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Dr Chai Lay Ching and Dr Nadiah Ghazali joined PETROSAINS Science Facilitator Ms Norhayati Zulkifli at the PETROSAINS STEM Live on 20 May 2020 via Facebook Live and YouTube Live.
PETROSAINS STEM Live is created as a space for discussions with STEM experts to discuss current issues from the point of view of STEM. It provides interesting and relevant information that is useful for everyone.
Dr Chai, President of the Young Scientists Network-Academy of Sciences Malaysia, Microbiologist and Senior Lecturer at University of Malaya was given the first question: What is the difference between the SARS-CoV-2 virus and other pathogens, how is it able to cause a global pandemic?
Dr Chai first clarified that her expertise lies within infectious pathogens contracted via food and drinks and waterways, such as Salmonella, Cholera, Hepatitis B and the Norovirus.
According to Dr Chai, SARS-CoV-2 comes from the coronavirus family. There are several types of viruses under this family that can infect animals and humans. Some only exclusively infect animals and not humans. The SARS (2003) and MERS (2102) viruses are also under this family of virus. Dr Chai explained that characteristics of COVID-19 are somewhat different from those that causes MERS and SARS.
Comparatively, SARS is deadlier than the other two because it causes serious symptoms in patients. Conversely, COVID-19 has more mild symptoms, meaning that most patients do not need intensive care. Also, COVID-19 patients could also be asymptomatic, meaning that they do not exhibit regular symptoms such as fever and coughing. SARS do not have a lot of asymptomatic cases, causing it to be easily detected and curbed from spreading further. SARS has a six-month run affecting around 20 countries. The fact that patients could be asymptomatic makes it harder to detect, and hence caused it to be harder to curb and causes it to be spread to more countries affecting more countries worldwide.
Dr Nadiah is a YSN-ASM Member and Science Consultant at Frost & Sullivan that has experience working in a laboratory handling the SARS-CoV-2 virus, and Ms Norhayati wanted to know Dr Nadiah’s decision behind joining the laboratory and its differences to other laboratories.
Dr Nadiah said that she was feeling as anxious as any other Malaysians were when the COVID-19 situation became more serious in Malaysia because this was a virus that is yet to be fully understood. Her decision was driven by her curiosity about the coronavirus, so she started focusing her time on researching and understanding this pandemic and the virus.
According to Dr Nadiah, testing is an important step in eradicating COVID-19. As what the Director-General Dato’ Seri Dr Noor Hisham Abdullah said, testing, tracing, and isolating are the three pillars to flatten the COVID-19 pandemic curve.
Testing is the first pillar and poses its own challenge; we must ensure there are enough tests available to ensure new COVID-19 cases can be detected and identified. Testing for COVID-19 uses the Real Time Polymerase Chain Reaction (RT-PCR) technique that will detect the molecular signature of the coronavirus. The signature enables labs to identify that the person has the virus and also to differentiate between the virus’ signature and other elements, such as the patient’s cells. Dr Nadiah’s training on RT-PCR during her PhD enabled her to be given the opportunity to join a lab in Malaysia to conduct testing on COVID-19.
Dr Nadiah said that working in the lab was a rewarding and fulfilling experience. She learnt how a clinical sample processing was carried out, how to handle dangerous samples, e.g. wearing full personal protective equipment (PPE) and maintaining a “flawless” technique to ensure everyone’s safety. Dr Nadiah also stated that it was a humbling experience; before this, she was only handling animal samples, but with this lab, she had to handle human samples. This made her realise that the samples are more than just a serial number; it may come from a mother, a son or daughter, or even an infant. It was an emotionally charged experience to her.
Continuing her explanation, Dr Nadiah credited her dedicated teammates in the laboratory that allowed the lab to run round-the-clock for to ensure the capacity of COVID-19 testing can be maintained to ensure that we can flatten the curve.
Ms Norhayati asked Dr Chai an oft-asked question: how long can the virus last outside of the human body? this was in view of the new practice of people disinfecting their purchased items such as groceries and courier packages, which will supposedly eliminate the virus.
While it is good to wash your vegetables and fruits after buying them, it is not necessary to disinfect with alcohol, Dr Chai said. She continued to say that we need to understand how COVID-19 is really spread: it is typically spread from human to human via droplets while talking, sneezing, or coughing. If someone is close enough to you, these droplets can be passed to you, allowing the virus to infect you via soft tissues in your respiratory system. Another transmission method is via touch: you may transfer the virus to yourself from contaminated surfaces if your hand then touches your eyes, nose, and mouth.
According to Dr Chai, COVID-19 can survive between several hours to several days on surfaces depending on the temperature, humidity, type of surfaces, and whether the surface is exposed to ultraviolet light. Coronavirus prefers a smooth surface; porous surfaces like cardboard and paper are not conducive to the virus’ survival. Some metals such as copper and silver have an oligodynamic effect has the ability to kill microorganisms including viruses, hence reducing the time of the virus surviving on that surface.
Having said that, the major transmission method of COVID-19 is via human to human contact. Therefore, it is not necessary to disinfect your purchases. It would suffice to follow the recommended hygiene practices such as social distancing, hand washing and disinfecting, and wearing a proper face mask. Dr Chai also cautions against spraying disinfectants on oneself via sanitation pods or other methods; when inhaled, the microdroplets of disinfecting agents will bring more harm than good.
When asked whether it is effective to spray disinfectant on public areas such as parks, roads and other public areas, Dr chai advises against doing so as these are not the main method of transmission. Plus, the overuse of disinfectants may give rise to superbugs that are drug-resistant and will resist antibiotics and drugs.
Ms Norhayati continued the session by asking Dr Chai and Dr Nadiah: will COVID tests be a new norm and what is the process of the test? According to them, widespread testing will be a bit difficult at this moment because of Malaysia’s limited capacity: at this moment, they can process 20,000 tests a day. There will be other challenges to overcome before widespread testing can be implemented; of course testing is the ideal thing to do, but it is not feasible to carry it out widely at this moment.
This is further complicated by the fact that one person will need at least two tests with two negative results to be considered disease-free. In the current testing scenario, targeted testing is the best strategy. This means that tests are given to those who have the highest likeliness of having COVID-19, such as those in close contact with patients or those exhibiting COVID-19 symptoms. During her time as a researcher, Dr Nadiah stated that there was a steep increase in testing when the Conditional Movement Control Order (CMCO) was put in place. The increase in tests carried out is because employers are giving their employees tests because they realise that their workers will have more difficulty in maintaining social distance due to them coming back to work, especially those working in construction.
In view of this increased demand, researchers can use alternative methods such as rapid test kits. RT-PCR may be the gold standard of testing, but it takes up to two to three days to produce results, in addition to requiring fancy equipment and plenty of resources such as cost, chemicals, and skilled manpower. Rapid tests can provide results in as little as 30 minutes, but at this moment there are no rapid test kits that have the accuracy and sensitivity of an RT-PCR test. This is the reason why the World Health Organisation (WHO) and the Malaysian Ministry of Health do not approve of any rapid tests kits as a primary testing method.
Dr Chai explained that a virus is not the same as bacteria. A virus is more like a particle; it is not alive and would not be alive outside of a host (e.g. humans). It will only reproduce, grow, and spread within a host. The panel mentioned a research that looked into whether a virus that infects someone will become more or less pathogenic over time. The research looked into the evolution of the virus: a very deadly (termed pathogenic) virus will kill its host very rapidly. Therefore, there will be no host for the virus to survive. On the other hand, a less pathogenic virus is less deadly, thus maintaining a way for it to survive by not killing its host and will continue to spread and infect other hosts. Over time, virus tend to become less pathogenic; it may still cause the symptoms, but this disease may not be fatal.
Having said that, those who contracted COVID-19 will eventually develop an immunity against it. However, scientists currently are not sure if all those infected have developed an immunity to it; there are many factors that needs to be considered. For those with mild symptoms, the SARS-CoV-2 virus might have been eradicated and deactivated by the non-specific immune system before the body manages to produce an antibody. However, one thing is for sure, the number of cases will decrease over time. This is due to the nature of the virus’ evolution and the eventual development of immunity by humans. But in terms of being totally eradicated, that will depend on the successful development of a COVID-19 vaccine.
Developing a vaccine is dependent on the mutation rate of the virus; different strains of viruses will require different vaccines. Without a vaccine, this pandemic will never be over. Dr Nadiah explained that the mutation rate of the SARS-CoV-2 virus is quite low compared to the influenza virus. For influenza, its high mutation rate necessitates a vaccine to be taken annually because the body’s antibody is only specific to a particular strain and the immune response will decrease annually. The low mutation rate of the SARS-CoV-2 virus works in favour of vaccine development.
Aside from mutation rate, another factor that needs to be accounted for is the location of the mutation on the virus. Dr Nadiah explained that a virus has several components; when developing a vaccine, a particular target on the virus is targeted. The most promising target is the part which the virus uses to identify the host cell, which it will use to reproduce. Presently, it was observed that the most important component that is being targeted currently in vaccine development does not undergo frequent mutation; this is good news and it will greatly assist vaccine development.
We need to remember that the pandemic is not over yet and learning about this virus is an ongoing process. We are moving quite rapidly in terms of learning about the virus, and the implication from these researches is still quite unknown. These strains that have been identified may not cause any implications on vaccine development; the component being targeted is still quite identical across all strains. Therefore, research is still being carried out on targeting this component to disable the virus. We need to be optimistic in this process and hope it results in a positive outcome.