Testing BCG vaccine against COVID-19

The University of Exeter is leading the UK arm of a large global trial designed to test the theory that the widely used BCG vaccine might help protect against COVID-19 amongst healthcare staff and care home workers.

Called the ‘BCG vaccination to reduce the impact of COVID-19 in healthcare workers’ (BRACE) Trial, the Exeter study site started recruitment in October 2020 and is ongoing in the UK and globally. In January 2021 the University of Exeter partnered with the Royal Devon & Exeter NHS Trust (RD&E) to recruit staff, and has opened new clinics in Teignmouth and North Devon.

Researchers in the trial say that as well as finding out if the BCG vaccine reduced COVID-19 disease severity, they would also be testing whether it could boost the effect of specific COVID-19 vaccines by training the body’s immune system.

The BRACE trial is coordinated by the Murdoch Children’s Research Institute (MCRI) in Melbourne, Australia. The trial has received more than $10M from the Bill and Melinda Gates Foundation and AUD1.5M from the Minderoo Foundation to allow its global expansion. The Peter Sowerby Foundation has contributed funding to support the Exeter trial site.

The UK is working with centres in Australia, the Netherlands, Spain, and Brazil in the largest trial of its kind. Globally, the trial will recruit more than 10,000 healthcare staff. Participants will be given either the BCG vaccine (currently given to more than 100 million babies worldwide each year to protect against tuberculosis (TB)) or a placebo injection. In the UK, routine BCG vaccination was stopped in 2005 because of low rates of TB in the general population.

Previous studies suggest that the Bacillus Calmette-Guerin (BCG) vaccine could reduce susceptibility to a range of infections caused by viruses including those similar to the novel coronavirus causing COVID-19. Examining the mechanism by which this may work is part of the trial being conducted by BRACE researchers. The BCG vaccine boosts immunity by ‘training’ the immune system to respond to other subsequent infections with greater intensity.

Participants are asked to complete a daily symptom diary via an app, be tested for COVID-19 whenever they have symptoms, complete regular questionnaires and provide blood samples. These samples will allow scientists to understand how blood cells respond differently to exposure to COVID-19 and other viruses, with and without the BCG vaccine.

Exeter part of UK-wide genomics consortium

Scientists at the University of Exeter and the Royal Devon & Exeter NHS Trust have been contributing to national efforts to map how COVID-19 spreads and evolves.

As part of the COVID-19 Genomics UK (COG-UK) Consortium (COG-UK), the work has been backed by the Department for Health and Social Care Testing Innovation Fund to expand whole genome sequencing of SARS-CoV-2.

COG-UK is made up of an innovative partnership of NHS organisations, the four Public Health Agencies of the UK, and researchers from academic partners across the UK.

COG-UK researchers have built a central database and developed cutting-edge analytical methodology and data pipelines for SARS-CoV-2 genomics. COG-UK has led the development of analytical software to define viral lineages and shares methods globally. Collectively, these data and tools have provided important scientific insights into the spread and evolution of the virus, at local, regional, national and international scales.

From March to November 2020, COG-UK generated and made publicly available more than 100,000 SARS-CoV-2 genomes, making up over 45 per cent of the global total. This unprecedented effort has not been achieved previously for any pathogen, anywhere in the world.

In November £12.2 million in funding was provided to the consortium to enable COG-UK to grow and strengthen current genomic surveillance efforts, with the aim of increasing sequencing capacity across the national network and reducing turnaround time from patient sample to genome sequence. The viral genome sequencing data will be integrated within the four UK Public Health Agencies & NHS Test and Trace to help understand outbreaks and strengthen infection control measures. It will also be used to detect and track mutations that could be harmful to human health, such as those that could reduce vaccine efficacy.

Next-generation triple antibody test for COVID-19 approved for use in the UK

University of Exeter scientists have developed a revolutionary new device that could allow health professionals to test patients’ antibody response to COVID-19 in as little as seven minutes.

While traditional tests that require laboratory analysis can take up to 72 hours to get results, this test from Exeter spin-out company Attomarker, is able to deliver quick and accurate quantitative results in just seven minutes.

Following successful trials from an initial patient study at St. Thomas’ Hospital in London conducted in 2020, the test device has received approval by the Medicines and Healthcare Regulatory Agency (MHRA). These trials were fully funded by University of Exeter alumni and friends, more than 1,300 of whom gave a total of £120,000 through the COVID-19 Emergency Appeal.

While many of the currently available tests only measure antibodies for one nucleocapsid protein (N) of the SARS-CoV-2 virus, the Attomarker device can simultaneously test for multiple, clinically relevant, biomarkers against the SARS-CoV-2 virus.

The device can test for three virus proteins (Spike 1, Spike 2 & N) and three classes of antibodies (IgM, IgG and IgA), giving a more powerful profile of the patient’s immune response to COVID-19.

Professor Andrew Shaw, CEO & Founder of Attomarker, and Associate Professor of Physical Chemistry at the University of Exeter, said: “The Attomarker team is excited with the high sensitivity and specificity results of our patented new triple-antibody testing technology. To deliver the technology to the front line and to build capacity for volume testing we are now working with Smiths Detection, part of multinational engineering company Smiths Group.”

COVID-19 test could determine whether patients are still infectious

A new test which could detect whether people who have had COVID-19 are still infectious is under development by Professor Lorna Harries at the University of Exeter Medical School.

The test aims to detect how much active virus an infected person is harbouring – known as viral load. Unlike current tests, which do not separately measure the inactive (non-infectious) and the active parts of the virus, the team is refining a test that could tell users not only whether they are carrying active virus, but also how much. This could help healthcare workers and others know when they are safe to return to work.

Professor Harries said: “Currently, people with COVID-19 can recover completely, yet still test positive. That’s because the tests detect any genetic material left over by the virus after it is inactivated by the immune system. If successful, this new test will specifically look for active virus, and tell us how much of it is present. It would be incredibly useful in helping people safely to return to frontline duties, or patients return to care homes.

“Since beginning the research we’ve now measured active viral load in over 270 positive patients and are now beginning to do the analysis to see if active viral load can inform on outcomes. We’ve also done some serial samples that suggest that positivity for active virus tails off some time before positivity using the existing test.”

Five tips from project to support people with dementia and carers in COVID-19 lockdown

New guidance has been developed as part of a major project to support people with dementia and family carers who are facing isolation and reduced services as a result of COVID-19.

A new leaflet features five simple tips, developed using the latest robust research and with the input of people affected by dementia, and is the first output of an ongoing project to support people living with dementia and their carers through the COVID-19 global health emergency.

The project takes into account the concerns expressed by people with dementia through partner networks such as Alzheimer’s Society. They are describing concerns about maintaining supplies of food and medications, anxiety about what would happen if they were admitted to hospital, lack of confidence, feelings of loss and grief, increases in symptoms like agitation, and a more rapid decline in cognitive and functional ability.

For carers, lockdown means they are more captive in their role and lack respite opportunities. Many carers are finding it difficult to explain the current restrictions and enable the person with dementia to remain safe, and are deeply worried about the safety and well-being of their relatives.

Professor Linda Clare, of the University of Exeter Medical School, who led the project, said: “While not currently classed as ‘vulnerable’ on health grounds, people with dementia and their family carers are disproportionately affected by social distancing, isolation and lockdown.

"Our research tells us that many people living with dementia and carers felt isolated and lonely before COVID-19, and now these feelings will be amplified. They can feel overwhelmed by the volume of generic advice and guidance available, and may be unsure how to select information that is relevant to them and their families and what information to trust. This project aims to provide robust information, developed with the crucial input of people affected by dementia, to offer support through this crisis.”

The leaflet, available online here gives practical and self-help tips, as well as signposting sources of support, on five key points: - Staying safe and well - Staying connected - Keeping a sense of purpose - Staying active - Staying positive

University of Exeter leads “rapid response” data analysis to aid NHS during COVID-19 pandemic.

Researchers from the University of Exeter and the NIHR Applied Research Collaboration South West Peninsula (PenARC), in partnership with the NHS, have developed a crucial new tool to ensure health trusts maintain sufficient levels of life-saving equipment and bed spaces during the COVID-19 pandemic.

The research team, led by Professor Gavin Shaddick from the University of Exeter, has developed a new data modelling tool to help forecast demand on crucial NHS resources in the region. The forecasts have been used to help predict the demand for in-patient beds, intensive care, PPE, ventilators, oxygen and testing kits. Crucially, it has also incorporated not only predicted hospital staffing requirements, but also the levels of staff that may be off-duty due to illness and self-isolation.

The team of data scientists and health professionals have been collaborating to produce high quality models and data to aid quick decision making, within a rapidly evolving environment, to influence key healthcare decisions.

Nic Harrison, Principal Analyst and NHS Lead for Northern and Eastern Devon collaborative COVID analysis and modelling said: “This is work that the NHS is having to deliver at pace, so we are delighted that the University is helping to support us with this at such a challenging time so that key decisions are based on the strongest possible evidence base.”

The analysis works by comparing local patterns of the spread of COVID-19 with other areas both nationally, and abroad. The researchers are able to use daily ‘live’ data to adjust their forecasts as the spread of the disease evolved in local populations.