IT’S TIME TO PUSH CANCER DIAGNOSTICS UP THE WAITING LIST
O
THROUGH THE LOOKING GLASS Diagnostics firms are in a race to discover the ‘holy grail’ of virology – a rapid test biosensing device for Covid, according to IVOR CAMPBELL
T
he race is on in the diagnostics industry to develop a device that instantly detects coronavirus for use in large public spaces and airports. The biggest companies are chasing the ‘holy grail’ of a rapid-test, biosensing device – similar to that used to test blood sugar levels in diabetic patients – that will identify whether a patient has Covid within a matter of seconds. While several firms are continuing to commit resources to producing lateral flow and PCR tests in bulk to service government contracts, their research and development focus has switched to the creation of a more sophisticated test. Now that the dust is beginning to settle, and the sense of emergency has faded, companies are now looking to develop more sophisticated ways of detecting Covid, because they know it will be with us for the foreseeable future. There are already lobbyists for the pharmaceutical industry
telling governments and anyone who will listen that ‘you’ve had your pandemic, that’s the first one in a century but who’s to say the next one won’t be next month’. Companies are now directing specialists in all areas of physics and chemistry to work on this single priority. While it’s too early to develop a prototype, directors and sales teams want to know what the tests are going to look like. It won’t be long before the current lateral flow test, which involves sticking a swab up your nose, will look crude and outdated. While it has served a purpose, in that it’s relatively quick, it’s also intrusive and unreliable and totally unsuited for use in public spaces. The PCR test is more accurate, but it is hopelessly slow. What policymakers are demanding is a multi-use device that combines the accuracy of PCR with the speed of the lateral flow test, like we currently have to test for diabetes. The speed at which patients receive test results is the
Companies are directing specialists to work on a portable Covid testing device, similar to those currently used to test for diabetes, inset. most problematic obstacle to life returning to normal in many parts of the world. In the UK, people have to wait up to 72 hours to get their PCR tests results but, in many other countries, including in some parts of the US, the wait is up to 14 days. In addition, some tests return a false negative result of up to 33%. Among ideas currently being considered by next-generation test developers are wearable devices that could be used to record patients’ health data, providing an early Covid diagnosis,
even when they are asymptomatic. Researchers at Imperial College London and the University of Freiburg have suggested that such devices, which record ‘quantified self-movement’ could take the form of clothing, masks, contact lenses or even tattoos. Intelligent face masks are already used to detect other health data so it may be possible to adapt them for use as Covid tests by monitoring the air around the wearer, alerting them to the presence of harmful airborne molecules, according to Dr Firat
G�der from the Imperial’s Department of Bioengineering. While the industry’s focus has been on the developed world, there is also everywhere
south of the Mediterranean and South America to consider and it is now several leagues ahead in its thinking. The industry has had a shot in the arm as a result of government investment over the past 16 months, and it’s now looking ahead to the long term. The money is there and the manpower and capital equipment are in place, so it’s only a matter of time before we
begin to see a new generation of highly sensitive, and suitable for point-of-care testing, which could significantly facilitate the testing of Covid-19.
ne of the side effects of Covid is that nothing else is really being tested. Other things have been put on hold and the big thing is oncology. People were either scared to turn up to a hospital where they might get Covid and were suffering in silence, or they just couldn’t be seen by doctors who were putting things off, or there were waiting lists for non-urgent scans and tests. There is going to be a bulge in cancer diagnostics and people who would have been caught a year ago at stage one for an easy treatment such as melanoma, are now much more advanced, and it is either going to kill them or they are going to be a lot sicker for a lot longer. The companies that are doing early-stage cancer testing, accurately and cheaply screening, can expect to have their products out there sooner. They can do well by doing good. They may be interested in diagnosing cancer much earlier because they have people in their families who have died from it. There are people interested in neurodegenerative disease, perhaps because they have family members with dementia of sorts, and it would be great to get ahead of things like that. The public now understands that you can do diagnostics on viral diseases. The country is beginning to understand that you can do the same quality and calibre of tests on cancers and screening for cancers. We have mammograms, cervical smears, faecal tests etc, but there are now companies who can find the tumour cells or the effects on DNA for those tumour cells before they even show up in somebody’s bloodstream. The NHS is notoriously reactive, it treats us when we are sick. It doesn’t stop us getting sick in the first place. It is good at treating us if we present with a lump but it’s less good at screening us for years before the lump occurs. The greater our understanding is of diagnostics, we are coming to realise that, if we can fight Covid successfully, we can do the same with cancer.