Coronavirus accelerates a new age of diagnostics

From biosensor chips to wastewater epidemiology, the COVID-19 pandemic is accelerating the development of next-generation disease diagnostics.

Why it matters: If we’re going to stop a disease, we first have to know who has it and where. New technologies promise to provide doctors with more reliable intelligence about who in a community has a disease — and who is likely to get seriously ill.

What’s new: In response to COVID-19, a number of researchers and startups are pushing new diagnostic technologies that take advantage of cheaper and quicker genetic sequencing to provide far more accurate and rapid intelligence on just where COVID-19 is, and where it might be going.

  • «With the coronavirus, we are being catapulted into a new era,» says Milan Patel, the CEO of the DNA-based diagnostic company PathogenDx.

Some of the most promising new technologies involve what are called molecular electronics biosensor chips.

  • While the RT-PCR tests used for diagnosing active infections repeatedly copy specific viral sequences in a sample before they reach detectable levels, biosensors can detect the presence of viral genes in a sample as it is, producing results much more rapidly.
  • As it becomes cheaper, such technology holds the promise of being able to test an entire population for specific viruses, or even scan the physical environment for signs of viral contamination.
  • «Imagine an active surveillance system that pings offices, shops, airplanes, train stations to see if you have hot spots for a given pathogen or infectious disease,» says Barry Merriman, the co-founder of Roswell Biotechnologies, a startup leading the way on developing commercial biosensors for disease surveillance.

A cruder form of environmental surveillance is already under way — underground. Researchers in several cities have begun testing city sewage for the presence of SARS-CoV-2 viral RNA.

  • Sewage is unique as a diagnostic source in that it represents a near-universal sample of what is in — or coming out of — the community. As Mariana Matus, co-founder of the startup Biobot Analytics, told NPR: «Every person that is using the toilet has a voice.»

What to watch: Next-generation diagnostics can go beyond simply determining who is and isn’t infected. A number of researchers are working on tests that can identify biomarkers that might predict just how sick a COVID-19 patient will become.

  • Scientists at the New York University College of Dentistry have developeda mobile app that takes four biomarkers found in blood tests that were significantly elevated in COVID-19 patients — along with known risk factors like age and sex — and uses a machine-learning algorithm to produce a predicted severity score that runs from 0 to 100.
  • Quanterix has developed a highly sensitive antibody test capable of indicating early in a COVID-19 infection whether a patient is likely to develop an immune overreaction — called a cytokine storm — that can lead to a more severe case. «That allows for an entirely different insight on disease severity and treatment options,» says Kevin Hrusovsky, Quanterix’s CEO.

The catch: «Testing is a conservative field,» notes PathogenDx’s Patel. There’s good reason for that — we’ve already witnessed the damage that inaccurate tests can do — but it does mean that new technologies may be rolled out too slowly to make a major difference for the first wave of the pandemic.

The bottom line: COVID-19 struck us in a surprise attack, but better diagnostics could help ensure that we aren’t caught off guard again.


-Robots as a service

The robotics industry is looking to copy the successful software-as-a-service (SaaS) model as use of robots accelerates during the COVID-19 pandemic.

Why it matters: A major challenge to the spread of industrial robots has been their high initial cost. A model that charges companies regularly for robots based on use can offer better returns for robotics companies and widen their potential customer base.

What’s happening: Due to concerns over vulnerable supply chains and the potential for infection of human workers, the COVID-19 pandemic has spurred growth in the robotics sector.

  • 41% of executives surveyed by Ernst & Young say they expect to accelerate automation because of the pandemic.
  • Since mid-April, the performance of the ROBO index fund, which tracks companies in the automation sector, has outperformed the S&P 500.

Yes, but: There are still plenty of obstacles holding back the automation wave.

  • Traditionally, industrial robots have been sold or leased to companies. That requires a potentially large one-time capital expenditure that could discourage some customers.
  • It also discourages VCs, since hardware companies rarely enjoy the revenue multiples that SaaS startups do.

In response, robotics companies are pursuing a robotics as a service (RaaS) model, where customers essentially subscribe to industrial robots as they might a cloud service like AWS.

  • New customers find it easier to employ an industrial robot if they know they can pay for it over the course of months or longer based on use, says Austin Badger, the director of Silicon Valley Bank’s frontier tech program and the author of a new report on robotics.
  • «This leads to smaller and more mobile and specialized robots» that can service a number of industries,» he says.

What to watch: Better financing models help, but ultimately we’ll only see the robopocalypse if robots really can effectively replace human workers.

  • We’re not quite there yet, as an Information storyabout Apple’s struggles to expand the use of manufacturing robots in China demonstrates.

The bottom line: Everyone wants to be in the subscription business — including the bots.


-Food safety tracking through DNA barcodes

New research suggests that synthetic bacterial spores programmed with DNA barcodes could be used to track objects through a supply chain.

Why it matters: Each year, there are an estimated 48 million cases of food-borne illness in the U.S., causing 128,000 hospitalizations and 3,000 deaths. The technology could make it easier to trace a product’s path from supplier to customer in the event of food-borne contamination.

Background: When authorities see evidence of an outbreak of a food-borne illness like E. coli, they need to quickly identify the contaminated food and trace it back to its source.

  • Given the length of supply chains — and the fact that one head of industrial lettuce looks much like the rest — that can be incredibly challenging.

What’s happening: Researchers led by Jason Qian at Harvard Medical School developed a means of tagging items with synthetic spores that contain a unique DNA barcode.

  • The barcode, which is programmed with about 38 DNA base pairs, can indicate where an item originated, aiding any investigation.
  • Unlike UPC barcodes physically attached to packaging, the DNA barcode isencased in a tough spore and sprayed on a product. It can persist in diverse ecosystems within the item, ensuring it will survive from farm to table.
  • To read the barcode, researchers merely need to extract DNA from the product and run a detection assay on it.

Of note: If it feels weird to think about eating lettuce with engineered spores attached to it, know that we consume microbes with our food all the time — including phages sprayed on meat to prevent bacterial contamination.

The bottom line: The newest frontier of surveillance is the supermarket.


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