Cambridge’s rapid coronavirus test could revolutionise the UK’s testing infrastructure

Oxford University has a good war, generating coronavirus good news stories through its contribution to the global push for a vaccine and its role in organising ambitious randomised trials of potential treatments.

Its cousin in the Fens, Cambridge University, has kept a somewhat lower profile. But in the spirit of its phenomenal legacy of scientific discovery, Cambridge-based researchers appear to have made the first step in solving Britain’s problems with its testing infrastructure.

The SAMBA II device, developed by Diagnostics in the Real World, can give a diagnosis of 2.6 hours rather than 26.4 hours in standard lab tests.

The UK has so far used PCR testing which looks for the virus’s RNA genome. It requires a sophisticated laboratory infrastructure. Turnaround can be as slow as 48 hours and a significant proportion of the tests return false negatives.

Our lack of a “gold standard” point of care test underlies several prominent features of the UK crisis, especially the epidemic in care homes. Without a rapid diagnostic test and no capacity to keep elderly patients in quarantine in hospital for extended periods of time, many have been discharged back into our care sector where standards are more uneven.

Some of the care sector is excellent and was strategically well-placed to handle coronavirus with enough PPE, hospital-standards of cleanliness and discipline. Other care homes have struggled to contain new outbreaks.

In trials at Addenbrooke’s hospital, the use of the SAMBA II device which has a highly accurate sensitivity and specificity to coronavirus, led to a massive increase in capacity and efficiency at the clinical end of things.

The average length of time patients spent in specially designated coronavirus “holding” wards dropped by almost half from 58.5 hours to just 30 hours.

The new testing devices prevented 11 ward closures in the ten-day period after they were brought in.

“Keeping surgical bays open means fewer cancelled operations, speeding up access to life-saving clinical intervention,” said Professor Ravi Gupta, of the Cambridge Institute of Therapeutic Immunology & Infectious Diseases, who is leading the study.

“Rapidly testing admissions for SARS-CoV-2 at the point of care is essential for reducing COVID-19 transmission in hospitals, speeding up access to urgent care and allowing safe discharge to care homes. It could make all the difference in a few months’ time,” he continued.

The device was first developed by Dr Helen Lee, CEO of Diagnostics in the Real World, at the Department of Haematology at Cambridge. The science behind the machines has already been shown to be successful in rapid HIV diagnostics in Africa.

The new devices could free up vital capacity in the NHS and make it easier to handle a new outbreak or a second peak of coronavirus closer to September when seasonal respiratory viruses and disease begin to circulate.

Our over-centralised testing apparatus has so far been dogged by delays, false results and massive backlogs, which have had debilitating knock-on effects in the NHS. SAMBA II device could allow hospitals a far greater degree of flexibility in managing care. And that is crucial next step in the fight against coronavirus.