Pune: For National Institute of Virology (NIV) director, Dr Priya Abraham, her tenure at the helm has been one of trial by fire. Abraham took over as director of India’s apex laboratory with expertise in virology in November — two months before the first coronavirus case was detected in India.
Since then, the Pune-based NIV, which is at the forefront of India’s battle with coronavirus, successfully isolated the SARS CoV-2 virus in March and recently developed the indigenous antibody detection kit for Covid-19, which will be used to determine the spread in the country. The NIV is also working with drug manufacturer Bharat Biotech to produce an indigenous Covid-19 vaccine.
All of these activities have been undertaken by about 60-70 people, Abraham said. “I have been extremely impressed by the resilience and the resolve of the staff and scientists at NIV… It’s a privilege to be working with them,” she added.
In an exclusive interview with ThePrint, Abraham spoke about the characteristics of the coronavirus, why it is difficult to predict how it will progress, the difficulties with validating testing reagents and the ongoing projects at NIV.
Hand-holding testing labs
Until mid-February, the NIV was the only diagnostic laboratory that could detect Covid-19. It first began training personnel of 13 laboratories that were part of the Virus Research Diagnostic laboratories — a network of laboratories set up to detect emerging viral infections across the country.
The network has since expanded to over 612 laboratories, including 400 government-owned ones, most of which have been trained by NIV to conduct the reverse transcription real time polymerase chain reaction test (RT PCR tests) for Covid-19.
Abraham said that even though the laboratories have been trained and have been given the tool kits, including positive control, senior NIV scientist Dr Varsha Potdar has been hand-holding them through the testing process by looking at the results and providing them feedback.
“All of the laboratories are part of a WhatsApp group and are in touch with Dr Potdar,” Abraham said.
She added that a NIV team of 8-10 members has also been handling the logistics of sending the kits to laboratories across the country.
“They often were thrown off guard with requests such as shipping 5 lakh reagents within days, but they pulled it off,” she said. “The whole process from making kits, quality control, putting them into boxes with dry ice and sending out the shipment required extraordinary efforts considering it was a lockdown and no commercial planes were flying. We had to use cargo aircraft and even Indian Air Force planes.”
The country’s testing kits and testing rates
Even as India has ramped up its testing capacity from a 1,000 a day four months ago to over 1 lakh plus tests now, there are concerns about the shortage of reagents, chemicals required to conduct RT PCR tests, which need to be imported from China.
There have also been concerns about the shortage of other components of the testing kits such as magnetic plates and micro tips.
Abraham said the country will have to look at alternatives, such as promoting manufacturing in India, to overcome the shortages. “Right now we are doing okay but we don’t know where this is going, so we will have to find alternatives,” she said.
NIV has also been busy validating not just reagents but also RNA extraction kits, components of swabs, as well viral transport medium manufactured by companies in India and abroad.
“We have done 90 per cent of all validations in the country,” she said.
On the time taken for the test results, the NIV chief said that it has remained at four hours, which is at par with the global standard.
“This is because the process starts with matching the samples with the names given in forms and then involves careful handling of the samples and cross-checking the results,” she said. “It is not like you put the samples in a machine and walk away.”
With the peak expected in July, Abraham said that it is hard to tell how the pandemic will progress or when it will peak, especially since migrants have been moving back from one state to another.
“We don’t know how that would impact locally and how, what kind of containment will be there in each of the states. I think most of the states are now throwing up their own plans,” she said. “So it’s hard for me to say where this will go. I think that’s a universal sentiment that nobody knows exactly how it will go.”
NIV’s Elisa test and why earlier antibody tests failed
On the NIV’s Elisa test, the country’s first indigenous antibody testing kit to combat Covid-19, Abraham said that it was not a rapid test, which has had less reliable results.
The Elisa kits are similar to rapid antibody tests, which detect antibodies in the blood to find out if an individual was infected with Covid-19 infection. This will help determine the spread of the disease in the country.
Abraham said that the Elisa test has better sensitivity — proportion of positive samples correctly identified — and specificity, which the proportion of negative samples correctly identified, than the rapid kits and is easier to perform than RT PCR.
Since the sensitivity of the test is at 92 per cent, there are efforts to improve it, she added. “One of the scientists at the institute had already sent a proposal to work with recombinant protein or synthetic peptides that can improve its sensitivity,” she said.
On the Chinese rapid antibody kits failing, Abraham said one of the reasons could be batch-to-batch variation and improper transportation.
The NIV had validated the Chinese rapid antibody kits but by April end, after states complained about their poor quality, the central government announced that the kits were faulty.
Different strains but no difference in transmission
Abraham said there are various ways of classification of the virus — there is S, G, V and the unclassified variant according to the mutations the virus has undergone.
In India, there is the biggest representation of G and the unclassified variant. “But in metros such as Delhi, we have a representation of S and V as well,” she said, adding that these variations suggest separate introduction of the virus into a population but are not associated with higher disease potential or higher transmissibility.
NIV’s future projects
On future projects, Abraham said that the NIV is looking at working with Equine Sera, which is using serum antibodies produced in horses for treatment for Covid-19.
“This technology has been used in the past where you injected viruses in the horses that develop antibodies, which then becomes a form of readymade antibody for people who are very sick,” Abraham said. “This was popular before and is used for anti-snake venom and in diphtheria. The serum is then tested for quality, its potency and for toxicity before being used.”
Scientists at NIV are also looking at monoclonal antibodies — artificially produced antibodies that work against the virus — these can be mass produced to treat Covid-19. “We have just started baby steps into it,” the NIV chief said.
The NIV has also not just visualised the virus under the electron microscope, it has been using immune electron microscopy — one of most specific methods to diagnose viruses.
In this method, viruses are allowed to combine or co-incubate with the antibody of the person who has recovered from the infection. “When you do that, you realise that the virus is aggregating and the antibody is binding up the virus,” she said.