The coronavirus pandemic has touched every corner of the world in unprecedented ways, including Latin America. Chile, for example, had more than 300,000 cases of COVID-19, the disease caused by the SARS-CoV-2 virus, as of July. And as cases continue to rise, the need for quick, effective, and accurate testing is paramount.
Two alumni of the Pew Latin American Fellows Program in the Biomedical Sciences are part of a critical effort to boost testing in Chile. Gloria Arriagada, a 2007 fellow, and Fernando Bustos, a 2015 fellow, are researchers and professors at Andrés Bello University in Santiago. Recently, they rapidly converted their university labs to run patient samples in order to identify the presence of SARS-CoV-2 infections.
These two experts recently spoke with Pew about the challenges they’ve faced in responding to this public health crisis and its impact on their region. Their responses have been edited for length and clarity.
What was your research focus before the pandemic and what motivated you to shift to COVID-19 testing?
Arriagada: Before the pandemic, my research focused on the relationship between viruses and their hosts. I was specifically looking at endogenous retroviruses—viral genomes that have integrated into our DNA—and how they can affect cells and contribute to disease.
Our motivation to shift to COVID-19 testing was in response to the Chilean government’s call for greater testing capacity. Many hospitals around the country are near capacity attending to COVID-19 patients, requiring them to outsource their testing operations to outside labs. Understanding that the national health care system could not carry this burden alone, the government sought university labs with the right expertise and equipment—including ours—to help meet the demand.
Bustos: My usual research focuses on genes associated with autism spectrum disorder. For example, to learn more about the role of certain genes, I manipulate them using the gene-editing technology CRISPR-Cas9, to see if the resulting phenotype resembles autism.
I returned to Chile in February 2019 after completing my postdoctoral fellowship at the Constantine-Paton Lab at the Massachusetts Institute of Technology (MIT). To put the current testing scenario into perspective, the Broad Institute of MIT and Harvard has the capacity to run about 35,000 COVID-19 tests each day. Comparing this with Chile’s daily rate of 12,000-21,000 tests nationwide, we wanted to bolster COVID-19 testing and provide accurate diagnoses as quickly as possible.
What are some of the challenges your labs have faced while converting to COVID-19 testing?
Arriagada: Because our labs focus on academic research instead of running clinical tests, we have faced several challenges in shifting to diagnostic work. First, we had to obtain clearance from the Chilean government and hit the ground running with testing in a matter of two weeks. Second, we have faced administrative barriers because we must input data manually. This limits us to returning about 160 tests each day, but also ensures we can provide same-day results.
But perhaps the greatest challenge is tracking patient data and ensuring accuracy of results. For example, you can run into cross-contamination when one of the samples you’re extracting is highly positive and it only takes a tiny drop of the positive sample to alter the negative sample, which can lead to inaccurate results. Knowing this, taking our time to carefully run and review samples is vital.
Bustos: Another great challenge is that for many years, there has been a lack of investment in science and research in our country. Therefore, our lab and others in Chile can be limited in what we’re able to do and how quickly we can do it because we do not always have the resources we need. As a result, we’ve had no choice but to be innovative.
For instance, when we no longer had access to N95 medical masks, we had to find ways to protect ourselves from infection while working. Our answer was found in the work of another member of Pew’s biomedical network, Manu Prakash, a 2013 Pew biomedical scholar and associate professor at Stanford University. He developed the “Pneumask,” a modified snorkel mask, as a form of personal protective equipment or PPE. (More about the Pneumask on page 30.)
Prakash published the instructions to make the mask online—for free—and we were able to print the ventilation port, which acts as a swap-in replacement for the snorkel tube, using a 3D printer. Fortunately, we had recently purchased a 3D printer with funding from Pew, and this mask was a great alternative that made our work more comfortable.
As another example, nationwide, we have had trouble finding sufficient magnetic racks in stock, and, if found, they have been extremely expensive (about US$500 to US$800). These racks are an important tool for isolating and purifying viral genomes from samples so we could run COVID-19 tests. Instead, we designed a similar version that we are able to reproduce with our 3D printer at a lower cost (about US$50) and distribute to diagnostics labs in hospitals and universities across the country.
How has this testing affected your local community?
Arriagada: I believe our testing efforts have made a huge impact, not only on the country’s health system, but also to help Chileans understand the significant contributions that scientists can provide. This unprecedented pandemic may help build a case for greater investment in research and science moving forward.
Bustos: When we think about how this pandemic can affect entire families, neighborhoods, or even the region at large, it reminds us of the difference we’re making to ensure people aren’t circulating the virus and potentially harming others. For instance, many families in less affluent neighborhoods have as many as 20 or 30 people under one roof, meaning that if one person contracts COVID-19, the entire household will likely become infected. So each individual result matters and can have a significant impact on the entire community.
As part of the Pew network, I’ve met many talented scientists working to advance foundational science and health. Some have inspired me to consider new research interests, especially as a result of the current pandemic, including the need for faster detection technologies for emerging viruses, and greater production of essential resources to support science throughout Chile.
This article was previously published on pewtrusts.org and appears in this issue of Trust Magazine.