Researchers in Western Australia are leading the fight to understand why young, healthy patients who don’t have any of the usual warning signs are still getting very sick and dying from COVID-19 while others in their cohort are barely affected.
World Health Organisation (WHO) data has found about 80 per cent of people recovered from COVID-19 without special treatment.
But on a recent WHO mission to assess the situation in China, epidemiologist Bruce Aylward said the health staff could not work out why certain patients crashed.
“[The doctors and nurses] genuinely couldn’t put their finger on that,” Dr Aylward said.
“Indeed, people who did have comorbid conditions had a much higher ratio of dying from the disease, but in most people there were no other predictors, apart from age, that they could die.”
Genetics and environment both in the crosshairs
The Australian National Phenome Centre, south of Perth, is one of the hubs ramping up research to find out why this is happening.
The centre analyses characteristics of biological tissue and fluids to try to predict the complex genetic, environmental and lifestyle interactions that cause disease.
They are looking to use data and samples from local COVID-19 patients to try to predict variation in how severe the disease will be for each individual, and understand different responses to treatments.
ANPC director and pro-vice chancellor for Murdoch University’s Health Future Institute, Jeremy Nicholson, said the information could help point out who would need intensive care and optimise hospital resources.
“Just knowing that you’ve been exposed to the virus does not tell you at all whether it’s going to be severe or not,” he said.
“We know already a lot of the risks. We know that if you’re older and male, that tends to be a bad thing.
“We know if you’ve got underlying health conditions, diabetes, obesity, high blood pressure, all of those things we know [are risk factors].
“But there are now an increasing number of people who are relatively young, certainly quite a lot in Canada for instance, who are under 40 who are getting this who don’t have any underlying health conditions.
“We really need to understand what it is about those people that makes them high risk.”
The ANPC team has dedicated at least the next year to researching COVID-19, with 20 people in the centre allocated to the task.
“There’s no more important project than this one,” Professor Nicholson said.
Frontline data will drive research
Next door to the ANPC, University of Western Australia professor and Fiona Stanley Hospital surgeon Toby Richards is organising one of the clinical trials to respond to COVID-19.
Professor Richards, like many others, is working almost around the clock — his day starts at 4:00am with early morning tasks, on to his regular shifts as a doctor in the hospital, to phone hook-ups with European researchers in the evening.
Professor Richards said the trial would capture the clinical information and blood tests of people testing positive to COVID-19.
He said Australia was in a unique position.
“It might seem incredibly difficult to individuals, but we’ve gone into isolation ahead of the world, we’ve learned from the rest of the world,” he said.
“We can see what’s happened elsewhere. We know what drugs work and what drugs don’t work.
“We know the lessons that people are learning from the UK, from Italy, from America, and we can take that knowledge and advance it.”
The data his team gathers will go to the ANPC, along with other laboratories across the state, as just one of a number of trials feeding information to a larger network.
“What we’ve achieved in the last four weeks is astounding,” he said.
“The goodwill of everyone — COVID-19 has aligned everyone in one direction.”
Community study to track long-term effects
Cardiovascular epidemiologist Christopher Reid is leading a community research response at Curtin University, looking at the impact on people’s general physical and mental health.
Participants will be able to complete a series of surveys to report on their cardiovascular health, respiratory health and mental health in the wake of COVID-19.
“There may be some really valuable information and opportunities to support people who’ve found themselves in situations really no one could have anticipated,” he said.
“What we’re trying to do is provide a pathway where we’re able to identify people who’ve been in that position, find out how they’re going in the longer term to really shine some light on the impact on long-term health outcomes.”
Universities, private sector working together in common purpose
Western Australia’s COVID-19 research is being coordinated by the WA Health Translation Network (WAHTN), which encompasses the five WA universities, six major research institutes, public and private hospitals and the Health Department.
WAHTN executive director Gary Geelhoed said there had already been remarkable collaboration, with increasing numbers of volunteers, medical students and private companies also trying to offer up help.
“It’s been an absolutely challenging but exciting time. To see everyone start to cut the red tape and come together and cooperate … so many people have volunteered their time,” he said.
“So many other jurisdictions have been caught out by underestimating the effect of COVID-19, so we need to have all this in place.”
The WA Government recently put $3 million on the table to fund local COVID-19 research and the Federal Government is set to provide more than $13 million to researchers nationwide looking to develop antiviral therapies and treat patients in severe respiratory distress.
An urgent piece of legislation has also passed through WA Parliament to make clinical trial participation possible for people who are critically ill or otherwise incapacitated.
While efforts ramp up around the world to learn about coronavirus and potential treatments, a vaccine is still some time away — experts say at least 12 to 18 months.