Illustration: Sarah Grillo/Axios

From biosensor chips to wastewater epidemiology, the COVID-19 pandemic is accelerating the development of next-generation disease diagnostics.

Why it matters: If we're going to stop a disease, we first have to know who has it and where. New technologies promise to provide doctors with more reliable intelligence about who in a community has a disease — and who is likely to get seriously ill.

What's new: In response to COVID-19, a number of researchers and startups are pushing new diagnostic technologies that take advantage of cheaper and quicker genetic sequencing to provide far more accurate and rapid intelligence on just where COVID-19 is, and where it might be going.

  • "With the coronavirus, we are being catapulted into a new era," says Milan Patel, the CEO of the DNA-based diagnostic company PathogenDx.

Some of the most promising new technologies involve what are called molecular electronics biosensor chips.

  • While the RT-PCR tests used for diagnosing active infections repeatedly copy specific viral sequences in a sample before they reach detectable levels, biosensors can detect the presence of viral genes in a sample as it is, producing results much more rapidly.
  • As it becomes cheaper, such technology holds the promise of being able to test an entire population for specific viruses, or even scan the physical environment for signs of viral contamination.
  • "Imagine an active surveillance system that pings offices, shops, airplanes, train stations to see if you have hot spots for a given pathogen or infectious disease," says Barry Merriman, the co-founder of Roswell Biotechnologies, a startup leading the way on developing commercial biosensors for disease surveillance.

A cruder form of environmental surveillance is already under way — underground. Researchers in several cities have begun testing city sewage for the presence of SARS-CoV-2 viral RNA.

  • Sewage is unique as a diagnostic source in that it represents a near-universal sample of what is in — or coming out of — the community. As Mariana Matus, co-founder of the startup Biobot Analytics, told NPR: "Every person that is using the toilet has a voice."

What to watch: Next-generation diagnostics can go beyond simply determining who is and isn't infected. A number of researchers are working on tests that can identify biomarkers that might predict just how sick a COVID-19 patient will become.

  • Scientists at the New York University College of Dentistry have developed a mobile app that takes four biomarkers found in blood tests that were significantly elevated in COVID-19 patients — along with known risk factors like age and sex — and uses a machine-learning algorithm to produce a predicted severity score that runs from 0 to 100.
  • Quanterix has developed a highly sensitive antibody test capable of indicating early in a COVID-19 infection whether a patient is likely to develop an immune overreaction — called a cytokine storm — that can lead to a more severe case. "That allows for an entirely different insight on disease severity and treatment options," says Kevin Hrusovsky, Quanterix's CEO.

The catch: "Testing is a conservative field," notes PathogenDx's Patel. There's good reason for that — we've already witnessed the damage that inaccurate tests can do — but it does mean that new technologies may be rolled out too slowly to make a major difference for the first wave of the pandemic.

The bottom line: COVID-19 struck us in a surprise attack, but better diagnostics could help ensure that we aren't caught off guard again.

Go deeper: Coronavirus diagnostic test pricing is relatively tame

Go deeper

Sep 13, 2020 - Health

Pfizer preparing to distribute COVID vaccine by year-end, CEO says

Pfizer CEO Albert Bourla told CBS News' "Face the Nation" Sunday that his company will know whether its coronavirus vaccine is effective by the end of October and that it has already manufactured hundreds of thousands of doses in anticipation that the vaccine will receive FDA approval.

Why it matters: There has been a major push by the Trump administration to get a coronavirus vaccine to the public this fall, though it may only be available for certain high-risk groups. The Centers for Disease Control and Prevention has already urged governors to have vaccine distribution centers ready by November.

Sep 13, 2020 - Politics & Policy

Infectious-disease expert: "Telling the truth never causes panic"

Michael Osterholm, a renowned infectious-disease expert and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said on NBC's "Meet the Press" Sunday that leaders must tell the truth when it comes to public health and that "telling the truth never causes panic."

Why it matters: Host Chuck Todd asked Osterholm if President Trump had made a mistake by not being upfront with the American people about the dangers of COVID-19 and the threat of a pandemic. In an interview for Bob Woodward's new book "Rage," Trump said that he was purposefully "playing it down" so as not to create a "panic."

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 7 p.m. ET: 31,444,163 — Total deaths: 967,305— Total recoveries: 21,551,157Map.
  2. U.S.: Total confirmed cases as of 7 p.m. ET: 6,889,086 — Total deaths: 200,641 — Total recoveries: 2,615,974 — Total tests: 95,846,925Map.
  3. Health: The U.S. reaches 200,000 coronavirus deaths — The CDC's crumbling reputation — America turns against coronavirus vaccine.
  4. Politics: Elected officials are failing us on much-needed stimulus.
  5. Business: Two-thirds of business leaders think pandemic will lead to permanent changes — Fed chair warns economy will feel the weight of expired stimulus.
  6. Sports: NFL fines maskless coaches.

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