Innovative Approaches to Combat COVID-19 Pandemic: An Overview

Novel Approaches for Community Screening and Prediction of Viral Transmission Rates

The biggest challenge during the onset of COVID-19 was the contact tracing and screening of population for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2) infection. Spreading of SARS-CoV-2 via asymptomatic carries made contact tracing a challenging task for the health workers, thus urged scientists to look for some innovative approaches to assist in stringent tracing and monitoring of COVID-19 positive patients. Many Smartphone applications were developed in different countries for contact tracing, tracking of individuals, training of healthcare workers which include Aarogya situ, Apple COVID-19, COVID-UAE, Apollo COVID-19, ECDC threat reports and Pakistan’s National Action

Plan for COVID-19 etc [1]. Contact tracing helped in immediate isolation of positive patients from normal population. Moreover, machine learning, artificial intelligence and deep learning tools have enabled the study of large datasets that have helped to understand fundamental knowledge regarding this virus [2], same approach can be used in future to strengthen the basic research.

Revolutions in COVID-19 Diagnosis

Easy and affordable diagnosis is an important parameter in dealing with a novel pathogen like SARS-CoV-2. Since RT- PCR has been well accepted as a gold standard for pathogen diagnosis but COVID-19 pandemic urged the use of different tools which are easily accessible and affordable technologies to help in rapid diagnosis of COVID-19. CRISPR technology, nanotechnology, RT-LAMP etc were exploited to develop diagnostic kits for rapid diagnosis of SARS-CoV-2. SHERLOCK Bioscience was the first approval of CRISPR-based diagnostic by FDA which provides test results in one hour. Other CRISPR- based diagnostic methods that are under development include CARMEN-Cas13a (Combinatorial Arrayed Reactions for multiplexed Evaluation of Nucleic Acids) by Broad Institute and Harvard University, and CRISPR-Cas13- based electrochemical microfluidic sensor by University of Freiburg, Germany VIRRION (Virus captured with rapid Raman spectroscopy detection and identification) [3]. Researchers also employed CRISPR-Cas13a for low cost and rapid screening of SARS-CoV-2 from the nasal swabs of the patients where the results can be visualized by mobile phone microscopy [4]. Certain CRISPR-based diagnostic technology that is believed to be parallel in sensitivity with RT-PCR based diagnosis is CASSPIT, a Cas13a-based diagnostic kit developed by MCARS, Jamia Millia Islamia, India [5]. Furthermore, FnCas9 Editor Linked Uniform Detection Assay (FELLUDA) has been developed by CSIR-IGIB Delhi, India [6]. Many other potential diagnostic approaches that had been brought on table by various scientists, as reviewed by Islam, et al. [7], which might add the advantage of rapid, affordable and accurate diagnosis in future. Another novel approach employing nanoparticles for stringent detection of pathogen like SARS-CoV-2 was demonstrated recently [8]. There are many more such new approaches that have potential to become rapid diagnostic approaches in pandemic or epidemic health crisis.

Healthcare Innovations Inspired by Covid-19 Pandemic

Ideally it takes years to develop methodologies and technologies in healthcare system and also millions and billions are spent to make these technologies ready for public use. However, a global pandemic like COVID-19 that has swept through the population and has inspired innovative healthcare approaches which has changed this typical timeline of years into weeks. Moreover, T plastic cube designed to cover head of the patient with two arm holes for performing intubations during handling the COVID-19 patient [9]. Building Fangcang hospitals in China was a novel approach to respond to COVID-19 pandemic, these were implemented first time in China in February 2020 to tackle the SARS-CoV-2 outbreak [10]. India and Pakistan responded to COVID-19 crisis by making trains as the hospital wards that was an extraordinary move to combat SARS-CoV-2 spread [3]. Moreover, drug repurposing was another approach to combat SARSCoV-2 infection, which allows an emergency use of an existing (non-specific) drug, in this approach an existing drug (not specific for the pathogen) is tried for the novel pathogen based on its computational screening and docking results. Combination of Hydroxylchloroquine and Azithromycin was used as a repurposed drug against COVID-19 prophylaxis [11]. Another such approach, where a combination of existing antivirals is being proposed to work against SARS-CoV-2 as suggested by research conducted by Bhat, et al. [12] these approaches can help in basic understanding of novel therapeutics against pathogenic diseases.

Rapid Development of COVID-19 Vaccines

COVID-19 pandemic has witnessed a rapid vaccine development since its inception. Just after the availability of sequence data of SARS-CoV-2, research on vaccines was eventually started in different countries which led to the early development of various vaccines against this pathogen [13]. World has never experienced such a rapid development of vaccines against any other pathogenic diseases. Usually it takes around 20 years to develop any sustainable vaccine against a pathogen but severity of SARS-CoV-2 spread in the population prompted the early development of COVID-19 vaccines [14]. According to the WHO updates around 63 vaccines are in clinical trials (early or advanced) and 177 vaccine candidates are in preclinical development in academia and industry (https://www.who. int/publications/m/item/draft-landscape-of-covid-19- candidate-vaccines). There are different generic platforms which have been employed to develop vaccines against COVID-19 including nucleic acid vaccines (RNA/DNA), inactivated viral vaccines, live attenuated vaccines, vector- based vaccines, protein subunit vaccines etc [15]. Among the frontrunners, it is important to mention that there are mRNA based vaccines such as BNT162b2 (Pfizer/Biontech) [16] and mRNA-1273 (Moderna), [17] as well as others like Adenoviral vaccine, Covishield (Oxford University) [18] and inactivated virus vaccines like Coronavac (Sinovac Biotech China) [19], and Covaxin (Bharat Biotech/ICMR) [20].

Conclusion

The global challenges experienced by world during the COVID-19 pandemic have inspired creative and innovative approaches to deal with its severity and consequences. Technological innovations had somehow helped frontline workers to deal with COVID-19 patients. Innovation in diagnostic approaches like SHERLOCK, CRISPR technologies have taken the diagnostics to a next level by providing easy, rapid, affordable and reliable diagnostic approaches to combat SARS-CoV-2 spread. The pace of research on COVID-19 and research collaborations has signified the strength of research round the globe. Public-private partnership has been the hallmark for speeding up the promising treatments and COVID-19 vaccine development. The global pandemic further highlights the importance of research and funding for disaster management and public health emergency.

Acknowledgment

The support of Ramalingaswami Fellowship grant (BT/ RLF/Re-entry/09/2015) from Department of Biotechnology (DBT) and the support of Early Career Research Award grant (File No. ECR/2018/002114) from Science and Engineering Research Board (SERB), Department of Science & Technology, Government of India to author JI is acknowledged.