Around the world, scientists are volunteering to help battle the coronavirus pandemic in whatever way they can. Many are retooling academic laboratories into testing centres — including researchers at the Francis Crick Institute in London, a high-profile biomedical-research facility.
Nature spoke to Charlie Swanton, who leads a group studying cancer evolution at the Crick, and is also a consultant oncologist at the University College London Hospitals (UCLH), about what that involved.
How did this start?
About four weeks ago it was clear that London was going to lock down and labs were going to be left empty. Scientists didn’t want to sit at home and read despondent reports about increases in deaths. It struck many of us that a reason for the inability to control viral spread in Italy, compared with South Korea, was the lack of rapid testing.
We reached out to UCLH and they said there was an unmet need for staff and patient testing. So researchers set up a working group to convert laboratories here into a rapid real-time polymerase chain reaction (RT-PCR) screening facility for healthcare workers and patients. Five large laboratories here have now been repurposed. Everybody wanted to help.
What does it take to retool a cancer lab into a diagnostic testing facility?
You need the right people, laboratory infrastructure and reagents. We have here BSL-3 (biosafety level 3) facilities and BSL-3 trained staff, 10–15 RT-PCR machines all of the same make, environments to extract RNA from viral samples, and space.
The biggest problem was a potentially limited supply of the kits used to extract viral RNA. With our RNA biologists we developed our own extraction kit in-house; we’ll publish the protocols on the Crick’s website. We bought industrial quantities of guanidinium lysis buffer [a chemical that breaks the virus’s envelope apart and preserves RNA for extraction], enough for 100,000 tests, I think. And we repurposed a lot of the software tools that we already use to track patients’ cancer and blood samples to help us track COVID-19 tests, with a web-based reporting tool so that we can aim for a 24-hour turnaround time from sample to result.
We get swabs couriered to us from UCLH every day: they’re taken up in an isolated coronavirus-specific lift and barcoded; the virus is inactivated, the PCR test done, and they get reported back through a messaging app to medical staff.
How did you get your testing protocol approved?
We were very fortunate to have an accredited testing facility, called Health Services Laboratories, close to us, which is allied with UCLH. They oversaw our test, benchmarked it against their assay, and signed it off.
How have scientists and other staff adapted?
This is a new way of working for many of our scientists and staff. What worries me most of all is their safety, particularly when handling the samples for inactivating the virus. So many people have helped us with safety protocols, including Steve Gamblin, our director of scientific platforms, and Eleni Nastouli, a clinical virologist at University College Hospital. Much of this diagnostic work is repetitive and quite boring, but the stakes are high. It’s been extraordinary to see the selflessness of scientists here to help in the bigger effort of getting doctors and nurses back to the front line.
How many tests are you doing?
We’re doing low hundreds of tests per day at the moment, and hope to get up to 500–1,000 tests per day. That’s small-scale: a centralized diagnostic facility might do 50,000 tests a day. [The United Kingdom is currently performing around 16,000 tests each day. The government has set a target of more than 100,000 tests a day by the end of April.] But I hope it will be a valuable resource for our local patients, doctors and nurses.
Public Health England, a national agency, has been criticized for not asking academic labs to help with tests. Could they have asked you?
I do understand why Public Health England (PHE) want large, scalable testing facilities and the desire to centralize and standardize the tests. It is difficult to control the quality of tests in multiple local labs. But to be clear, PHE were aware of what we doing and nobody stopped us — and it’s the same with other UK academic labs.