The Kirby Institute has wide-ranging expertise in the fields of infectious diseases and epidemic response. We conduct research across the full spectrum of health and medical discovery from our laboratories to our behavioural research and interventional trials – ensuring that our research is developed with the strongest possible focus on implementation in the real world.
As an Institute, we have quickly mobilised our teams to bring our knowledge, experience and collaborative networks to support the global efforts to control COVID-19.
We have a strong track-record in designing solutions to infectious disease threats that can be scaled for maximum impact across diverse communities and populations. Too often, minorities and marginalised populations are most at risk. By putting the most affected communities at the heart of our research, we have designed tests, treatments and cures that have the most chance of success across a range of communities and settings.
Over the past two months, we have repurposed our laboratories and adapted our clinical and public health research strategies to address critical questions in the fight against COVID-19. Our work in this area expands every day.
Our COVID-19 research is centred around three core areas: understand, intervene, implement; and is underpinned by the principle of working with vulnerable communities.
Understand
We need to know how SARS-CoV-2 works at a cellular and molecular level, how it spreads and who is most impacted by the spectrum of COVID-19 illnesses.
The Kirby Institute has a long history of highly impactful research in understanding, monitoring and predicting how infectious diseases move through individuals and communities. This understanding is critical to preventing SARS-CoV-2 (the virus that causes COVID-19) transmission and targeting treatment to the areas of greatest need.
While global knowledge of COVID-19 improves each day, we still need to learn more about exactly how the virus is being transmitted between people, and why it makes some people very ill when they become infected, while many others have mild or even no symptoms.
In our laboratories, we are examining swabs, blood and other samples from people who have been infected with SARS-CoV-2 to examine how the virus causes disease and what our bodies are doing to fight it off.
Another project will aim to understand how widespread infection with SARS-CoV-2 is within the community. Current testing methods focus on detecting active infection, in those with symptoms, so these methods miss very mild or asymptomatic cases.
Through our wide network of clinical and community collaborations, we have established new cohort studies, which will help us understand how COVID-19 impacts particular populations and to discover critical information to guide clinical management of other infections or diseases, such as HIV. We are rolling out these studies among people in aged care facilities, healthcare workers, people living with HIV and people who are immune suppressed. Samples from some cohorts, which will also enrol people who test negative for SARS-CoV-2, will help us understand the accuracy of antibody testing.
We have also adapted several of our existing studies to collect information on potential risk factors and behaviour changes as a result of COVID-19, and how these behaviour changes will influence both the pandemic of COVID-19 and other infectious diseases. These studies are being conducted in Australia and within our region.
Our teams of modellers are using mathematical models of COVID-19 transmission to make predictions about how COVID-19 affects different communities based on different scenarios. One project is forecasting COVID-19 among Australia’s remote Aboriginal populations to understand how it might spread within and between isolated communities, and to evaluate the impact of a range of preventative strategies.
Another project is using similar methods to asses the impact of prevention strategies and interventions to reduce transmission in the prison system. Our modellers are also working with the WHO Western Pacific Regional Office to provide disease modelling support to our closest neighbours.
Associate Professor Stuart Turville examining the SARS-CoV-2 virus through the microscope, with the image portrayed on the computer screen. Image: Richard Freeman / UNSW
Intervene
We are developing potential treatments using antibodies, testing existing antiviral therapies to see if they are effective against COVID-19, and optimising ways to deliver successful treatments into our body’s immune system.
Building on our existing research strengths, we have focussed major efforts towards developing and testing potential treatments for COVID-19, which will complement the vaccine development that is being spearheaded by our collaborators.
We are currently exploring and developing two antibody-based treatments for COVID-19. Antibodies are a part of a healthy human immune system. They form in response to an infection, or can be triggered or replicated by a successful vaccine or treatment. As SARS-CoV-2 is a new virus, the population does not have pre-existing protective antibodies.
The first of these studies is a collaboration with the Garvan Institute and will develop synthetic antibodies (monoclonal antibodies) aimed at preventing SARS-CoV-2 infecting cells and causing disease. The aim is to produce these in a lab, test them in clinical trials, and then give them to patients and healthcare workers to help the body’s immune response and stop COVID-19 from infecting healthy cells.
The second study is based on naturally produced antibodies in the blood, of patients who have recovered from COVID-19 infection and whose bodies have already generated strong antibodies against the virus. We will purify and pool those antibodies into a standardised therapeutic. If successful in the lab, these treatments would also be tested through clinical trials, and then provided to people most at risk of serious COVID-19.
In both cases, these therapies have the potential to be used to stop people infected with SARS-CoV-2 from becoming severely ill, but also, as a tool to prevent infection in the first place. If a person has enough of these antibodies in their system, it could prevent SARS-CoV-2 from the latching onto cells in the body all together.
A key part of developing any treatment or indeed vaccine for COVID-19 is to optimise the ways of delivering that treatment efficiently to the appropriate cells in the body’s immune system. Building on our work on HIV, we are developing specialised nanoparticles that could deliver an antiviral COVID-19 gene therapy through an inhaler or puffer.
Another project will aim to rapidly develop molecular and cellular tools to help identify exactly how SARS-CoV-2 replicates in the body and to screen potential new therapies, which is critical to how we start the development of new therapies.
Alberto Ospina Stella (L) and Associate Professor Stuart Turville (R) in the Kirby Institute’s PC3 containment lab where they are working to grow the SARS-CoV-2 virus and determine how it responds to different treatments. Image: Richard Freeman / UNSW
Implement
We coordinate with communities on the ground and work with collaborators around the world to ensure rapid uptake of evidence-based health solutions.
As soon as our treatment options for COVID-19 pass the lab-based tests, we will utilise our existing global clinical trials networks to ensure they work to improve health in range of populations and settings.
We are also utilising our global clinical trials network to test existing antiviral treatments that may work against COVID-19. This network spans over 100 clinical sites in more than 40 countries. We design our clinical trials to encompass broad populations and diverse health systems, which ensures rapid and practical scale-up the moment a superior treatment option is identified.
Even with effective treatments, testing will remain a central component of any COVID-19 public health strategy for the foreseeable future. Together with Aboriginal Community Controlled Health Organisations, the Australian government and our industry partners we have devised strategies for the implementation of testing technologies, and leveraged these technologies for rapid diagnosis of COVID-19.
These ‘point-of-care tests’ are being rolled out to 85 health services in remote Aboriginal communities in Australia and will ensure test results are delivered within 45 minutes. In the case of a positive test, this buys critical time to isolate patients and their contacts and test for them for COVID-19, significantly reducing the potential for the spread of the infection in these communities, and if tested negative prevents unnecessary complicated medical transfers to distant city hospitals.
