A former Aucklander is part of a US team that has come up with a cheap and game-changing test for coronavirus.
Scientist Anne Wyllie fully realised the gravity of Covid-19 only when young, fit athletes started producing harrowing test results usually associated with old and seriously ill patients. Some of the sports stars she'd tested for the virus were asymptomatic, but after positive tests, further medical checks revealed scarring on their hearts or damaged lungs – conditions that will hamper or shorten their sports careers and lives.
A University of Auckland graduate who grew up on the city's North Shore, Wyllie did postgraduate study at McGill University in Canada and completed her PhD at the University of Utrecht in the Netherlands before being lured to Yale University in 2017. She is now one of the leaders of the team at Yale's school of public health who developed SalivaDirect, a test that is being hailed as a game changer in the fight against Covid-19.
The saliva test makes it possible to identify people with the virus and isolate them before they are infectious. It is as accurate as nasopharyngeal (NP) swabbing, the method most commonly used in New Zealand, but non-invasive and cheaper, and importantly, test results can be produced quickly.
Similar low-cost tests are now being rolled out to low- and middle-income countries under a global initiative involving the WHO and the Gates Foundation, potentially saving many thousands of lives and allowing mass screening of health workers who are dying in disproportionate numbers.
Apart from the benefits for the general population, SalivaDirect has potential for those hosting major sports events, and the Yale team have made the methodology freely available worldwide. It has been authorised by the US Food and Drug Administration (FDA) and is one of several saliva tests being evaluated by New Zealand authorities for use here.
In the US, the recent National Basketball Association (NBA) playoffs were possible only because of SalivaDirect's involvement in the strict health protocols followed by the 22 teams.
Wyllie, an only child, is close to her parents, Robyn Carter and Brian Wyllie, and especially her grandmother Valma Carter. She last saw them a year ago, pre-Covid times she recalls with nostalgia. She stayed, as is her custom, with her grandmother at her retirement village and also went for long runs around the North Shore's bays and beaches, her haunts since childhood.
The White House and the FDA have called SalivaDirect a game changer. Does it live up to that claim?
Yes, they're throwing that term around and it is exciting. We now have an option for testing that takes away the reliance on swabs, the supply-chain issues and the risk to healthcare workers. It's less risky for people, too; they don't mind providing a saliva sample.
How did the test make the NBA playoffs possible?
The NBA had seen our early work with saliva and needed something more reasonable than an NP swab. We worked with them and even testing every second day was enough to catch infected players before their viral load was high enough to be infectious and before they were symptomatic. We could withdraw them from their teams and the community, and that was enough to protect everyone. That's how they formed such an amazing bubble for the playoffs – regular testing that detected players who were positive before they became infectious.
How fast is the test turnaround?
The fastest time would probably be 3-4 hours if the person was near the lab and the test was processed on arrival. For bubble-type testing with an onsite lab, we could get results from 92 samples in three hours. In many cases, we expect same-day results to be possible – 24 hours at most.
Rugby fans were disappointed that New Zealand is not hosting the Rugby Championship after the governing body, Sanzaar, opted for Australia's quarantine set-up. Could SalivaDirect have helped?
For a transtasman sporting bubble, SalivaDirect could be a good way to proceed. Teams could be tested leading up to getting together, then monitored while together. With the NBA, teams were getting together to train each day, so there was close contact but successful isolation, and there weren't further outbreaks after someone was caught early. The saliva test could be used daily to be certain. Every NBA member we detected was asymptomatic or pre-symptomatic.
Will a coronavirus saliva test eventually evolve along the lines of a home pregnancy test?
Yes, that's what we're working towards. If you could take a test often enough to detect as you become infectious, that would be critical, because that is when you want to be isolating. For now, we wanted to go down the path of least resistance with the FDA. We're not allowed to use the word approval, but during a pandemic, the FDA can issue emergency-use authorisation, and that is what we have. We are not making money out of this, not selling it. We just want to be able to say, "this works", and share it, and we have.
The US is one of the worst-affected countries. What's it like living and working with the coronavirus?
I went into this kind of complacent or naive. This was an unknown virus, of course, but I was definitely one of the people who thought it was just going to be a bad flu, something that would hit some people worse than others and would peak in April and May. I was hesitant about wearing masks, because of the risk of spreading other germs around if people aren't wearing them properly. But I have completely changed my tune. I've seen this virus and it is so unpredictable. Very early on, we saw those who were worst afflicted – older people and those with comorbidities. But there have been retirement villages here where 50-75 per cent of the entire village has died. That's not your normal flu season.
And the young people you have tested?
I've seen people in their thirties with the lungs of an elderly individual and they just can't breathe. Some are top athletes or sports stars – who knows if they will get better? Or they may be asymptomatic individuals who seemed fine, but they've now got scarring on their hearts.
Are you worried for yourself?
You don't know how it's going to affect you and I'm not ready to take that risk. I had a flatmate move out because he had very different ideas. We were friends, or friendly, but it became confrontational. We were talking and I said we might want to start thinking about where we're going and who we're seeing because of the risk. But he reacted a bit aggressively, saying no one was going to tell him what to do, where to go or who he could see. He moved out and I got a new flatmate who's a nanny for two doctors, so she is very aware of staying healthy for them.
Do you see a time soon when life in the US might return to some sort of normal?
We're living in a crazy world. I wonder when we might do things like shake someone's hand, go out singing and dancing with friends again, or go to a concert, the movies or a show. Maybe I might do them if I can get back to New Zealand, because you're living in a very different world. Until recently, things were almost back to normal in New Zealand, but the rest of us are living a very quiet and distanced life.
You're now 35. Having reached great heights at Yale, are you lost to New Zealand?
I've always thought I'd end up back there, at least for a bit. Staying in the US is not ideal. I like healthcare, annual leave and gun control. And when I was last home and doing my runs, I loved seeing the city – Auckland is beautiful – and just how friendly people are. Everyone I passed would wave or say "hi". New Zealand is such a fantastic place; sometimes it takes living overseas to realise that.
- Clare de Lore, New Zealand Listener