A virus detection network to stop the next pandemic Pardis Sabeti and Christian Happi
[In January 2020,
Christian Happi and Pardis Sabeti
presented an Audacious idea]
[Sentinel: An early warning system
to detect and track the next pandemic]
[Here’s how it would work …]
Christian Happi: Sentinel is a proactive
early warning system to preempt pandemics.
It is built on three major pillars.
Pardis Sabeti: The first pillar is Detect.
Christian and I have been studying
infectious diseases together
around the world for two decades.
We have been using genome sequencing.
Reading out the complete
genetic information of a microbe,
it allows us to identify viruses,
even those we’ve never seen before,
track them as they spread
and watch for new mutations.
And now with the powerful
gene-editing technology CRISPR,
we can use this genetic information
to rapidly design exquisitely sensitive
diagnostic tests for any microbe.
CH: One of these tools is called SHERLOCK.
It can be used to test known viruses
on simple paper strips.
It is very inexpensive,
and frontline health workers
can use SHERLOCK
to detect the most common
or the most threatening viruses
within an hour.
PS: The other tool is CARMEN.
It requires a lab, but it can test
for hundreds of viruses simultaneously.
So hospital lab staff
can test patient samples
for a broad range of viruses
within a day.
Our second pillar is Connect.
Connect everyone
and share this information
across the public health community.
In most outbreaks,
hospital staff share case information
through paper, Excel – if at all.
This makes tracking an outbreak
through space and time
and coordinating a response
extremely difficult.
So we’re developing a cloud-based system
and mobile applications
that connect community health workers,
clinicians, public health
teams – everyone –
and allows them to upload data,
perform analysis, share insights
and coordinate a response and action plan
in real time.
CH: Our third pillar is Empower.
An outbreak surveillance
system can only succeed
if we empower frontline health workers
that are already out there
taking care of communities.
It requires a lot of training.
Pardis and I are very much aware of that.
We’ve spent the past 10 years
training hundreds of young
African scientists and clinicians.
Over the next five years, we will train
an additional 1,000 health workers
to use Sentinel detection tools
and empower them
to train their colleagues.
This way, we will improve
the original health care system
and integrate surveillance
into medical practice.
[Since presenting their Audacious
plan at TED, the world has changed …]
Briar Goldberg: So here we are.
We’re recording this.
It’s April 7th, 2020,
and obviously, we are in the throes
of this crazy global pandemic
caused by this new coronavirus.
So you two have been working
together forever,
and you really came together
pretty aggressively
with the Ebola crisis back in 2014.
What does it feel like
from your perspective?
CH: Pretty much six years
after the Ebola outbreak,
we’re really facing another crisis,
and we still pretty much, like,
we never learned from the previous crisis.
And that, really, for me,
is heartbreaking.
PS: I think that this pandemic
has shown us how unprepared we are
everywhere in the world.
Christian and our partners together
had diagnostics at our hospital sites
in Nigeria, Sierra Leone
and Senegal in early February.
Most states in the United States
didn’t have it until far later.
It tells us that
we are all in this together,
and we are all very much behind the curve.
BG: So, this Sentinel system is amazing,
but I know that the question
that’s on everybody’s mind is:
How is that playing into the here and now?
PS: You know, we describe Sentinel
as a pandemic preemption system,
and here we are in a pandemic.
But what’s great is that, actually,
the same tools you need
to preempt a pandemic
are the ones that you need
to respond to one.
And so all of the technologies
that we have laid out –
the point-of-care testing,
the multiplex testing,
the discovery and tracking
of the virus as it’s changing,
and the overlay of the mobile
applications to dashboard –
are all critical.
CH: For us, it is a war.
We are basically committed
for 24 hours' turnaround time
in order to give results,
and that requires for us
to work around the clock nonstop.
So it’s a pretty challenging moment.
We are away from family.
At least I have the privilege
to see family today,
and then I’m sure tomorrow
I’m heading back in the trenches.
In my lab, we sequenced
the first COVID-19 genome
on the African continent,
and that really was done within 48 hours.
This is revolutionary
coming from Africa
and then making this information
available for the global health community
to see what the virus
within Africa looks like.
I believe that with
technologies and knowledge
and then sharing information,
we can do better and then we can overcome.
PS: The whole idea of Sentinel
is that we all stand guard
over each other.
We all watch.
Each one of us is a sentinel.
Each one of us, being able to monitor
what is making us sick,
can share that with
the rest of our community.
And I think that is what
I profoundly want,
is for us to all stand guard
and watch over each other.
[Dr. Pardis Sabeti
and Dr. Christian Happi]
[Ingenious scientists.
Courageous partners.
Global heroes.]