A new research initiative backed by pediatrician Priscilla Chan and her husband, Facebook founder Mark Zuckerberg, aims to track the coronavirus pandemic and identify emerging hot spots as the economy reopens in the Bay Area.
Through the Chan Zuckerberg Initiative — a limited liability company established with Facebook shares by Zuckerberg and Chan in 2015 — the couple is donating $13.6 million to a pair of studies that kick off next month with Stanford University, the University of California, San Francisco, and the research center known as the Chan Zuckerberg Biohub.
The researchers aim first to get a sense of when and where new infections crop up as stay-at-home policies are relaxed in coming months. To that end, they’re seeking to enroll 4,000 Bay Area residents who will be tested monthly for Covid-19 through December 2020. Critically, the scientists will use both a standard Covid-19 test known as PCR, which identifies people with active infections, and an antibody test, which looks for evidence of a previous, but perhaps silent, infection.
The reliability of many of the available antibody tests is uncertain, so anyone with a positive antibody result will be tested again in an effort to ensure accuracy, said principal investigator and Stanford senior associate dean Yvonne Maldonado.
As soon as the researchers begin to see a pattern in the testing data that could suggest a hot spot, they will share the results with public health departments.
“We’re going to release the findings in real time,” Chan told STAT in an interview on Tuesday. “We’re not even going to hold it for a preprint” to be posted online.
If successful, the work could help give researchers and public health officials a window into how the Bay Area fares as some businesses are reopened and people attempt to revert to something resembling a state of normalcy.
“We’re in uncharted territory here,” said Maldonado. “It’ll be kind of a feedback loop.”
There’s also potential for the effort to provide some insight into whether and how people develop immunity to Covid-19, a critical aspect of the pandemic that remains shrouded in mystery. Understanding how immunity develops — a natural response in which the body churns out protective Y-shaped proteins called antibodies after infection with a pathogen — can also help researchers develop a vaccine.
So, the researchers hope to enroll 3,500 frontline nurses and clinicians, follow those who become infected, and look out for reinfections by testing them every week for roughly three months. If reinfections do not occur, the scientists can home in on the antibodies that likely helped to protect them from the virus.
“You have to understand which antibodies are protective and which are not,” said George Rutherford, principal investigator on the study and UCSF professor of epidemiology. “It’s fine to look at test tubes and say this neutralizes this or that, but we’re looking to understand how this happens in real people.”
To qualify for the studies, all participants must have previously tested negative for Covid-19 and be following shelter-in-place guidelines. The researchers are still ironing out the kinks of how they’ll vet whether volunteers meet these requirements, but Rutherford said people will need to have received a negative test at least three weeks before enrolling.
While test results from the studies roll in, the researchers will send viral DNA from positive samples to the Biohub. There, researchers will look for genetic signatures that could suggest whether a particular cluster of virus is being transmitted locally, by community spread, or whether it’s coming from outside sources, such as from travelers from other states or countries.
Overall, the work could help to inform local stay-at-home policies while also advancing basic science and deepening our understanding of Covid-19, Rutherford said.
Still, there may be questions about why CZI, founded with a mission of solving problems using technology, is focusing its latest effort so strongly on basic science research.
Chan said that despite the effort’s heavy science bent, engineers and tech workers have as much to do with the new studies as lab researchers. As an example, she cited the tool the scientists are using to do the DNA sequencing, which is a piece of software developed by Biohub researchers that is called IDseq.
“That’s software, that’s technology that we’re building. It’s not an app, but it’s core infrastructure that puts science into the hands of folks everywhere,” Chan said.