French team from Université Paris-Saclay and Assistance Publique des Hôpitaux de Paris (AP-HP) and member of the European University EUGLOH (European University Alliance for Global Health). We are clinicians, researchers and engineers in microbiology and infectious diseases fields. We are part of one of the French research laboratories authorized to detect SARS-CoV-2 RNA by RT-qPCR by the French government. We have access to various samples (nasopharyngeal swab, saliva or feces) to be tested for rapid and self-testing.
The problem our project solves: to this day, in France, the only people to be diagnosed with COVID-19 are hospitalized or experience serious symptoms. By the end of the shutdown, these tests could not be generalized to the whole population. Current tests are based on a molecular method by nasopharyngeal swabs, then involving heat inactivation of the swab samples followed by extraction of nucleic acids and RT-PCR in real time. This rapid technique (it only takes around 3 hours) is highly efficient (96% positive detections on average) but cannot be generalized due to the use of heavy equipment and a global shortage of reagents and swabs. Another possible way to efficiently end the shutdown implies that a high rate of the population would be immunized. However, the first predictions show a low rate of immunization: only 6% of the French population should have immunity by the end of the shutdown. Uncertainties remain about the protection conferred by this immunity and its persistence over time. Indeed, several publications report the probable reinfection of some people and the low level of antibodies for those who have been infected with SARS-CoV-2. In addition to social distancing measures and the wearing of masks, if we want to limit the spread of the virus and allow the population to live again without enduring any other shutdown, the ability to detect infected people will be essential whether people are asymptomatic or not. Indeed, rather than shutting down, it is necessary to quarantine potentially contagious people. Therefore, the main idea is to have a test that can be carried out by everyone without needing to go to a laboratory or to the hospital and which would make it possible to know if a person is contagious or not. In the latter case, the infected person could quarantine themselves.
What it does
The solution we bring to the table: currently, tests similar to the flu test (rapid influenza diagnostic tests) targeting the SARS-Cov-2 are assayed to know whether they could be specific and accurate. However, they need a nasopharyngeal sample using a swab. In our proposal, the test should be performed in a simple and autonomous manner (self-test). We propose to adapt those tests to be easy to use by everyone. Almost 70% of the patients tested positive for SARS-COV-2 have traces of the virus in the sputum and 30 to 50% would have them in the feces (detection made by RT-PCR in real time). In addition, very recently, tests have shown that detection by real-time RT-PCR of SARS-Cov-2 was more sensitive using saliva samples than those using nasopharyngeal samples. It should be noted that human-to-human contamination is mainly due to droplets and that the presence of the virus in sputum or saliva can therefore be a very likely sign of transmission of SARS-COV-2. A saliva sample therefore seems appropriate to perform a test. We propose to challenge the available tests and evaluate the detection of the virus using saliva as samples. Some members of our team are microbiology clinicians and have access to a large panel of samples (e.g. nasopharyngeal swab, saliva, feces) from patients, symptomatic or not. The detection will be compared to detection by RT-PCR in real time, quantified for its sensitivity and assayed for its specificity.
The solutions impact to the crisis: the goal here is not to systematically identify all cases of infection (diagnostic), but to detect people who are likely to be contagious in order to isolate them using an inexpensive test. The cost of such a test is around 10 euros and they can be manufactured on a large scale (100,000 per day). This kind of test applied to COVID-19 would make it possible to detect a large number of carriers of the coronavirus. If most of the population was to be tested, even if not exhaustively, then detection would be more important than current tests. This could be decisive for people to lead their lives with the circulating virus but avoid another shutdown.
How I built it
From the idea that we need large scale and rapid tests to detect people who are infected, whether they are symptomatic or not. These saliva auto-test could allow contagious people to detect themselves and then isolate themselves in order to limit the spread of the virus.
We tried during the weekend to think out the box and fine-tuned our project.
Challenges I ran into
Find different companies agreeing to donate us some tests to evaluate their detection using saliva and feces as samples.
Convince that these tests are needed to detect a maximum of persons who are likely to be contagious and therefore limit the virus propagation.
Accomplishments that I'm proud of
We are proud to have the idea, set it up and finally find one company to start the adaptation of the tests.
What's next for Self-tests for detection of SARS-CoV-2
We need to find more startups or firms agreeing to donate us some tests to evaluate the practicability of this approach.