Transcript: Episode 7

How close are we to finding a cure?

Vivienne Parry  0:05  
Welcome to a special edition of Coronavirus. The whole story made especially for the Cheltenham Science Festival at home by UCL Minds. I'm Vivienne Parry, a writer, broadcaster, UCL alumna and host of this podcast. We're looking at the whole story of Coronavirus, recognising the critical insights that UCL researchers from every discipline can contribute to our understanding of Coronavirus and its impact. If you're joining us for the first time today, we're very pleased to have you on board. If you want to catch up with previous episodes, which explore life and intensive care, impact on education, and even what 19th century yellow fever outbreaks in Buenos Aires can tell us about COVID. We'll be giving you details of how to find them later. In this edition, we're going to be looking at how we tackle and track the virus. what's already clear is going to take more than a single silver bullet to defeat Corona. And my four guests today each have a special part to play in its downfall. So let me introduce them to you Suzy Farid is professor of Biochemical Engineering and co director of the future targeted healthcare manufacturing hub at UCL. She leads research on novel software based decisional tools to plan the best route to manufacture new buyer therapeutic candidates. Dr. Richard Angell is principal research associate in the translational research office of UCL School of Pharmacy and set up their drug discovery unit. His job is to help researchers at UCL convert interesting science into new drug discovery approaches. Now their sites are firmly focused on COVID-19. Francois Balloux is director of the UCL Genetics Institute and also professor of Computational Systems Biology at UCL. He's recently published On the genome sequence of the size code, v2 virus, and it's particularly interested in viral evolution. Finally, Judy Brewer, professor of Biology, whose specialty is pathogen sequencing, reading microbes genetic code, letter by letter. And I should say that Judy and I last met during the last pandemic, when we sat on a committee talking about just this kind of thing together. So let's start with you, Judy. The knowledge of the virus itself, how does knowing the viruses genome help us?

Judith Breuer  2:36  
Well, if we have the viral genome, and we have, and we are able to sequence it, that gives us all the letters that are in the genome. And there are lots of things we can do with that. We can understand how those letters translate into proteins and that gives us information on what the virus uses to bind to receptors, how the virus gets into cells, the machinery that the virus uses to reproduce itself. But we can also use the letters of the genome just to compare between viruses. And we can ask is one virus the same as another are the letters the same as the as the virus next door. And that gives us very powerful tools to actually track what's happening to the virus over time. So we can use it both for the biology and understanding the biology and the proteins. But we can also use it for understanding the epidemiology of the virus

Vivienne Parry  3:38  
because it's not the only Corona viruses it so that we have, I think there's something like seven Corona viruses. Three are dead nasty, but for a just ubiquitous in the human population, we experience them as colds. So does knowledge of the demon sequence help you track down which one is which

Judith Breuer  4:00  
Well, yes, I mean, we can use the genome sequence to design tests. And it's very important for understanding viruses and diseases that they cause to be able to detect them. So we you know, that the normal sequences of the of the Coronavirus, this is circulating generally is different from the virus sequence for the size COVID for COVID-19. And we can design tests that will distinguish between these viruses. And that allows us to say who what the infection is in an individual person. And you're quite right that we have tests in fact for the see what we call the seasonal Corona viruses that are circulating and they come back every winter. And we use a test called PCR which detects this these viruses and most of the time, we don't find that they cause very many problems except occasionally in people whose immune systems are compromised. And then you mentioned to other virus verses that have caused problems or more problems in humans, and that's the MERS coronavirus, and the SARS coronavirus, which appeared in the early 2000s. And again, we can use the genomes of those viruses to design tests that allow us to detect the virus and decide which virus is causing the infection that we're interested in.

Vivienne Parry  5:22  
So the tests that you're developing are the kind that tell you have I had it or have I got it right now rather, rather than have I had it?

Judith Breuer  5:33  
Absolutely. People will have heard of the PCR test or the antigen test and the the PCR test or an antigen test tells you whether you've got the infection at the time, and then we use antibody tests to decide whether we've had infection in the past.

Vivienne Parry  5:49  
Okay, so we've got the basic straight now there, Judy, tell us what you're doing at UCL.

Judith Breuer  5:55  
Well, I'm involved in a number of studies and one of the very exciting things that's happened with this outbreak that this this pandemic is that we have really started to use new technology to try and fine tune how we control the virus. And one of the things that we've started doing as a country is a national project called the cog UK project, which sequences, all the viruses that we can get hold of to look at the genetic code and look at the number of the letters that make up each sequence. And that helps us to link one sequence to another and that's giving us information about how the virus is spreading in this country, where the viruses first came from, when they first came into the country and how they are mutating and and that will give us information that will feed into vaccine design. It will feed into understanding whether drugs are causing mutations. It will tell us whether the virus is becoming more virulent or less virulent. And it will also help us manage things like after lockdown, we'll be able to say whether there's been a particular outbreak in one part of the country, or whether it's come from another part of the country and spread, because someone has brought their virus with them. And that will help us in this effort to try and fine tune how we control the virus in the months to come.

Vivienne Parry  7:25  
So

Unknown Speaker  7:26  
very useful for tracking.

Vivienne Parry  7:30  
Absolutely. The outbreak. But explain something which I think lots of people find difficult to understand. So we couldn't start making tests, of course, until we had the genome sequence which came from China. So we've only been had that since January. Why can't we have the kind of test which you just take a swab from your mouth, and then it's a bit like a pregnancy test. Why is it so difficult to do a test

Judith Breuer  8:00  
Well, you know, making a test requires that you have reagents that can be quality controlled, they have to be sensitive, they have to pick the virus up. They also have to be very specific, They mustn't pick up viruses that are not the not the COVID virus. And getting that right is really quite difficult. And you need all the ingredients, you need to test all the ingredients and optimise all the ingredients, not just the virus itself, but all the buffers and, and all the other things that go into making the test work needs to be fine tuned and tested. And, and getting that right can be quite problematic. I mean, you know, we all want a test that we can just do at the bedside or do it in our homes, but actually point of care tests which we what we call them are very difficult to get right. And we've only really had good point of care tests in the last, you know, three or four years in fact, so producing them for COVID-19 in the space of three months has been an absolutely extraordinary effort. And we're now beginning to get those tests. But you can imagine that, you know, optimising everything to get those tests working has just been a really Herculean task.

Vivienne Parry  9:18  
I mean, people have put extraordinary effort into it. It's in in some ways, it's unfortunate because perhaps people look at the media, and they see testing as a failed exercise. And yet, the amount of work that's going on at UCL and and other places has been extraordinary. What have been your most significant challenges?

Judith Breuer  9:37  
I think the most significant challenges work trying to get tests that worked quickly and you know, are in a pandemic, there is usually a sort of master plan that we tend to follow and we follow that master plan and and that includes rolling out tests that have been developed in one lab and then rolling them out to other labs. That really didn't work. For this, it was spreading so fast and was causing so much of a problem that that traditional master plan that traditional roadmap didn't work. And what we really needed to do was to put lots of different people together, to work to, to develop tests all at the same time. And I think that that has been the challenge that we've sort of learned from our mistakes about and we just didn't get our test development up fast enough in the UK. And I think that's something that we will learn for the for the future. I mean, testing is something that we have at our disposal, which was not present in the past, you know, in the 1918 pandemic, for example, in previous influenza pandemics, we have not had the rapid test stabilities that we've got now. And these are incredibly powerful tools that can give us enormous ability to stratify to to target how we manage these pandemics, so that we can get away from the sort of blunt tool of having to lock everybody up, what we'd like to be able to do is really just, you know, keep those people who are infected away. And to do that we need these these very precise tools and, and developing those rapidly has been a really big challenge. We've not seen yet

Vivienne Parry  11:18  
partly because of the problems with testing, a very extensive testing of population who appear not to have been exposed, but actually some of them probably will have been exposed and not had any symptoms. What are your thoughts on that? How many? What's the percentage of population that you think have been exposed to this virus?

Judith Breuer  11:42  
Well, you know, as you say, we don't know because we don't have the test. So this is, you know, this is based on sort of slightly guesswork and modelling work that people have done, but you know, depending on the area of the country, it's somewhere between 510 percent and possibly even as high as 15%. In some parts of the world, whether or in some parts of the country where there's been more of more infection, so it's going to be very low wherever it is. And but until we have good antibody tests, and we can roll those out at scale, we can't really make, you know, we can't really decide exactly how many people have had that have had the infection. But it will be key, I mean, to allowing us all to move about, certainly in the short term, we will be key to know who's had the infection and who may then have a measure of immunity.

Vivienne Parry  12:39  
And of course, that's another big $64,000 question that we don't know the answer to. Let me turn out to Francois because one of the things that we all know about viruses is that just like the flu viruses change constantly, and I know that for your budget acutely interested in how viruses evolve over time. And the great worry is that there will be a sudden kind of switch to something much more pathogenic. How are things looking at the moment? I would say things

Francois Balloux  13:15  
are looking pretty good. I don't know many people have predicted that the virus might become more pathogenic in the short term. What has been claimed is that some lineages and sub niches are evolving towards becoming more transmissible. And we looked into that quite carefully recently, and very happy to tell you that so far, none of the mutations that have emerged seem to be associated with higher transmission. I cannot tell you where in the future this might happen or not. But it's relatively implausible that we will see much more transmissible images in the future. Now, obviously, all viruses mutate actually sounds creepy. Unlike other Coronavirus is a bit unusual because they have a proofreading mechanism. So actually the mutation rate or the evolutionary rate is much slower than what we see for instance, the influenza, so influenza A, which cause season, which is a major cause of seasonal flu. And interestingly also the mutations we see are not of the kind of only standard type of mistakes made by the virus when it replicates. But many mutations we see actually on mutations which are induced by our own immune system, which has some RNA editing mechanism. So actually, most of the mutations really, in circulation now, are mutations that the immune system created. And that's actually quite good news, because it really does not suggest that we see the evolution of the more transmissible or more virulent, nasty viruses on this stage.

Vivienne Parry  14:58  
No often We've seen in the past that as the virus spreads very widely, it sometimes becomes less pathogenic. I know people are worried, as you say about becoming more pathogenic, but how about less pathogenic as it spreads? Because after all, viruses going to get further and faster? If it's, it doesn't inconvenience people, and they spread it nicely for it.

Francois Balloux  15:28  
Sure, you're absolutely right. And one of the features which makes sounds copy to so difficult to control with traditional, let's say hybrid control methods is that an important subset of people actually have either no symptom or very mild symptoms. So essentially, they still carry on they travel. They don't necessarily realise they're infected, especially in the early stages of the pandemic, which obviously led to a very fast spread of the virus and the virus which is much more aggressive. It's a it's people on the world. Seriously unwell would not have had this capacity to spread so fast. This is what we saw previously was related viruses like sounds copy one or 2000s for most which is also related bowels. You are absolutely right that a virus or any pathogen in itself actually doesn't get any evolutionary benefit it doesn't spread better, if inconveniences or makes its host sick. However, we it is difficult to make really prediction weather predictions when a virus will become more aggressive or less aggressive. It's quite complex and this kind of rule of thumb that a virus becomes always less aggressive to its host is actually only strictly true for viruses that are inherited vertically for instance from mother to offspring. And in this case, obviously, if a virus hurts these carriers then it has a lesser chance to be passed on to the next generation vertically, or horizontally transmitted virus from person to person, it is a bit more difficult to make strong predictions on for instance, they can be a positive correlation between the number of say, for it's a virus that is better, replicating might hurt its host more. And so it depends a lot on the populations function, all sorts of things where they actually will become more or less virulent. So I think we should be bit agnostic when it becomes less or more virulent. But fundamentally, there's no reason it should become more insofar as it transmits very, very well. And it's a that is can be obviously is extremely lethal for a subset of its hosts but also for larger subset of the tours can be essentially borderline as symptomatic or have very little symptoms, and they do not believe there's any evidence so far. That is going up in virulence. And I do not believe there's any reason to believe, to the to expect that we will see more virulent sub lineages of image,

Vivienne Parry  18:10  
you know, Judy's doing her testing, but in this evolution of the of the virus, could that have an impact so that the tests you've developed don't work because the virus has evolved too much for the your test to pick it up in the way that the tests were designed for. Just briefly, if you would,

Francois Balloux  18:34  
yes, very briefly, no, because at the moment, we still have very little diversity, though. So essentially, it emerged in late 2019. We're quite confident about that. And so far, it's a pretty big genome, and the ones that have the highest number of mutations from the most recent from the ancestor of all of them, it's about 2829 mutation. So no, I can tell you confidently that there has not been enough evolution for Test like a PCR test not to pick up bombs at this stage.

Vivienne Parry  19:11  
You're listening to Coronavirus the whole story, a podcast brought to you by UCL Minds. If there's a question about Coronavirus, you'd like our researchers to answer please email us at minds@ucl.ac.uk or tweet at UCL. So that's if you like the virus side. Let's now turn to treatments. And Richard Angell COVID is with us right now. So first of all, have we got anything in the cupboard in terms of drug treatments right now?

Richard Angell  19:46  
I guess the the quick answer to that is not good treatments, but people are investigating. So the first port of call has been to investigate the existing antivirus compounds that are sat on the shelf, and the most advanced compounds that many of us have heard about will be Remdesivir. But I really is pretty much the only compound at the moment.

Vivienne Parry  20:12  
What about drugs that exist already that might have activity, but we don't yet know about them in. In other words, I'm not making this up, I hasten to say, but it, you know, a drug for athlete's foot that,

Richard Angell  20:27  
Say we're faced with a situation where we need to repurpose existing drugs. So we can repurpose existing antivirals into Remdesivir ERISA, sort of the poster boy for that approach,

Vivienne Parry  20:42  
because they are developed for Ebola, wasn't it?

Richard Angell  20:45  
So Originally, it was developed for hepatitis C, but it showed activity against a bola and it also showed activity against other Corona viruses, including SARS and MERS. So it's an opportunity to Develop a compound against other another Coronavirus, family member. In terms of repurposing other drugs, we could target the host cell processes. So in order for the virus to exist, it needs to hijack the cell processes in some way. And there are several approaches that are currently being explored. With that in mind, I think probably the biggest caveat is that we, at the moment, we have a limited understanding of how the virus interacts with the cell processes and our understanding is developing with time. So it's quite clear that the virus has a unique way of entering the cell. And there are approaches at the moment examining how the virus fuses to the cell surface and see if we can interfere interfere with that process and indeed, a compound that's approved to Japan for the treatment of acute pancreatitis. protease inhibitor is currently being examined in human patients as a way of stopping the virus getting into the cell. So I guess that's a better example of how to how you could repurpose a drug that was developed for a completely different indication for treatment of the virus,

Vivienne Parry  22:18  
but probably not athlete's foot, but it's so it's, It normally takes at least 10 years to develop a drug. So, how is the drug discovery industry responding to COVID? At the moment, because, you know, 10 years is a timeline is that, you know, we haven't got 10 years. Yes,

Richard Angell  22:41  
yeah, you're right. It takes a long time to move a potential drug through the next necessary human testing and the regulatory hurdles, and we're compressing those timelines tremendously, but it will still take time. So I guess the repurposing discussion that we just had speaks to The most obvious way we're trying to do that so we could remove the drug discovery phase of the process. And we can focus on molecules that we have already discovered to be safe in humans. And they either kill the virus or related virus, or they disrupt processes that the virus hijacks. So I think that's probably the the, the primary way, we're looking to accelerate the process.

Vivienne Parry  23:26  
Now, it was inevitable that there would be a pandemic. I mean, we've been preparing it for a very long time and yet we aren't prepared. And they still come along like Christmas. It's, it's it happens. So how are we going to make sure that we're not taken by surprise?

Richard Angell  23:46  
Yeah, it's very hard to convince people to spend money on something that might never happen. And I guess a lesson from the Coronavirus help. has been that we haven't invested in the what if scenario, and I think certainly University groups but also a drug discovery. Commercial drug discovery groups are now starting to realise that we need to invest some time and effort in preparing for the what if scenarios, I think that principally means from Coronavirus. Specifically, we need to understand how the virus interacts with the biology of the cell more clearly, that will then highlight particular mechanisms that we could target in host based, if you like broad spectrum antivirals, but I think also we need to build up a battery of we could call them poised molecules. So molecules that have activity against a broad spectrum of Corona viruses that may be targets specific processes, unique To the virus. I mean, the advantage of targeting virus specific approaches obviously, is that we avoid potential off target or host toxicities. So if we can selectively kill the virus without touching any of your cell processes, then obviously that's the ideal scenario. So certainly we would be advocates of building up a a library, if you like, of compound of police compounds that have Coronavirus provenance.

Vivienne Parry  25:32  
Let me just go back to Judy a second on this because now you're a biologist. What are the viruses on the horizon that we're worried about? I mean, of course, there's flu. There are Corona viruses, but anything else that's on the horizon that we need to be have these poised drugs for?

Judith Breuer  25:52  
It's very difficult to say. I mean, we know that a lot of the viruses that have spread pandemic come from bats. And there is work going on to look at to try and characterise what's present in bats all over the world to see whether we can actually pinpoint other viruses. So there are viruses like NEPA Hendra, which did cause outbreaks in Malaysia. And also in Australia, it that didn't spread. But again, it there's possibility that something like that could spread. We know that there are viruses that are present in areas of the world where there are vectors where there are mosquitoes and ticks and and those may become pandemic as climate change occurs because the the vectors that spread those viruses may be able to survive in different climates. And then we have the the viruses that we've seen, for example, Ebola and other hemorrhagic fevers that occur in Africa. Again, it's possible we did have something of a scare With the Ebola virus, it's possible that the conditions may be right. For spread of some of those viruses that have not been pandemic, I think what we, what we seem to what seems to be the case is that those viruses that really do end up becoming pandemic tend to be respiratory virus spread by the respiratory root, because

Unknown Speaker  27:21  
because they're spread too easily,

Judith Breuer  27:23  
it spread too easily. And so I think that I would might, my bet would be that the next pandemic will be a respiratory virus, what it will be, I don't know, we still haven't had a really different flu virus. So that's still a possibility. And yeah, who knows what it could be, but likely to be a respiratory virus, I would think.

Vivienne Parry  27:43  
Okay, let me turn now to our last speaker, Professor Suzy Farid, because we talked about all the medicines that we might develop, we talk about vaccines, we talk about, you know, monoclonal antibodies, all these biological products, and yet that is only the beginning. Have a process which has to happen at enormous pace and scale, if you're thinking about pandemics where billions of doses are required, so how does what you do contribute to developing the pipeline and the actual sort of product on the shelves.

Suzanne Farid  28:22  
And so as you said, developing a new biological treatment or vaccine is typically a lengthy, costly and risky journey. And in Biochemical Engineering, we're focusing on ways to accelerate the development of the bio processes for these new modalities. at a national level, UCL by chemical engineering is feeding into national manufacturing task forces that have been set up by the bio Industry Association on things like monoclonal antibodies and vaccines. Were working Contributing with innovative tools to enable rapid generation of large numbers of doses against pandemic threats such as COVID-19. At the moment, we have been working and doing the groundwork that has been instrumental in the manufacturing of the Oxford to file vector vaccine to ensure that it can be made in enough quantities and at the right quality for phase one clinical trials.

Vivienne Parry  29:28  
What are the kind of challenges Sorry to interrupt though that what kind of challenges do you face because I suspect a lot of us think of medicines as a bit like widgets in a in a factory, you just feed in the whatever you're making it from and out the other end pops vaccine or medicine. But that's not like that at all, is it?

Suzanne Farid  29:51  
Yes. So and these biological therapies are often there. They rely on us culturing cells that are As many factories to express our target product followed by a series of recovery and purification stages and then feel finished and this is a very highly regulated sector and all aspects of the manufacturing process must comply with the highest safety and quality standards. And all the clinical trials are underpinned by by having this robust and scalable manufacturing process to hand and it's not too easy to change a process for a biological product as when you change the processes the risk that you actually change the biological product and and the risk that you need to repeat clinical trials. So having sophisticated analytics is another key component to help move through the development pathway as smoothly obviously, as clinical trial results are are coming through manufacturers and by chemical engineers are are faced with thinking how to prepare for mass production, but we're trying to do this without knowing which candidate will prove successful in clinical trials or what the dose will be that will show efficacy. And if we're thinking about manufacturing millions or it say perhaps billions of doses, we need to think how to scale up the process to support these very large demands. And looking across the globe, you may see that the sector may struggle to meet these high demands. And so there may be a shortfall in capacity and it's not so easy to build manufacturing capacity as that typically takes about three years requires several 10s or hundreds of millions of pounds, which is obviously not a routine in a pandemic situation. So be necessary for the sector to come together. Think about sharing capacity to supply the large number of doses required thinking about how to repurpose existing facilities to ramp up at that production at UCL we've been interested in using Are decisional tools to help map out the cost benefits and risks of alternative capacity sourcing strategies in these pandemic scenarios and help identify the critical challenges in that space. Another key thing when ramping up production is that there may be challenges actually sourcing materials at these large scales that that we're visiting.

Vivienne Parry  32:29  
And we've already seen that, in fact, it has been a problem getting the reagents for for for tests. One of the things that people have said to me it's going to be a problem is that ampoules are those little glass vials that doses typically come in? manufacturing those by the million is also going to be difficult.

Suzanne Farid  32:54  
And yes, indeed, so so sometimes people sort of forget about the full finish. Part of this but if you think about sourcing billions of files, the specialist equipment that are actually needed to fill the files, and then even storing all of these files, you can see that there's potential for a bottleneck there as well.

Vivienne Parry  33:16  
And other other industries that are using other processes can they be common did in the same way that we've seen, you know, engineering companies turn their hands to ventilators? Are there processes that are used perhaps in food manufacturer or any other process that could be repurposed in order to make vaccines, perhaps the fit the fill, but

Suzanne Farid  33:45  
potentially, I guess, the challenges and some of these require other specialist pieces of equipment and require GMP or good manufacturing practices and facilities that are built to the standards to the sector may have to be creative in trying to source or identify capacity solutions in the space. But I imagine that they will initially be looking at existing biotech facilities and how they can be repurposed before perhaps considering other sectors which might be able to be adapted to this.

Vivienne Parry  34:25  
Finally, these things take a great deal of time and we're talking about years of development. What are organisations doing at the moment to speed up the normal, very lengthy r&d timelines?

Suzanne Farid  34:40  
And yes, so So on average, it can take, you know, say a decade to bring a new therapeutic or vaccine to market and it's worth also bearing in mind the attrition rates. So typically, it might be only one in 10 drugs that enter clinical trials that actually make it to the market. So companies typically, you know, have to to hedge their bets with multiple candidates, you know, just to ensure a single success. In the COVID-19 cases, we're now hearing organisations quote a target of 12 to 18 months to bring these therapies and vaccines to market which is a very much expedited route. So how are they doing this? So it's on the manufacturing front as some of these candidates have been able to speed time to clinic by adopting platform manufacturing processes. And so this is it's like a templated approach to process development where organisations can leverage the experience gathered with an established sequence of bioprocess operations from previous projects that might have been used for different therapies. So for example, the Oxford viral vector candidate has been benefited from a specialist adenovirus manufacturing platform that has been adapted for COVID-19 Part of this work was actually done in a UCL Oxford collaboration that called the effects hub on the clinical front. Typically clinical trial phases are run in sequencing where you wait for the outcomes of phase one Before starting, say phase two clinical trials. But when we're now moving at pandemic speed through trials, organisations are looking at how they can stagger the start of clinical phases and run the activities in parallel. So essentially, they're operating more at risk. And regulatory authorities such as the M HRA are helping to find ways to do this and identify areas of regulatory flexibility to support this sort of global healthcare response to pandemic.

Vivienne Parry  36:50  
It's an extraordinarily complex set of things that have to be done to defeat COVID. I mean, You know, you come all of you come from completely when I suppose Judy and Francois have come from roughly the same area of biocides, but even so very different approaches. And you need everybody together to get anywhere at any speed. I wanted. I mean, this is very naughty of me asking you to speculate because obviously scientists never speculate. But it's clear we're gonna have to live with COVID. And I wonder what kind of approaches you think we'll see as routine in say, three years time, from your perspective. Richard, let's start with you on that.

Richard Angell  37:45  
Yeah, so the interesting question, I think, one of the things that I've been encouraged to observe over the last few years is the move by pharma companies to open the doors to their compound collections. to their internal knowledge base to both university research groups, but also to small companies. And I would like to see an Inc an acceleration of that approach so that we could remove redundancy where we are all researching the same thing where actually our results are open and available to each other and we can come to a solution more quickly. That would be an ideal scenario, I think, going forward from here.

Vivienne Parry  38:31  
And it's interesting, isn't it? Some of the things that people would have taken three or four years to do have happened in as many weeks. I mean, it's been extraordinary. The pace of change, and some things will go back to perhaps a semblance of what they were before, but a lot I think will have permanently changed for us. Well, what about you, where do you what do you think we'll be doing as routine in your particular field?

Francois Balloux  39:00  
I think it's, it's been quite remarkable that the pace at which people have produced genomic sequences it's been quite remarkable at which pays people have been sharing them. And I think it's been useful. I don't think it's been a game changer. It allowed us to understand a few things. But fairly fundamental things where, when and where did it start to say, clearly China and of 2019, we could confirm it spread very rapidly. We're following obviously, very closely the emergence of mutations that informs drug vaccine design. So it's been, in some sense positive, what's been really positive as this is removed by the community to share data, which is completely unprecedented. I was working with similar things during the 2009 influence is when everyone panic and they say it's really to change the field has changed, and I would say for the better now is still facing tomorrow. But let's say I think, at least, the field of genomics has made some fundamental contribution so far, they hope they will become more important as we, as we progress.

Vivienne Parry  40:14  
So, Judy, what will we be doing as routine in the testing and tracking area?

Judith Breuer  40:21  
Well, I think this is this pandemic has changed our whole approach to how we follow and how we manage pandemics. I think that we will do much more testing for pathogens, we won't rely on modelling. To tell us what to do at the outset, we will be gathering data by doing a lot more testing of people. I think genomics will become pathogen genomics will become routine. We'll use it to manage outbreaks and the community will use it to manage outbreaks in hospital I think point of care tests, tests that you and I can do at home. will become much more common. We'll be able to test ourselves to see whether we've got an infection and that will just become routine. And I'm hoping more specifically for the Coronavirus that we will have an effective vaccine and effective drugs. That will mean that this virus becomes a pathogen that affects children or doesn't infect anybody you know that either we rely on it infecting only children, the rest of us are immune, or in fact, we can prevent it from affecting anybody at all.

Vivienne Parry  41:32  
And please tell us to do that we'll be able to do saliva testing because I don't know whether anybody has tried to sample themselves that that with a swab, but it's like trying to poke your eye with a fork.

Unknown Speaker  41:49  
It's really hard.

Judith Breuer  41:51  
So nasal pharyngeal swabs are really a nasty thing to have done. There are now good. I mean, saliva is a good thing. sample to test for this virus in and increasingly we will be using samples such as saliva also perhaps pinprick test, not necessarily for COVID. But for other other pathogens. So that it there'll be much better technology that will allow us to detect pathogens in very small amounts of easily obtainable samples.

Vivienne Parry  42:22  
final thought from you, Suzy, what's going to be the normal modus operandi in three years time in your area?

Suzanne Farid  42:31  
I think that the outbreak case outbreak is focused attention on a rapid development of these bio therapeutics and diagnostics, and so is paving the way for new benchmarks on on times to get these products to market. As a pandemic has given urgency to establish these new routes and new regulatory guidance guidelines to move at pandemic speed. I think we'll see more optimism manufacturing processes that are more robust and more easily scalable to better prepare for these outbreaks. And there'll be greater potential hopefully to harness the insights from the genomic screening tools that Judy has been talking about to develop more personalised therapies, and which are more tailored to particular individuals or particular strata of the population. Another thing we need to do in this time also is upskilling people to run and operate these facilities and tapping into the UK science and technology sort of add capabilities in in universities to underpin in all the fundamentals related to, for example, for the bio process, business and regulatory aspects for these broad ranges of modalities coming through.

Vivienne Parry  43:54  
And on that note, can I thank all of our contributors today. It's been So interesting. So you've been listening to an episode of Coronavirus. The whole story brought to you by UCL Minds in a special edition for Cheltenham Science Festivals at home event. This episode was presented by myself Vivienne Parry, produced by UCL with support from the UCL health of the public and UCL grand challenges and edited by the lovely Cerys Bradley. Our guests today would Professor Suzy Farid, Dr. Richard Angel, Professor Francois Balloux, and Professor Judy Brewer. If you'd like to hear more of these podcasts from UCL Minds, subscribe wherever you download your podcasts, or visit ucl.ac.uk forward slash Coronavirus. This podcast is brought to you by UCL Minds bring you together UCL knowledge, insights and expertise through events, digital content and activities open to everyone. Bye for now.

Transcribed by https://otter.ai