India’s CSIR’s Role in Combating COVID 19
The Council of Scientific and Industrial Research’s (CSIR) constituent leading biology lab, the Centre for Cellular and Molecular Biology (CCMB), based in Hyderabad, is employing several tools and approaches in the country’s fight against COVID-19.
Addressing the 79th foundation day of the Council of Scientific and Industrial Research (CSIR), the minister hailed the contributions of the scientists at the organisation and said, “Ever since the first case of Covid-19 was reported in the country in January, our scientific community at CSIR has risen to the occasion and contributed in various forms, sometimes outside their mandate, to put up a fight against this pandemic.”
The minister further shared the story of how India - which once imported testing kits, PPEs, ventilators among other medical equipment became self-sufficient in manufacturing and supplying these items, all during the last few months.
“Today, we perform about 13 lakh tests, manufacture 10 lakh testing kits and close to 5 lakh PPEs in a day. There are over 110 companies manufacturing ventilators in the country. All this has been possible due to scientists and industries working together,” said Dr Harsh Vardhan.
He added, “Even those states, which cried of a shortage in PPEs during the initial months, are now delaying procurement as they have cited lack of space to stock the additional supplies,” the minister said.
Speaking on the occasion about the Covid-19-related technologies that have been developed, CSIR Director General Shekhar Mande said a few international scientific communities have shown interest in CSIR-developed technologies. “Indian industries, too, have shouldered the responsibility in Covid-19-related technology development during the recent months. As a result, it was possible to fast track technology to the market,” noted Mande.
“The Chief Scientific Advisor to the Government of Australia contacted CSIR regarding our Covid-19 technologies. Netherlands too has contacted us with a similar request,” said Mande.
CSIR has a chain of 38 labs across the country. Very early on, before the lockdown started, our strategy was defined as five verticals: surveillance and epidemiology, diagnostics, drugs and vaccines, hospital assistive equipment and supply chain logistics.
CSIR is uniquely placed as an S&T organization to deliver these at this critical juncture, having proven expertise in sequencing (first human genome sequencing), diagnostics for rare genetic diseases, and being the fountainhead of generic industry in the country.
CSIR has advantageously positioned itself to pursue the focused R&D to develop, integrate, scale-up, and deploy necessary technological interventions for combating the Coronavirus pandemic in the country. Considering the multifarious problems created by a coronavirus that require interventions in several areas and a multi-pronged strategy, CSIR has set up five technology verticals for addressing the emerging situation due to pandemic.
These verticals are need-based and span multiple research labs and disciplines and draw upon the strength of scientists, students, and harness it for the fight against COVID-19. In addition, CSIR is also working on promoting rural employment and providing ready to eat food to migrants and other outreach programs.
Surveillance:
They have begun genome sequencing in many of their labs such as the Centre for Cellular and Molecular Biology (CCMB), Hyderabad; Institute of Genomics and Integrative Biology (IGIB), Delhi, and Institute of Microbial Technology (IMTECH), Chandigarh. The idea is that they span a large population across the country and address the question:
Is the virus evolving rapidly or not?
What kind of mutations is being accommodated?
They are also integrating surveillance using serological methods, and that study is set to begin in Kolar.
Genome sequencing is very useful in many different ways. First, it will help track how the virus is moving from place to place. Secondly, it helps with understanding what parts of the virus are evolving more rapidly than the others. If there is a drug that binds to a particular region of the virus or a surface protein, and if that part is evolving more rapidly than other parts of the virus, it is possible that we may have drug resistance tomorrow. Therefore, their strategy for developing drugs would have to be drastically different.
Isolation and social distancing being key measures in containing the Corona outbreak, the goal is to able to trace patients digitally and establish virus transmission chains and mitigate transmission. Further, identification of the strain of the virus and its sequence are critical towards understanding molecular epidemiology, which will assist inaccurate diagnosis, development of suitable vaccines, and drugs for the Indian population.
Molecular Surveillance: The country needs digital surveillance data to help trace the recent movements of coronavirus patients and establish virus transmission chains. CSIR is taking support from Industries to come up with optimum solutions for digital surveillance. CSIR-IGIB will lead the laboratory to implement digital surveillance of coronavirus and also take other CSIR labs on board. The database will be managed in a dynamic mode for feeding the R and D channels.
CSIR-CCMB, CSIR-IGIB, and CSIR-IMTech are doing sequencing of coronavirus to know if any genetic changes are occurring in the virus while it is spreading in the country. The information will help gauge the severity of disease in various geographical regions, developing an ELISA detection test, and ultimately vaccine against coronavirus.
One hundred and sixty-six virus samples have been sequenced as on 28 May 2020. CSIR is targeting to sequence more than 500 viral genomes.
Digital Surveillance Platform: The objective is to integrate digital data on the virus such as the viral genome, with deep patient data and disease course data including outcomes. These require the integration of data from multiple platforms and must be linked together before the identification. While Aadhar could be used as a hidden private integrator, it is not available in most data, so the alternative is to have a unique ID and consented data tracing via an app downloaded at the time of initial testing, and a network of clinical and molecular partners.
CSIR is building end to end capacity in this vertical. A platform for surveillance is being developed in partnership with Intel India.
CSIR and TATA Group have completed the district level screening in Kolar. The study has shown the value of a combined serology plus RT-PCR intelligent strategy, informed by virtual data. After the pilot study on digital surveillance in Kolar, CSIR is planning to do the next pilot surveillance in Jamshedpur and NCR
Diagnostics:
More than a month and half ago, CSIR labs started doing RT-PCR based diagnosis. CCMB was one of the first. They have come up with some clever strategies for RNA isolation, quick testing and pooling. They also started training people in Telangana to scale up diagnosis very quickly.
The standard RT-PCR test takes 2-3 hours and has multiple steps. Two tests on the horizon are exciting: RT-LAMP, which is being developed by Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, and the other is the ‘Feluda’ test of IGIB. Both tests are very quick and can be done within 30 minutes. Both are very cheap. With Feluda, they are targeting a price of about Rs. 300 per test. Both will be available to the public very soon.
IGIB was able to come up with this idea of paper-based diagnosis for COVID-19 quickly. This is very similar to the pregnancy test. It has now been validated in the labs and gone for third party validation. Prominent biotech companies have lined up to commercialize the test as soon the regulatory authority gives permission.
Drugs and vaccines:
The evaluation of new drugs is a long process. It can take 10-12 years. So, most people including CSIR plunged into repurposing drugs straight away. The World Health Organization also came up with a candidate list of drugs, such as hydroxychloroquine, azithromycin and remdesivir, under the solidarity trials. CSIR has generated synthesis processes for many of these drugs, as well as drugs such as arbidol and favipiravir.
For vaccines, they took a conscious decision that they would be focusing on immune-boosting vaccines. They decided to work on an indigenously developed vaccine called Mycobacterium w (Mw), a heat-killed formulation. Cadila Pharmaceuticals has already shown that heat-killed Mw reduces mortality of sepsis patients by as much as 50 percent by simply boosting host immunity. Therefore, CSIR along with Cadila approached the Drug Controller General of India for clinical trials. They will carry out three kinds of trials:
- on those who are critically ill
- those who are hospitalized but not yet in ICUs
- those at risk of developing the disease.
They have roped in AIIMS Bhopal, AIIMS New Delhi and PGI-Chandigarh as partners.
They also realized that India has a very rich traditional knowledge, and so they have tied up with the Ministry of AYUSH to test a number of immune-boosting cocktails.
Hospital assistive equipment:
They began work early on hospital assistive equipment. They foresaw shortages in things such as protective clothing, which at that time was being imported from abroad. They have received a large order from the Government of India and are ramping up their capacity. At the moment, their capacity is 30,000 suits per day, but are ramping it up to make it a few lakh suits per day very soon. Similarly, they are planning for nasal swabs, masks, shields and so on. They are also working on a non-invasive type of ventilator and have tied up with a large number of companies and PSUs to start manufacturing prototypes soon.
Supply chain logistics:
They foresaw that every corner of the country will face shortages, and people will not know where to source items from. For example, when they looked at the hydroxychloroquine supply chain logistics, they realized that the two components required are imported from China.
Their strategy was focused on how to make them in India!
They also expected a shortage in hospitals and isolation wards. The Central Building Research Institute in Roorkee and the Structural Engineering Research Centre in Chennai have designed an isolation ward that can be generated in 3-4 days. They reached out to the National Disaster Response Force and successfully was given a site where they are showing a prototype 50-bed hospital.
CSIR Supply Chain initiative is to ensure, to the extent possible, that no user organization (hospital, testing lab, ambulance network, health center, mohalla clinic, police, municipality, etc) ever runs short of what is needed to address the COVID-19 pandemic.
Effectively, the platform is to assure security to any individual user who is infected with or at risk of infection from the SARS-CoV2 (doctors, nurses, hospital attendants, sanitation workers, police, etc). This is expected to become the national benchmark for all future epidemics and a model for pre-emptive disaster relief.
There are four thrust areas within this effort:
Develop and coordinate an IT platform: for visibility of demand and supply of required goods and services to tackle the COVID-19 crisis. Development of the platform is in progress and collaboration discussions are on with partners TCS and CII, the first rollout expected soon.
Establish Regional Inventory Centres: for visibility of demand and supply of required goods and services to tackle the COVID-19 crisis. Development of the platform is in progress and collaboration discussions are on with partners TCS and CII, the first rollout expected soon.
Pre-emptive identification of supply chain issues in new launches of CSIR products (Devices, PPE, kits, drugs, vaccines etc) and services (testing, training) for COVID-19 management
Establish best practices and synergies from other efforts (Rural Employment Generation, Food Security for marginalized sections, Epidemiological forecasting and Regulatory Standards Development)
Presently, CSIR Supply Chain Vertical Team is working with PAN CSIR lab/unit scientists, TCS, CII, and other third parties to set up information management and forecasting databases at a national level to capture demand and supply scenarios for key items that are required to address the COVID-19 emergency. The primary aim is to build a public platform that will not only help users source primary items (those that can be used for surveillance/testing/vaccines/treatment/devices / personal protective equipment e.g. human temperature checking devices, kits, remdesivir, ventilators, masks, sanitizer) but also their first-level components, so that:
- Anticipated shortages can be addressed;
- Black marketing, hoarding, and over-forecasting is dis-incentivized; and
- Over-production can be avoided.
The key task is to prepare a bill of materials for each key item category and to provide a document or link to the specifications. There may be more than one specification for a product category (e.g. home, mobile, and hospital ventilators).
After that, an Item master- a standard form capturing all details of the primary use item - has to be prepared in line with TCS, CII requirements, which will be spelled out on national level healthcare information and demand forecasting platform.
Regional Inventory Support: CSIR has launched the ‘Regional Inventory Support’ initiative for seamless management of the supply chain of essential items to tackle the COVID 19 pandemic in areas around several CSIR labs, leveraging the available space and resources. This initiative will also take care of the visibility of demand and supply of required goods and services.
As of now, CSIR has identified 11 of its national laboratories across India to act as regional inventories for buffer stocks of critical items like PPE and reagents for local hospitals and for testing centers.
These regional inventory points will also stock and showcase CSIR-developed products (like oxygen concentrators, hands-free washing units, and nasopharyngeal swabs) relevant to tackling the COVID-19 pandemic as such products are launched and go into bulk production.
Every issue in all the five verticals has a corporate partner associated with it through Corporate Social Responsibility funding, co-development, or technology transfer to corporate houses.
This scientific institution has come forward and contributed in various forms to fight the Covid-19 pandemic.
