Expert comment on COVID-19 by David Wraith, Professor of Immunology and Director of the Institute of Immunology and Immunotherapy:
As pointed out by Mark Walport, Chief Exec of UKRI, the critical tools that we need to provide long-term control of the coronavirus (COVID19) infection are first an effective vaccine and second, a test to define the immune status of people who have or who may have been infected.
Various companies have recently reported development of tests for anti-SARS-CoV-2 antibodies, including the finger-prick assay that is to be used in the UK. At present these are not extensively tested but will give a +/- readout of immune status.
Scientific publications released this week, show that it will be possible to establish a more accurate way to detect anti-SARS-CoV-2 antibodies. This is important because antibody tests will give us a safe way to judge whether or not someone is infected since we now know that antibodies appear shortly after symptoms.
This will allow us to distinguish those people who have had SARS-CoV-2 versus the many other bugs that are flying around at this time of year and can give similar symptoms. This is a key point: the information provided will tell us who among individuals in our NHS and other essential workforces are immune to the virus and, therefore, safe to return to their vital work.
For many people, it is difficult to know whether they have had a cold, flu or SARS-CoV-2: if these individuals don’t need to self-isolate for long periods then they can return to the critical workforce confident that they have built up immunity to the infection. However, a more sophisticated test than those currently available is required to assess the type and strength of immunity that correlates with effective and long-term protection.
Furthermore, when a vaccine for this virus comes along, we must have a validated and quantitative assay for us to test the vaccine. In the meantime, we need a validated test to identify individuals who make strong immune responses who could donate antibodies to those who are severely affected. We could also isolate antibody genes from such strong responders to reproduce their antibodies in the laboratory and use them as drugs for immunotherapy of critically ill patients.
Much work still needs to be done to optimise the sensitivity, validate the assay and put this onto a platform that can be used readily. This work is critical and urgent and Universities, particularly UK universities, will be key. We in Birmingham have the expertise required for this and will work with industry to do all that is required to produce an effective test.