tools at their fingertips. We hope to send a wake-up call to the industry and be part of a much-needed paradigm shift in the way countries respond to future outbreaks.