One early morning this past March, Assistant Professor Danielle Anderson, from the Emerging Infectious Diseases (EID) Programme at Duke-NUS Medical School, was being adjusted in a chair, in an unused Duke-NUS laboratory bench for a documentary interview on COVID-19 frontliners, by the cameraman. She was smiling but her eyes looked tired.
“Prof Anderson, what time did you sleep?” I asked.
“3am,” she said quietly.
“How long has this been going on?”
On 11 March 2020, COVID-19 was characterised by the World Health Organization (WHO) as a pandemic, a worldwide phenomenon. It is only fitting the whole world is fighting COVID-19, collectively.
At Duke-NUS, we know, understand and feel that we are in this fight, personally, because our scientists and our SingHealth Duke-NUS Academic Medical Centre (AMC) community have been on the frontlines in the fight against COVID-19 since the very beginning.
In January 2020, Professor Wang Linfa, Director of Duke-NUS’ EID Programme, was in Wuhan, China, on a prearranged trip to discuss with colleagues in the Wuhan Institute of Virology, about their long standing collaboration on research into bat viruses. Naturally, at the Institute, their full attention was on this new coronavirus, which was just discovered as the cause of an unknown pneumonia outbreak.
When Prof Wang returned to Singapore after that trip, he put himself into self-imposed quarantine for 14 days and initiated Duke-NUS’ collective efforts to address and contain the coronavirus. He is a member of multiple WHO committees on COVID-19, and is also part of the Singapore’s clinical and research task force to aid nationwide research efforts on COVID-19.
Once the outbreak hit Singapore, Prof Wang, Asst Prof Anderson, and their team were one of the first groups in the world to isolate and culture the virus. After receiving the specimen, the team in Duke-NUS’ ABSL3 lab only took four days to culture the virus. The breakthrough was possible because of the collaborative efforts of Ministry of Health, Singapore General Hospital, the SingHealth Duke-NUS AMC and the National Centre for Infectious Diseases.
With the cultured virus, the Duke-NUS team rapidly developed a unique screening platform – using a combination of two different antibody tests, a virus neutralisation assay and an enzyme-linked immunosorbent assay, to detect virus-specific antibodies for contact tracing and other applications. Working with the Ministry of Health and the National Centre for Infectious Diseases, they proved that two people with very high levels of virus-specific antibodies in their blood were linked to disease clusters involving separate church groups. This result was a significant piece of evidence that confirmed the connection linking the disease clusters. This approach sets a precedent and is the first in the world for the use of this methodology for outbreak contact tracing. This research was featured in news headlines around the world, and publicly commended by Singapore’s Prime Minister Lee Hsien Loong and Deputy Prime Minister Heng Swee Kiat.
In parallel to these efforts, Prof Ooi Eng Eong, Deputy Director of the EID programme, and his team have been pursuing a solution to COVID-19 in the form of a vaccine. He has been leading Duke-NUS’ vaccine development collaboration with Arcturus Therapeutics, a leading biotechnology company. This partnership, announced in March 2020, was cemented to develop a COVID-19 vaccine for Singapore.
This is extremely welcome news, as this partnership will work towards bringing a vaccine candidate for clinical testing in the shortest time possible, using Arcturus’ technology for health vaccine applications and the unique platform developed at Duke-NUS that allows rapid screening of vaccines for effectiveness and safety. The team is also in communication with the Coalition for Epidemic Preparedness to prepare for conducting vaccine clinical trials in Singapore.
Prof Ooi is an eminent dengue researcher whose recent works have provided new insights on the genetic basis of vaccine safety and potency. Developing a safe and potent dengue vaccine has been a major challenge as a weak immune response can cause severe dengue. Now, his laboratory is applying the insights gleaned from studying dengue to develop a suitable COVID-19 vaccine.
In addition to the efforts in research and vaccine development, Duke-NUS faculty, including Prof Wang, Asst Prof Anderson, Prof Ooi, Prof Gavin Smith, Prof Antonio Bertoletti, Prof Duane Gubler, Professor John Lim, Prof Michael Merson, Prof Gregory Gray, Asst Prof Ashley St John, Asst Prof Ooi Yaw Shin, Asst Prof Yvonne Su, Dr Ian Mendenhall and Asst Prof John Ansah have been contributing to public education and safety efforts. Working tirelessly to share knowledge with the media and public, about what they know about coronaviruses, they are helping to educate communities in Singapore and worldwide.
One day in the future, we will know how this pandemic will unfold and how its story comes to an end. What is more certain is that, in the chapter of history where we celebrate those who fought against COVID-19, the names of the Duke-NUS scientists – who tested patients samples, who cultured the virus, who set aside their research projects, who educated people and who fought the virus so that all of us have a chance to return to the life that we once knew – will be written.
Duke-NUS Medical School and SingHealth have a longstanding partnership in Academic Medicine that enables Duke-NUS scientists to perform the research that they need to, in order to counter COVID-19. Since the inception of the school in 2007, clinicians in SingHealth and scientists in Duke-NUS have exchanged ideas, shared clinical and experimental data, and collaborated on research and clinical trials.
When the first case of COVID-19 was diagnosed in Singapore, scientists in the EID Programme started working with SingHealth’s clinicians to share clinical data and patient samples between SingHealth hospitals and Duke-NUS labs for study. Assoc Prof Jenny Low, Senior Consultant at the Department of Infectious Diseases at Singapore General Hospital and an associate professor in the EID programme, was one of the many clinicians in SingHealth whose work with Duke-NUS allowed for this seamless transfer. The AMC framework is what has allowed and is continuing to allow the scientists at Duke-NUS to culture the virus, develop testing mechanisms and develop vaccine candidates.
Faces of the fight: The AMC connection