Evaluating the utility of SARS-CoV-2 serological and rapid antigen lateral flow devices
Aligned with our mission to advance the understanding and impact of microbiology, the Society reached out to our community of microbiologists to share their experiences in responding to SARS-CoV-2. We aim to showcase the perspective of scientists during the COVID-19 pandemic and the variety of roles adopted to mitigate the global crisis.
This case study was written by Dr Suzy Pickering, a Research Fellow at King’s College London. Similarly to her fellow Microbiology Society member and colleague Megan Taggart, at the start of the pandemic Suzy volunteered to help at a local COVID-19 testing facility to increase testing capacity. She describes the highs and the lows of this experience, including times where she felt she was “swimming against the tide”.
How did you respond to SARS-CoV-2 during the COVID-19 pandemic?
Prior to the pandemic, I was working as a postdoctoral fellow in the Department of Infectious Diseases at King’s College London (KCL), researching mechanisms of HIV-1 innate immune evasion. In March 2020, myself and several colleagues from our department volunteered to help increase testing capacity at St Thomas’ Hospital and support our frontline clinical colleagues in any way possible. Eager to help rather than hinder, we took on any job going. This included collecting and organising valuable longitudinal serum samples from COVID-19 patients, evaluating alternative RNA extraction and RT-PCR techniques (given that, at the time, supply of commonly used reagents could not be guaranteed) and evaluating point-of-care PCR, serological and antigen tests.
After an intense first few weeks, during which people had come from all over the UK and from various backgrounds to offer their services, we found our niche evaluating the utility of SARS-CoV-2 serological and rapid antigen lateral flow devices (LFDs), both of which were later used successfully in St Thomas’ Hospital to aid clinical decision making. When we returned to KCL in the late summer of 2020, we maintained close links with our clinical colleagues and carried out studies assessing the ability of rapid antigen LFDs to detect infectious individuals, alongside growing and characterising variants of concern, developing and optimising virological assays and studying individuals with chronic SARS-CoV-2 infection.
Was this response related to your work prior to the outbreak?
Only insofar as I’ve always worked on viruses, and my PhD was on the early antibody response to HIV infection, so this helped with the serology testing. But the research I was doing immediately prior to the outbreak was very focused on the details of virus immune evasion and signalling pathways, and far removed from clinical research.
What were some of the challenges that you faced during this time?
As was the case for everyone, waiting for that first wave to hit and not knowing what might come our way was a challenging time. I won’t forget the strangeness of a deserted Victoria Station at rush hour, with the closed shop windows frozen in time. Publishing on SARS-CoV-2 was also a challenging experience, given the obvious public interest and the scrutiny that was given to every development. In the early days of our work on LFDs, they weren’t widely accepted as useful public health tools. In fact, in some circles they were derided for being useless, so it felt a bit like swimming against the tide.
How did your experience throughout the response aid in your development?
I think the pandemic has caused many of us to reassess our research and the way we approach problems. I for one have really enjoyed working in a multi-disciplinary team, learning from people with a wide range of skills and expertise. The opportunity to carry out research on an immediate and urgent public health problem has been a challenge but also a privilege, with the reward of seeing our work have a translational benefit.
What can we learn about the importance of microbiology from the COVID-19 pandemic?
We don’t know where the next pandemic or even outbreak will start, or the nature of the microbe that will cause it. The COVID-19 pandemic has shown us all how much we need our established networks of virologists and microbiologists and the importance of the research they do.
How did the Microbiology Society play a role in your response?
The Microbiology Society Annual Conference has always been the home conference of the UK virology community and a place to discuss research issues and reconnect with former colleagues. During the pandemic, this has been more important than ever. Although in-person conferences have not been possible, the online SARS-CoV-2 and COVID-19 Workshop hosted by the Microbiology Society in the summer of 2020 was a really helpful experience and a great way to hear about how UK-based virologists responded to the pandemic.
About the author
Dr Suzy Pickering is a Research Fellow at King’s College London where she investigates the signalling pathways involved with the evasion of viruses from the immune system, such as HIV-1 innate immune evasion.
