The next-generation tools that will help us in a post-Covid world

28 Apr, 2021

In a piece originally published on RTÉ Brainstorm, Dr Andrew Kavanagh, a lecturer in the School of Food Science and Environmental Health at TU Dublin, explores the next-generation tools that will help us in a post-Covid world

Analysis: With the race to return to normality well and truly on, next-generation diagnostic tools such as chemical sensors and breathalysers will play as big a role as vaccines in helping us stay safe.

Buoyed on by the next generational vaccine efficacy data; this global pandemic may reach a point of inflection where (as of March 2021, with the ability of the vaccines to prevent transmission still to be determined) cases may still be high, but the vulnerable are shielded from the worst aspects of Covid-19 disease.

The race to this potential point of inflection has already started with governments around the world competing for these precious vaccine commodities.

Israel currently has the highest rate of vaccinations in the world and has introduced a green card system to allow for access of services to those who had their doses. The EU is considering a similar approach to allow for a cautious return to a safe and normal life.

It raises a number of questions. What will post inflection point pandemic life look like? Will we be able to travel or go to large events again? And how can technology aid us in this beyond the point of inflection?

Are there rapid, inexpensive, yet accurate technologies available to aid in safeguarding individuals during travel and at large gatherings in the future? Would you take a breathalyser with you to gain access to your favourite snug in your local?

From Radio 1's News At One, Dr Colm Henry, the HSE's Chief Clinical Officer and Dr Mary Favier, a Cork based GP and Covid 19 advisor to the ICGP, discuss the findings that one Covid case in 1,000 is picked up outdoors.

First, we must understand the current gold standard Covid-19 diagnostic test. When you look at your Covid tracker app, at the bottom, you will see the tests completed (and associated positive rate) for the last seven days.

The vast majority of tests currently in use in Ireland use the Polymerase Chain Reaction (PCR) laboratory method. PCR is an enzyme-mediated chain reaction that is used to selectively amplify viral genetic material from a very low starting point within a sample.

When a swab sample is submitted for analysis, Coronavirus RNA is first extracted from the virus by breaking the host down.

The reagents to kickstart the PCR reaction are added to amplify the viral RNA into a quantifiable amount of DNA.

Finally, a fluorescent "tag" molecule is added, which binds to the DNA molecule, producing unique fluorescent light as a result. Laboratory instrumentation diagnoses Covid-19 on the basis that a unique fluorescent light threshold has been met.

Despite its obvious benefits for pandemic control, one drawback of the PCR test is its complex laboratory sample processing with subsequent turnaround times for results taking days.

Rapid, less invasive and inexpensive diagnostic tests are becoming more and more mainstream, but is their benefit truly in the post point of inflection life that we all crave?

The US FDA has granted emergency usage authorisation of Covid-19 antigen tests, which diagnose a positive case by detecting the antigen (a toxin or foreign substance which induces an immune response in the body, i.e. coronavirus) itself.

Covid-19 antigen tests can be used outside of the laboratory and work by detecting protein(s) straight from a sample, typically producing a result within the hour. Point of care kits are available containing the necessary reagents to produce a coloured line, much like conventional pregnancy tests.

From Radio 1's Morning Ireland, Kingston Mills, Professor of Experimental Immunology at TCD, discusses his expert group's report on testing that has recommended to the Government the use of rapid testing for Covid-19.

Antigen tests do have a lower sensitivity compared to the gold standard PCR test, and despite the quicker result, some antigen tests still require the use of the much-maligned swab to retrieve a sample.

Are there even less-invasive, accurate and fast diagnostic tools available? Although not yet validated or commercially available, the answer is yes in the form of new chemical sensors for Covid-19.

In its simplest guise, a chemical sensor is one in which a material is used as a sensing agent and exhibits a selective interaction with a target species or analyte.

This specific molecular interaction between the sensing agent and the analyte produces a signal which can then be quantified via an appropriate detection scheme.

Multiple Covid-19 breathalysers are in development across the world. One such breathalyser (or a sensor) uses a hybrid gold/organic nano-particle surface as its sensing material.

When disease-specific compounds are exhaled from an infected person's breath, they interact with the sensing layer, producing a change in conductivity as a result. The change in conductivity is the measurable signal that can be used to detect and diagnose Covid-19 in this instance.

These rapid, non-invasive type sensing technologies have been developed in Finland and deployed across the world in trials, to detect Covid-19 disease within two minutes. A French hospital has also deployed breathalyser technology in a clinical trial.

So, could we use rapid diagnostic tests to gain access to large indoor events? Could we "swab/breathe n' go" in combination with other emerging technologies for international travel?

Augmented reality technology has already been used for safer, socially distanced airplane boarding at Curitiba airport in Brazil. A digital projection containing passenger boarding information is projected onto the terminal floor at a distance of two metres per passenger.

The digital projection tells passengers in what order to board the flight in a socially distant manner, with the same boarding information also reflected in the main aircraft to allow passengers to easily find their seat.

The race to return to normality is well and truly on, and we are told that vaccines will be another part of the toolbox to get us there.

With continued technology development, perhaps the toolbox will continue to swell as we strive for a safe return to normality.

Dr Andrew Kavanagh is a part-time lecturer in the School of Food Science and Environmental Health at TU Dublin

This article was originally published on RTÉ Brainstorm