National Microbiology Laboratory’s role in the COVID-19 response
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Overview
The National Microbiology Laboratory (NML) provides critical scientific leadership for Canada's response to COVID-19.
The NML:
- supports diagnostic testing across Canada
- conducts research on COVID-19
- creates models and manages data gathering to help guide public health planning and predict the course of the outbreak
Research
NML research is aimed at improving public health, within Canada and as part of global health initiatives.
The NML is conducting more than 100 COVID-19 research studies on a wide variety of topics. Some of these studies are focusing on:
- vaccines: designing and testing several different kinds of vaccines
- treatments: investigating treatments to see if they can treat COVID-19 and reduce its severity (many are already approved for use in other clinical applications)
- genomics: studying the genetic fingerprint of the virus to better understand and monitor it for changes
Vaccine
The NML has Canada's only Level 4 laboratories for human health. These state-of-the-art laboratories are essential for developing vaccines to protect against infectious disease threats like Ebola and COVID-19.
We have unique capacity to conduct pre-clinical research in animal models to ensure that vaccine candidates are:
- high quality
- safe
- effective
We're researching different approaches to developing a COVID-19 vaccine, including:
- research to develop in-house vaccines
- helping external collaborators evaluate vaccines developed by academia and industry
Vaccines can be grouped into 5 main categories:
- live replicating viruses that would not normally cause infection in humans, to act as the delivery system for the vaccine
- this approach was used for creating the Ebola vaccine
- replication-deficient viruses that cause mild illness in humans, but the vaccine is manipulated to not do so
- this approach was used for the smallpox vaccine
- incremental doses of live virus which uses small incremental amounts of the live SARS-CoV-2 virus to stimulate an immune response without causing disease
- nucleic acid-based vaccines, such as DNA vaccines, that contain the genetic codes for specific proteins (antigens) of viruses so that an immune response is triggered
- protein-based vaccines that use purified proteins from the virus as a vaccine
- different technologies can be used to create these types of vaccines, allowing mass production and distribution
Research on how long COVID-19 lives on surfaces
NML scientists studied how long the COVID-19 virus lives on personal protective equipment (PPE) surfaces and materials in health care settings.
We found that it depends on the surface and material. It ranges from less than 24 hours on 100% cotton to 21 days for detection of trace amounts of live virus on plastic.
This research provided evidence to support infection prevention and control measures, including:
- washing your hands often with soap and water for at least 20 seconds
- using alcohol-based hand sanitizer if soap and water aren't available
- reinforcing the need to strictly adhere to best practices for the handling of PPE
- cleaning and disinfection of reusable equipment and surfaces
- providing valuable insight about the most protective materials to use for non-medical masks
Research on the infectiousness of COVID-19
NML scientists conducted research to determine how many days after infection patients are able to spread the virus to others.
This knowledge helps to protect the health of Canadians.
Check out our blog on how infectious COVID-19 is and how it spreads.
Testing
Accurate and timely testing is key to the public health response to this pandemic. It allows early detection of cases so that further spread can be controlled. We work with provincial and territorial public health laboratories to ensure high-quality diagnostic testing that meets laboratory gold standards.
Our scientists helped develop and verify the COVID-19 laboratory tests we use in Canada.
Our priorities are:
- obtaining testing supplies such as reagents—the chemicals used to process samples
- comparing rapid point-of-care tests to our gold standard test
- procuring authorized test kits so that provinces and territories can ramp up testing
To meet these priorities, we:
- developed in-house reagents, as other commercial reagents are globally limited in supply and hard to source
- study the accuracy and performance of diagnostic tests and equipment
- procure laboratory supplies in bulk
- provide reference services
COVID-19 early days
In the early days of the COVID-19 outbreak, the NML performed follow up testing on all presumptive cases to confirm test results.
We confirmed Canada's first case of COVID-19 on January 27, 2020.
We performed genetic sequencing on early specimens to confirm that these early cases were truly positive for COVID-19.
In collaboration with the provincial and territorial laboratories, we validated and streamlined Canada's testing approach, so provincial and territorial laboratories could confirm results without additional NML testing.
Testing repatriated Canadians
We sent a mobile truck laboratory and a team of laboratory experts to Ontario to test Canadians with symptoms returning from:
- Hubei Province in China
- 2 cruise ships
The mobile truck laboratory has specialized equipment to carry out rapid onsite laboratory testing for infectious diseases like COVID-19. Test results are available in just a few hours.
This quick turnaround time is key to identifying cases and providing treatment.
The mobile truck laboratory can quickly mobilize anywhere in Canada and around the world. It is the equivalent of a Level 3 laboratory.
Reference services
The NML provides laboratory reference services to all provinces and territories for COVID-19. These reference services deliver a variety of services to laboratories across Canada, including:
- confirmatory testing
- quality assurance
- in-depth analysis of difficult to diagnose specimens
Serology testing
Serological tests are blood tests that detect the presence of antibodies produced by your immune system in response to an infection.
We're developing and evaluating serological tests to detect individuals that may have been previously exposed to SARS-CoV-2, the virus that causes COVID-19.
In addition to front-line serological tests, NML is developing a specialized test to detect neutralizing antibodies. Neutralizing antibodies can directly inactivate virus particles, which means they can usually prevent infection.
It's challenging to develop a laboratory test to detect neutralizing antibodies that are sensitive and specific. Our scientists are experts on developing and running these types of tests.
Using these tests, we'll gain important information about:
- possible immunity
- long-lasting protection from re-infection of the virus
These tests will be key to evaluating possible vaccines to determine their effectiveness before starting clinical trials.
Neutralizing antibodies can also be used as treatments for COVID-19 infections. Known as "convalescent plasma treatments," they're commonly used for other infectious diseases such as rabies.
We've also created quality assurance (QA) programs for serology testing of COVID-19. These QA programs ensure that serological tests are accurate.
Point-of-care testing
Working with our partners, we're deploying point-of-care testing devices across Canada.
Point-of-care testing helps address testing gaps in underserved communities that have limited access to laboratory testing. This type of testing is especially important to northern, remote and isolated communities. Since the specimens don't need to be shipped to a laboratory for analysis, test results are available sooner.
Quicker test results help reduce the spread of the disease through earlier:
- contact tracing
- isolation of positive patients
We conduct hands-on training sessions for health care professionals who use the point-of-care devices. We also offer ongoing support and technical advice. This includes a robust quality assurance program to confirm that the devices are consistently reliable.
We're exploring ways to increase the capacity of these devices, through innovative testing approaches such as sample pooling.
Working with the provinces and territories
Canada's public health laboratories work together through the Canadian Public Health Laboratory Network. The NML leads this network to support:
- coordinated COVID-19 laboratory testing
- information sharing
- bulk purchasing of equipment and supplies
Working with Health Canada
We will conduct independent scientific laboratory evaluation of some COVID-19 testing devices when requested by Health Canada.
Modelling and data gathering
Data gathering for COVID
Provinces and territories submit their COVID-19 laboratory results to PHAC for national tracking. We manage the Canadian Network for Public Health Intelligence (CNPHI), which is a scientific public health informatics and bio-surveillance platform.
CNPHI provides a centralized and secure web environment for sharing test results. It includes real-time visual analytics.
Modelling for COVID
The Public Health Agency of Canada (PHAC) has created a Canadian COVID-19 modelling network. It's made up of modellers and epidemiologists from all levels of government and universities. This network supports Canada's efforts to model and make predictions about the COVID-19 epidemic.
NML scientists, along with other PHAC experts, lead this network to develop mathematical models and other data analytics to:
- study how COVID-19 spreads
- anticipate the future course of the outbreak
- help guide public health planning and infectious disease control
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