If the big scientific institutes in Portugal all go forward with covid-19 diagnosis tests, the scientific community of the country could secure over ten thousand tests per day. The current capacity in the country is four thousand per day.
What if instead of concentrating everything in just one scientific research institute in Portugal we could have many scientists in their own labs - from Minho to Algarve - running novel coronavirus diagnosis tests? There’s a wave of Portuguese researchers wanting to help in the fight against the pandemic, and it’s spreading to the whole country. “If all big institutes decide to go ahead, we’ll secure the tests we need”, says Vasco M.Barreto, a biologist with a doctorate in imunology from CEDOC, the center of study for chronic diseases in the Medical Science Faculty at Universidade Nova de Lisboa. “The idea is so obvious to us, that we find the fact that none of our governing authorities remembered it says a lot about the weak scientific culture among the country’s political elites”.
How many science research institutes in Portugal are involved in the iniciative? And how many tests could be done per day in their laboratories? According to rough estimates, there are at least 14 institutions with a capacity for 800 tests per day each - that would amount to over ten thousand: “Admitting all of us join in and get the required financing”, (around 30 euros or less per test), Vasco Barreto points out, “based on the more than 360 qualified volunteers the movement I’m connected to has managed to gather, and on an estimate that’s below rechearch units’ existing equipment, we could lead to a big increase in the number of daily tests”.
To get an idea of the difference ten thousand daily tests could make, the current test stock in Portugal amounts to 27 thousand - ten thousand in SNS (National Health Service), and 17 thousand in the private sector. That’s according to prime minister António Costa’s declarations on Parliament on Tuesday, when he said that 280 thousand tests have been order. The first 80 thousand should arrive by Saturday, March 29.
So far, health authorities have been able to do 2500 tests per day in SNS and 1500 more in the private services. In all these tests, the ones that are in stock and the ones that were ordered, there’s always reference to detecting the genetic material of the virus, (ARN), using a polymerase chain reaction technique, (PCR). They only come out positive during the infection.
A spontaneous movement
Vasco Barreto tells us how this initiative to fight covid-19 was born within the Portuguese scientific community. “I believe many scientists came up with the same idea when they realized the SARS-Cov-2 tests would be fundamental”. This is because one of the strategies to combat the pandemic goes through running many tests to quickly determine who’s infected and who isn’t. In the words of Tedros Adhanom Ghebreyesus, WHO’s general director, we need to “test, test, and test”.
Vasco Barreto brought the topic up with his colleagues and friends on March 11. There was an idea for scientists to help the country with diagnosis tests. “I suggested there’s an enormous capacity in the various research units - both in terms of human resources and machinery - to do these tests”. The idea started taking the right shape. “The discussion quickly spread, including Maria Manuel Mota, from IMM (Institute of Molecular Medicine), which was already making an effort to test virus samples collected from infected patients”. Many others joined the discussion, like Mónia Bettencourt-Dias, director of IGC (Gulbenkian Science Institute), Carlos Penha Gonçalves from IGC, Carlos Ribeiro from the Champalimaud Foundation, and António Jacinto from CEDOC. “There was a frenzy of messages, video calls and phone calls, constantly marked by shared links to new studies on covid-19 that have been coming out very fast”.
This central nucleus of 4 institutions from the Lisbon area - CEDOC, IGC, IMM and the Champalimaud Foundation - was joined by the Faculty of Science and Technology at Universidade Nova de Lisboa, the Institute of Chemical and Biological Technology and the Institute of Hygiene and Tropical Medicine. The movement is forming in the Lisbon area, ans it’s also spreading to other scientific institutes, such as the Institute of Bioengineering and Biosciences at IST (Instituto Superior Técnico), and the Institute of Experimental and Technological Biology.
But the movement isn’t confined to the Lisbon area. The institutions looking to contribute with more tests are all over the country: The Research Institute of Life Sciences and Health at Universidade do Minho in Braga, the Institute of Research and Investigation on Health Innovation at Universidade do Porto, the Biomedicine Institute at Universidade de Aveiro, the Center for Neuroscience and Celular Biology at Universidade de Coimbra, and the Center for Biomedic Research at Universidade do Algarve.
There have also been two independent initiatives to do tests from the Medicine Faculty at Universidade de Coimbra, and from the Faculty of Pharmacy at Universidade de Lisboa.
All totaled, there are at least 16 scientific institutions engaged in this effort. “Many projects boosted by scientists came up spontaneously all over the country”, says Vasco Barreto, “we are organizing a list of volunteer scientists from all over the country who could be mobilized for a range of tasks, even in institutes they don’t work for”.
Own kit formulas
At IMM, for example, Maria Mota had also put out a call on March 12 for researchers to create their own diagnosis kit. Following a protocol set by WHO for diagnosis tests, the researchers at IMM adapted the “formulas”using reagents bought in Portugal. The reagents, which may now sell out due to high demand, are essential to the entire process, both for extracting the virus’ genetic material, and for detecting the virus. Let’s think of it as a cake recipe calling for a specific brand of margarine. In this case, the researchers used another brand of margarine, (the reagents), and then had to make sure the cake turned out right.
This diagnosis kit with a home sourced ingredients, (rather than an imported ones) has been certified by INSA, (Instituto Nacional de Saúde Dr.Ricardo Jorge), the country’s reference testing laboratory. The final result validation adjustments are being made, and according to Maria Mota’s declarations to Público a few days ago, IMM hopes to start with 300 tests per day and reach 1000 tests per day very soon. Excluding all the volunteer human resources, each test will cost around 30 euros.
João Gonçalves from the Faculty of Pharmacy at Universidade de Lisboa tells us they’ve developed a diagnosis kit with their own formula. “We assemble the kit, but we buy the reagents from foreign companies”. This test has also been certified by INSA, and just like IMM’s kit, it is able to detect the virus’ genetic material. “We started the process on our own two weeks ago, but at the moment we’re collaborating with other faculties and institutes to transfer know-how”, the researcher adds, saying that at the same time they’re looking to innovate and produce cheaper and more efficient tests. “We’re aiming for a maximum capacity of 700 tests per day, but at the moment our capacity is 350 tests per day”. To clear doubts, João Gonçalves reminds no one should go directly to these institutions for testing. “As research institutes we don’t do sample collection. The samples have to come through the SNS, (National Health Service). Any samples requested by the state will have to be paid through the SNS”. The team has already contacted the Regional Health Administration - (ARS) in Lisboa e Vale do Tejo, (Lisbon and Tagus Valley), for coordination. “ARS has to coordinate everything, so we can know which scientific laboratories are available to receive samples”.
Another diagnosis test formula comes from the Research Institute of Life Sciences and Health at Universidade do Minho. “It hasn’t been certified yet, but the protocol is based on WHO’s recommendations, and we’re in the last stage of validation”, says Joana Almeida Palha, a neuroscientis working in that institute, and the vice-president of the School of Medicine at Universidade do Minho. “A large part of the reagents used for this test is made in Portugal”, she adds. “For now we are validating the tests based in PCR, (to detect the virus’ genetic material). We have a capacity for 300 test per day, and a limiting factor could be the eventual lack of reagents”, says Joana Palha, explaining the laboratories at her institute are also collaborating with the hospital in Braga to increase the diagnosis capacity with the extraction of nucleic acids and diagnosis by PCR.
“There is a common understanding”, Joana Palha concludes about this movement throughout the country, “that effort optimization is important”. This effort goes beyond diagnosis tests. “Researchers are all willing to help, all over the country, in terms of diagnoses, equipment, and volunteering”, points out Mónica Bettencourt-Dias, including here a public communication on covid-19, and the understanding of many facets of this new relation between ourselves and the virus. “We are also sending volunteers to hospitals, to help them with more manpower”.
Going back to Vasco Barreto at CEDOC, it’s estimated they could do 500 to 800 tests per day. For now this center will start with IMM’s testing protocol. “It’s what we recommend to all institutes”, explains Vasco Barreto. “We will still have a small team working to develop a simpler alternative method we hope to validate soon to replace IMM’s method”. Vasco Barreto says he’s moved by this movement among the scientific community, “because scientists are generally individualists”. He still considers the Foundation for Science and Technology, (FCT) could assume a coordinating role. “A project of this nature, with the scale we want it to have, needs financing and today we have many institutions running out of funds. There are many financing sources to explore, from patrons to crowdfunding, but it would make sense to have the state finance part of the effort. It would be a good use of public funds. Now what’s left to know is whether the state wants to use the resources it already finances, or send all scientists home to write drafts on the chemotaxis of fruit fly larvae, or on the genetics of alopecia as an economy destroying virus”.