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 In April, when a key enzyme couldn't be delivered to his shuttered
laboratory, Northwestern University researcher Thomas McDade hunted
for the package across the empty campus near Chicago, finally
locating it at a loading dock. To verify the test’s accuracy, the
biological anthropologist and his colleague, pharmacologist Alexis
Demonbreun, asked friends and family if they’d be willing to spot
them some blood. McDade took a sample from his wife over their
kitchen table.
The scientists' goal is to look for people with coronavirus
antibodies - proteins that indicate possible immunity - in
Chicago-area neighborhoods with vastly different death rates. They
want to study why the novel coronavirus is deadlier for some groups,
such as African Americans and Latinos.
In early May, the team arrived at a test they believed worked. “All
the pieces are in place,” McDade wrote in an email to colleagues on
May 20. “All we need now is funding to roll it out.”
Across the United States, academic and regional government
researchers have embarked on antibody testing initiatives to
determine how the coronavirus is spreading, how deadly it is and who
is likely to suffer its worst effects. The results could help return
the country to normalcy, scientists say, by revealing who is still
susceptible and guiding prevention efforts and lockdown decisions..
Unlike clinicians focused mainly on diagnosing individual patients,
these scientists study states, communities and other subgroups. But
their jobs are made much harder, they say, in the absence of
substantial federal funding, standards and coordination.
“It would be better to have a unified information sharing system, a
unified testing strategy, and the resources to execute it everywhere
in the country,” said Dr. Joe DeRisi, co-president of the Chan
Zuckerberg Biohub, a medical research nonprofit in San Francisco.
Instead, the success of coronavirus antibody studies often depends
on luck, personal commitment and whatever resources researchers can
muster, according to Reuters interviews with more than 20
scientists, public health officials and others.
In a statement, Mia Heck, a spokeswoman for the Department of Health
and Human Services, said the administration of President Donald
Trump “continues to improve America’s testing capabilities and
capacity. As part of these efforts, the Administration is working
with diagnostics companies and academic researchers to develop the
next generation of tests, testing platforms, and testing protocols.
Antibody testing is a particularly important area of ongoing
inquiry.”
Of the more than $35 billion allocated by the federal government for
COVID-19 testing, relatively little has been earmarked for antibody
testing and research. HHS has focused much more on diagnostic
testing, which reveals active infections, as opposed to antibody
surveillance, which seeks to identify people who have ever been
infected with COVID-19, even if they showed no symptoms.
However, $306 million of the federal money has been set aside for
the National Cancer Institute to expand antibody testing capacity
and fund research projects, according to a public presentation last
month by Dr. Dinah Singer, the institute's deputy director of
scientific strategy and development. The institute will award money
to private-sector clinical researchers and academic institutions,
creating a coordinating center for sharing resources and data.
The U.S. Centers for Disease Control and Prevention, which is
overseen by HHS, plans to test for antibodies in 325,000 samples
from blood donors in 25 major metropolitan regions over 18 months,
beginning this summer.
ALL OVER THE MAP
So far, large-scale blood antibody tests, both by academic
researchers and local or state governments, indicate that most
people remain vulnerable to coronavirus infection. But results vary
- sometimes widely.
Researchers at Massachusetts General Hospital in Boston did one
study based on a street corner in a Chelsea, Massachusetts,
neighborhood with high COVID-19 hospitalization rates, finding that
31.5% of people had antibodies. In another study across several
Boston neighborhoods, the same researchers found 10%.
New York state has tested more than 50,000 people since April,
finding antibodies in 12.3% of the population statewide but 20% in
New York City, according to Jonah Bruno, a state Department of
Health spokesman.
Several antibody studies have been conducted in more affluent areas,
where funding was more readily available. Academics from three
universities in the San Francisco Bay Area, for instance, have
launched at least four antibody blood test initiatives.
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In Bolinas, California, a team from the University of California,
San Francisco (UCSF), tested more than 1,800 people for coronavirus
and its antibodies after locals crowdfunded the cost. The isolated
beach community in Marin County, one of the country’s richest, is
overwhelmingly white. Diagnostic testing in April showed zero
infections, and antibody testing showed between zero and 0.3% had
ever been infected.
“I wouldn’t have necessarily chosen Bolinas as the one community to test,” said
Dr. Matt Willis, Marin County’s public health officer.
With little standardization, some early efforts at antibody testing have proved
inconsistent, onerous and of questionable quality.
A study in April out of Stanford University found that the number of people
positive for COVID-19 antibodies in Santa Clara County, California, was more
than 50 times the number of infections confirmed through diagnostic testing.
Critics derided the results, in part because subjects were recruited via
Facebook, potentially skewing participation toward those who had experienced
symptoms. The authors argued they had adjusted for selection bias, but
nevertheless revised their estimates downward.
Researchers seeking to make their own tests can face difficulty obtaining
ingredients like proteins, test plates and color-changing enzymes.
The quasi-public Biodefense and Emerging Infections Resources (BEI), funded by
the National Institute of Allergy and Infectious Diseases (NIAID), provides free
materials to registered researchers looking to make tests, including those for
COVID-19 antibodies. But it’s first come, first served, and some scientists say
they have waited weeks for the materials they need.
About 1,300 researchers have applied for registration at BEI since February -
more than 90% for COVID-19 research - compared to a normal rate of about 70
applicants per month, a NIAID spokeswoman said. She said that, in general,
registration takes three days and materials are shipped out within another
three.
Even with the proper materials in hand, scientists say it can be difficult to
compare one researcher’s results with another’s.
“If I measure antibodies in my lab, using a method I cobbled together from
available sources, and someone else cobbles theirs together with a different
suite of sources, we’re going to get different results,” said Eleanor Brindle, a
researcher at the University of Washington who is studying whether nursing
mothers can pass the virus or its antibodies to their infants.
GOOD FORTUNE AND INGENUITY
McDade got lucky. He was able to join forces with Northwestern pharmacologist
Demonbreun, who had a key ingredient on hand and helped him quickly assemble a
blood antibody test.
The university helped pay for the initial work, and the team has applied for
more funding. Decisions like that can take a while, given the competition for
research dollars and the challenges posed by COVID-19.
“These days, when we’re wrestling with issues about how to bring research back
to campus, how to plan for a fall quarter that brings students back to campus,
we’ve really been swamped,” said Milan Mrksich, Northwestern’s vice president of
research.
The team sought support from several other potential funders, so far without
success. But last month, they secured a $200,000 grant from the National Science
Foundation.
Even that wasn’t easy: The NSF initially told McDade the project was not a good
fit, he said. He tweaked the proposal in May, focusing it on potential
scientific innovations. That brought “the work more in line with NSF’s mission,”
said agency spokesman Michael England, making it worth the investment.
McDade said the NSF money is enough to test 3,000 people - less than a third of
the goal - but he hopes it can help leverage more funding. He just wishes the
federal government would open the spigots more widely.
“Why are academics like me trying to find little pots of money to do what we
think is a basic public health surveillance effort?” he said. “It’s ludicrous.”
(Nick Brown reported from New York; Editing by Michele Gershberg and Julie
Marquis)
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