Sci-Café: COVID-19

Hello and welcome everyone to the very first virtual Sci-Café. My name is Nadia Kareem and this event is brought to you by the Office of the Vice President for Research here at KAUST. As you can see, I'm speaking to you today from my home. I'm exactly where I should be given the current circumstances. Like many of you, we have stayed at home, we have practiced social distancing, and we are trying to flatten the curve. But I think now more than ever, people are very eager to understand COVID-19, as it has affected many of us. This virus has not only shook the world, but it has changed the way that we work. It has changed the way that we communicate and integrate, and now it is changing the way that we do science. And whilst the repercussions of this global pandemic are yet unknown, I think we can focus on what we do know, which is the research. Here at KAUST, we've mobilized a rapid response research team called R3T. I do encourage you to Google that. And with me here today are 3 KAUST faculty who are going to talk to us about their ongoing and their future activities with regards to COVID-19. So without further ado, I will introduce our first speaker, as I'm sure our listeners are very eager to hear from the experts. Please let me introduce Professor Arnab Payne. Arnab, if you could tell us about your current activities with regards to COVID-19, who you're working with, who you're collaborating with, and introduce yourself.

My name is Arnab Pain, and I'm a professor in the Biological and Molecular Science Engineering Division at KAUST. My research in general focuses on applications of genome and transcriptome sequencing technologies and functional genomics and use of bioinformatic protocols to understand biology of pathogenic organisms that cause disease in human and also in animal. So in particular, we employ technologies to understand 3 areas. One is how genetic makeup of pathogen consists of and how it changes over time during infection processes and transmission. And also we study how the pathogen interacts with its host. So in essence, we really work like a detective to identify pathogens and track them and monitor them in their crime scene. and by analyzing their genomes. So in terms of the COVID work, I must say that I usually work on parasites and bacteria, so virus work is something new, but I am really taking this as a challenge, and I'll tell you in a moment what I'm going to do, or our group in collaboration with other partners within KAUST and also in the kingdom and elsewhere are doing. So In fact, I am doing the same work, that is essentially doing some sort of detective work. So in collaboration with the Ministry of Health in Saudi Arabia and hospitals under it and the Saudi CDC, we are leading a major effort, sequencing effort, to look at the genome of this virus and particularly the ones that are circulating in Saudi Arabia. So we plan to compare the genome, also track the mutations that they carry and as they appear during transmission, So we, our group actually has come up with a barcode, genetic barcode that defines these various changes in this genome. And if we can follow this barcode, we can actually eventually link them to how the virus, how their spread is, various control and other social distancing measures impacting the virus populations. And eventually combining the genome data as well as the metadata, that is the clinical datasets that would eventually be shared with us, with our partners in the hospitals, will allow us, potentially allow us to look at particular genetic differences that may be linked to virulence or transmission. And in addition to that, part of our group is also involved in developing some software tools to visualize the genomes in the context of the genetics of the virus. And I'm also trying to help my colleagues in KAUST to looking into optimization of the commercially available kits that are available to detect the virus. And also we are trying to optimize some of the available kits to make— so basically for saving reagents, and that's very important at this hour, and that's a big need for the kingdom.

Thank you.

Thank you, Arnab. That was an excellent explanation of your activities. I'm going to hang on to that word, that the barcode, the genetic barcode of COVID-19. And I think that's really important that we can go back to that as well and really understand how you're tracking these infections. And I will introduce now our next speaker, Professor Takashi Gojoburi. Takashi, I hand it over to you to just give us an indication of your activities with regard to COVID-19. Tell us who you're working with and who you're collaborating with.

Thank you, Nadia. Hello everyone, I'm Takashi Gojibori, distinguished professor of bioscience and acting director of CBRC, Computational Bioscience Research Center. As my research background, I'm developing computational tools constructing biological databases, and conducting genomic analysis of various organisms including human from molecular evolution and population genetics. As for the studies of viruses, I have worked on the molecular evolutionary studies of infectious viruses such as HIV, and hepatitis B and C viruses for a long time. In the COVID-19 pandemic situation, my group at CBRC is working on various agendas in collaboration with Saudi CDC and other clinical institutions, as well as the universities in the kingdom. As for our contribution to fights against the COVID-19 pandemic in Saudi Arabia, we are working on in the following 4 scientific agenda in KAUST COVID-19 R3T, as Nadia mentioned, which was initiated by Prime President Tony Chen and coordinated by BPR Donald Bradbury and Dean PL Majeswari. And number one, Mr. Mohammed Alwari, a research scientist in our group, had already spent 4 weeks in mid-March at Saudi CDC for our collaborative work on viral RNA extraction and genome sequencing of Saudi isolate. Even after he comes back to KAUST, we continue the collaborative works with Saudi CDC. Number 2, with Dr. Intikahar Alam, our staff, as well as Professor Carlos Duarte, Stefan Allard and Anab Pain here. My group is working on prediction of viral effective drugs against coronavirus. Number 3, we are also working on the development of viral mutation monitoring system with Professors Robert Hohendoff and Anand Pain, and with Dr. Aleksandar Radovanovic and the IntegraHub ALARM at our center, CVRC. I think that this is very important to make early detection of a new viral mutant that may have acquired stronger pathogenicity the coming months because the mutation rate of this particular virus seems to be, roughly speaking, million times higher than that of a human. So point 4, I'm supporting Professor Charlotte Hauser, Magdi Mahfouz, and Samir Hamadan's activities of developing a new effective method for detecting coronaviruses in a very short time. And finally, number 5, I'm also supporting Professors Xianglian Zhang and Xin Gao's artificial intelligence project for emotion analysis of Saudi people under quarantine by use of Arabic Twitters. I think this is also important for keeping mental health of Saudi people under quarantine. So this is what I'd like to say now.

Thank you.

Thank you, Takashi. Wow, an awful lot going on there. Fantastic efforts, great collaborations. Really nice to see that you collaborate with Saudi CDC as well. So I think it's fair to say, or maybe summarize, that you're looking at kind of you know, using computational methods to look at the genome sequence of COVID-19 and therefore find preventive measures like a vaccine. But we can touch on that again. So I will hand it over to our next speaker, which is Professor David Ketcheson. David, again, just let us know what you're doing with regards to COVID-19 research and your current activities, any future activities, and please introduce yourself.

Thanks, Nadia. So yes, I'm David Ketcheson. I'm a professor of applied math and computational science, and ordinarily I work with models and computer algorithms for understanding things like motion of a fluid or water waves or the flow of traffic. And in all these models, a fluid, for instance, is made up of so many tiny molecules that we can't possibly predict the motions of all of them, but we can accurately predict the motion of the fluid as a whole. And in the same way, while we can't predict the activities of individual humans, we can predict accurately the spread of a virus like COVID-19 in a large human population using statistical models. And so I'm working with these statistical epidemiological models to understand and predict the spread of the pandemic. And in particular, things like assessing the effectiveness and the eventual results of these huge changes that we're making as a society. So researchers call these changes non-pharmaceutical interventions, right? Things like stay at home, social distancing, and so on. Or just simply interventions, right? And I'm also devising and analyzing long-term strategies for how and when those interventions should be applied and relaxed. And I'm doing a lot of public outreach, writing articles about this, because I think that helping the public to understand these models and what they say about the spread of the virus is one of our key tools in fighting it. And I'm collaborating with several people, including Carlos Duarte, Hernando Mbao and Paulo Moraga on dashboard, an online up-to-date dashboard that is part of the KAUST collaboration that will include a lot of information about the spread of the virus. And I'm talking with some other potential collaborators here at KAUST looking at different aspects of understanding these models.

Thank you, David. So I think when we chatted a couple of days ago, you said something that kind of stuck in my mind with regards to your research. Because it is statistical modeling, so it's not research like what Arnab is doing. But you said, we know who's sick, and we know where they're sick, and therefore we can predict where the sickness is going to be in the future. So you're using your statistical modeling to kind of predict what's going to happen with regards to COVID-19. Is that fair to say?

Yeah, although I would say that one of the main issues is that we don't know who's sick, right? So a big difference between this virus and the SARS and MERS outbreaks, right? So those had much higher fatality rates, but also it was much more obvious when someone was sick. They almost always had severe symptoms very quickly. And so it was easier to use targeted measures where you just quarantine people who have symptoms. With the current virus, it seems that a large fraction of the cases, maybe 50%, are asymptomatic. And it seems that these people are still contagious. So we have a huge group. And without testing everyone, essentially, it's impossible to know exactly who these people are, right, that are spreading this. And that's why it's grown to the level that it has, right? Unlike those previous epidemics that started and were controlled much earlier on. And it's also why we're telling everyone to stay at home rather than just people who are obviously sick to stay at home.

Right. Thank you, David. So I just want to put a disclaimer out there that the questions that I'm going to ask actually have been sent in to us previous to this SciCafe going online. And so I think the biggest question on everybody's mind is vaccine. Is there going to be a vaccine for COVID-19? If so, when? And will it be administered like you would get your annual flu vaccine? Arnab, would you like to start that conversation off?

Sure, Nadia. Vaccine definitely is sort of one of— I know that at the moment there are 5 approved clinical trials, for example, as of a few days ago I saw, were actually happening in various parts of the world. So vaccine, of course, is the answer to kind of have a real protection offered to the population level. But having said that, at the moment what I see that actually to have a vaccine ready at a scale that is required and that is also effective at the same time, it's based on— I'm not by any means an expert on vaccines, but the experts are now predicting that it would take any between 6 to 12 months to have actually on the shelf available for mass applications. So vaccines definitely would come, but the virus is also very clever. It's, as Takashi mentioned, it's mutating very fast. So sometimes a vaccine, you know, there might be some vaccine escape mutants that may also come up. So, that's why it's always like a race between the host and the virus, that who wins. So, vaccine is definitely on the horizon, but the timescale is probably 6 to 12 months. That's what the experts tell us. But we also have to keep track of the virus, even under the vaccinated people, that how is it— is the vaccine, for example, able to restrict all the strains of the virus? Or maybe there are a sub-strain, a subgroup of viruses that has managed to acquire some mutation that allow them to escape and cause future infections. So we have to be, you know, it has to be a marriage of vaccine, vaccinations, and all the associated activities, as well as the tracking of the viruses that are in the population.

Thank you, Arnab. Takashi, do you have anything to add to that? potential vaccine for COVID-19?

Yes, actually I completely agree with what Anab said. Actually, it takes time to develop effective vaccine against particularly this coronavirus, but it takes maybe more than 6 months, could be 1 year. But the point that another made was so important to understand or to remember, which means first initial stage, maybe universal vaccine, a particular one type of vaccine could be effective all over the viruses. Therefore, some people might be saved quite much. But then afterwards, kind of viruses are diverging, differentiating depending on the regions. Therefore, eventually, just like influenza viruses, we have to make kind of a regionally specific vaccine. So therefore, we shouldn't relax ourselves even though we know the vaccine is coming. So I think this will be a very important message.

Thank you, Takashi. And then I guess kind of following on from vaccines, if we could talk about maybe the testing. So David, when I— you just mentioned previously, we don't know how many people are sick. So I mean, how do we test for COVID-19? What are the measures that we're taking at KAUST to contribute to this? I don't know who would like to start that one off.

So I can tell you about the statistics. I can't say a lot about specific kinds of tests. But there are places where they've administered tests to an entire population, right? Like some small towns in Italy, some of these cruise ships. And based on what we know from those, it's likely that the real number of infected people— well, there are hugely varying estimates from different experts, right? But I think a reasonable estimate is that they're on the order of 10 times as many people infected compared to the official confirmed cases. And that sounds really scary from one point of view, but from the other point of view, what does that mean? That means that the fraction of people who catch this virus who are being sent to the hospital or who are dying is actually much smaller than you would think from the numbers, right? Because the vast majority of those unconfirmed cases have very mild symptoms or no symptoms at all. So that same thing that makes this virus so hard to stop also means that it's, statistically speaking, much less of a danger to any given individual. I can say that testing has varied widely from one country to another. And also even from one time to another, testing policies have changed. Right, both to increase testing or to decrease testing in some cases. But it has been demonstrated, for instance, in these small Italian towns where they did this, right, they were able to very effectively contain it by just testing everyone and isolating the asymptomatic carriers as well as the ones who were showing symptoms.

Thank you, David. Yeah, that's a fair point. And I I think I just read this morning as well, I mean, Germany itself, they have a high infection rate but a low death rate, and they've said that that's due to their testing. Arnab, do you have anything to add to the testing?

Well, at the moment, yes, as already has been alluded to by both David and Takashi, testing is so important, particularly when this is a virus where actually people are looking apparently healthy on the streets, yet they're actually shedding the virus or they're effective transmitters to people who might actually develop very severe symptoms in case that's the case, or particularly if they are under the vulnerable category or immunocompromised. So, in terms of testing it, at the moment, most of the world efforts are based on Looking at the nucleic acid of the virus. So basically the RNA material, of course various technologies are being applied including in cows now. As Takashi mentioned, many of our colleagues actually are working as while I speak about developing these new techniques to identify the viral RNA in minute quantities and cheaply. And which could also be scaled up in terms of when there is a product. in the horizon to help the detection. Also, there are other methods being developed which are basically serologically based. So basically you look for the antibody, and that's also very important because these are the people who were exposed to the virus and now say they have the antibody in their body system and they're apparently protective. to the new exposure to the virus. And particularly this is relevant to the people, for example, who are working at the frontline, the nurses, the doctors, other healthcare workers. If they are, of course they are, because they're at the forefront, they are also getting exposed to the virus, even if they take all the personal protective equipment and so on and so forth, measures for safety. So they are some, and many of them, because they are now being quarantined, actually are not able to join the forces, which they are very eager to join, you know, to save lives and help to manage the situation. So we— this is very important that we also have a parallel development of antibody-based tests so that we actually look at people who have been exposed to and they're carrying the antibodies and in theory are protected to the virus, the new virus exposure. So yeah, I mean, these are the main 2 activities that are happening across the globe. And now our colleagues in KAUST are also quite active in this front. And I really hope that we come up with something that would be— that would make a difference.

Thank you, Ayanab. So I guess people then, I mean, we've been talking about the second wave that's happening, that's going to happen in China, and like as the world stood and we watched China, we're waiting once again to see this kind of second wave happen. And how— what can we do to predict or prevent this from, you know, a second wave happening where we are, where we're based now? David, I don't know if you want to kick us off with answering that.

Yeah, I can. So to answer this, I need to explain one of the most fundamental things, and this comes out of any epidemiological model. The details may differ, but there's an underlying number called the basic reproduction number. And this is in a, you know, under ordinary circumstances, if you have one sick person and they're in a population where everyone else is susceptible, right, no one is immune, how many people will they infect? And for COVID-19, that seems to be around 3 or 4. Obviously, it varies depending on the society that you're in and their habits, but it's around 3 or 4. And what we're doing by intervention is reducing that number, right? So if you don't leave your house, right, then you're unlikely to pass the virus, say, to anyone outside of your household, right? So that number is going to go down. But the other way that that number goes down is by People becoming immune right now. We don't have a vaccine yet. So the way you become immune is by catching the virus and recovering to health, as Arnav just explained. Now let's suppose that number is 3, right, that basic reproductive number. Then if we— it's wishful thinking that we could completely eliminate the virus from the earth, right? We're not going to do that at this point, at least not anytime in the foreseeable future. So ordinarily, if you relax the restrictions, that number goes back to 3, and there will be a second wave and a third wave and so on, right? The way that that ends is when you have enough immune people in your population. Now, you don't need 100% of them to be immune. If that number is 3, let's suppose now that 2/3 of your population is immune because they've already caught the virus or they've been vaccinated. then out of those 3 people that the 1 sick person would pass the virus to, 2 of them on average will be immune. And that person will only pass it to 1 other. So you won't have this growth of the epidemic. And if more than 2/3 of the population were already immune, then you would have a decrease over time in the number of sick people. So that's how this ends. And if you lift restrictions before you have that level of immunity, what we call herd immunity, then you have to expect a new wave of sickness. And at the moment, even taking into account what I said before, that the real number of cases is probably on the order of 10 times the number confirmed, no country in the world is close to herd immunity. In Italy and Spain, it's on the order of 10% of the population that has caught the virus.

And those are by far the highest.

So we're certainly not on the other side of this yet, even in those countries where the numbers are going down or have gone down. We don't have that level of immunity in place.

Great. Thank you. Takashi, do you have anything to add to that? A second wave, how can we prepare or predict for that?

Yeah, I think as David mentioned kind of a mathematical model for such infectious patterns, kind of accumulating data analysis would be very helpful. I mean, the first wave, certainly we are suffering much. But for second wave, we have to be careful, but we can fight in a, I would say, a little bit better way because we have experiences. And in particular, I would like to mention about like RNA testing, for example. As Anab mentioned, in KAUST we are now ordering kind of reagent materials for test— of testing, RNA testing, and all laboratories are shut down. But thanks to Vice President Office, Kwalab procurement team, I think like Professor Samia Hamadan, Molly, and Magdi Mahfouz, and Charlotte Hauser, and including my lab, checking those regions, how we can improve the RNA testing, particularly I think we are discussing frequently with the Saudi CDC team and what kind of improvement do they need. So therefore, kind of experiences that we are now accumulating, I think this kind of activities and some successful story must come out. Therefore, I believe that Certainly, we have to be prepared to have a second wave, but maybe we can deal with it in a much better way than the first wave.

Thanks, Takashi. And I guess, yeah, just to reiterate what you've just said, all research has been shut down except for non-essential— except for essential research. which is COVID-19 research. And the efforts involved in this are you 3, but also a lot of other people behind the scenes as well. And I hope that your efforts will help us prepare for this second wave, and thank you for that. So I think, okay, going on from the second wave, let's talk about the virus itself on surfaces. I mean, there's just so many conflicting things out there on the internet. that the average person is looking up, like myself, on a daily basis. And also at the beginning, we were told that if you felt like you had the virus, you were showing symptoms, or you've been tested positive, you were to wear a mask. Now there's conflicting reports saying you should just wear a mask all the time regardless. So maybe Arnab, you can get us kind of started with that. So let's talk about the use of masks and also the virus on surfaces. How do we deal with that? And, you know, if a virus needs to catch on to a host, how can it stay on a surface?

Thanks for asking this very pertinent question, and there's a lot of activity in the research front as well as, you know, in terms of technological innovation front happening as we discussed this. So in terms of the use of masks, actually, yes, you are right that now the recommendation is that we should wear a mask. And some of these recommendations stem from some very recently published studies. One of them, for example, came from the Massachusetts Institute of Technology, where they actually modeled the virus when people sneeze or cough. And it turns out that now the live viral particles have been discovered 6 to 8 feet away in terms of from the person. And that's one of the reasons, of course, if you put a mask on, that not only sort of allows you not to, even in case you have a sneeze and if you're a carrier at that point in time, to kind of release it to the vicinities. Or at the same time, if you happen to be a bystander at that place, you don't catch it because somebody else has just sprayed some virus in as a droplet. So this is definitely a very important recommendation to follow. And then about the surfaces, yes, it seems that the viruses this particular SARS-CoV-2 is quite stable on, seems to be on plastics and also on metals, but in terms of on copper-type metal, it actually hardly survives. That's sort of, again, researcher has actually proven it, not just by one group, but many groups at various places. Also on surfaces like bead sport, you know, like the boards, like paper boards, they also seem to survive for some time. So, and in terms of how do you get rid of it, you know, the advice has been pure and simple. Please use like normal soap for your hands, for example, and it doesn't need to be a disinfectant or the gel that we are always used to, but Actually, a normal soap with proper wash frequently would definitely help to get rid of this from the surfaces. And also make sure that if you feel that you're exposed, you just— or even on the clothes, try to— if you come home from, say, shopping or whatever, maybe it's a good idea to actually get— just put them on washing and then use another set of clothes or something. just, you know, for another level of safety. So yeah, the virus seems to be quite stable in terms of non-surfaces, but in terms of how to treat, usually the recommendations are like normal 70% ethanol would kill the virus immediately and sanitize. Or also, say for example, 10% bleach is also something that would do the same. sodium hypochlorite. So I mean, normal cleaning practices would get rid of the virus and clean it quite fairly well.

Thank you.

Thanks, Arnab. So yes, we should don a face mask now if we have one. And you've just said that 6 to 8 meters is what I heard you say there in terms of the virus No, 6 to 8 meters.

Sorry, 6 to 8 foot, I think. I think I got it wrong.

Yeah, okay.

Yeah, it's basically the idea was like, it was revised to 6 to 8 foot.

Thank you. And just keep washing your hands. So when we do come in with the grocery shopping, Maybe we don't need to sanitize absolutely every product that comes out of the bag, but just if we keep washing our hands and the surfaces that we touch, we're not further spreading the virus. So let's talk about the virus itself. I know, Arjuna, that you recently discovered there's 141 strains from 23 countries, 23 countries of a genome that you could find available. There's 2 ways to test the virus, if I'm right. It's through PCR and through this antibody detection, as Takashi talked about previously. So the PCR seems to be the more accurate way for testing, and it's, it's only if the virus is there within your body at that moment in time, whether it's active. But the antibody testing shows whether you had the virus. So I mean, can we just maybe touch on a little bit about how many different strains there are? How are we supposed to track something like this? And if it's— if there's 2 ways of testing, one when it's active and the second one when it's already been in your body, and the fact that there's so many different strains, let's talk about the actual virus itself now. I don't know, Arnab, if you want to kick us off on that.

Sure. Actually, the number of countries and number of strains that you referred to was the version of genomes that were available around 9th of March, so just over 4 weeks' time. In fact, as of 31st of March, so last week, now there are over 2,000 high-quality genomes that have been sequenced and made available for public scrutiny. In fact, we also aim to do the same. We will sequence as part of our activities in KAUST and then put it up in the global databases so that we all get to analyze them in our own ways in order to understand the virus well and better. So in terms of the mutation, so basically we did find at that point in time 7 clades of the virus were circulating and we could come up with like a 7 best pair barcode. And we now, what we are trying to do is, and in addition to sequencing, we are trying to now also come up with primers that only bind to those specific sequences so that we can actually do a simple PCR test to see what kind of viruses are actually circulating even before sequencing. Of course, the sequencing will give us the address of each and every base in a almost 30,000 base pair genome of the RNA genome of the virus. But, you know, there are, let's put it this way, there are 1.3 million now cases in the whole world. Of course, it is theoretically possible, but it's impossible to sequence each and every strain of a virus in a given country. And we are actually also in a situation now where we are under social distancing measures. We have travel restrictions and curfews in place in many places, including in the kingdom. So these methods are actually working. So how do you know they're working? If there are any symptoms of COVID-positive cases, we could actually look at either the genomic level or at least at the mutation level or the barcode level, that what are the sort of dynamics. So for example, what kind of virus strains were present from 1st of April as opposed to 30th of April while these measures are in place. And similarly, when it would be— when vaccine or other therapeutic measures would be in place, we'd like to know that how the different strains or types of the viruses are circulating in a population level. So in that sense, sequencing of course is the ultimate answer. But in terms of scaling the operation, when you're dealing with not hundreds, but not thousands, but tens of thousands, it is something where you have to have a first step to identify what is actually, what are the key strains that are circulating. And if it turns out that your barcoding at some point only detects, say, 70% of the circulating strains, that would give you enough indication. That means there must be some changes in the virus. which no longer detects some of the barcode that you generate earlier in your study. So that way you can prioritize those also for sequencing. So our idea is actually to keep track of the virus as it moves in the population. And of course, PCR-based techniques is one, but then that would allow— guide you which ones you want to put it through sequencing in case the numbers are very high.

Excellent. So you're using your barcode to basically track the infection rate of COVID-19?

That's the plan. We have tested it just last week on a handful of samples, not from here as yet, but some collaborators' labs in Ireland, and they work quite well. So, but our idea is to now employ, come up with a technique to work here, to optimize it here, and then see how the samples that we will sequence, or we are planning to sequence, how that can be utilized here in the Kingdom.

Thank you, Arnab. David, have you anything to add to that? The various different strains of COVID-19 going around, the tracking of this virus around the world at the moment.

No, but on this topic, I'll just say related to what I commented before, these antibody tests I think will be critical as we move forward to predicting second waves, to knowing when we need to impose new interventions. Because if you can perform those antibody tests, right, which tell you how many people are immune now, right, how many people had it on a significant portion of a population, then you can say, ah, if we have this many cases now in that population, here's how many we'll have in a month if we don't do anything, right? Here's when our hospitals would be overwhelmed, and so here's what we should do about it. If you don't know— right now we know the answer, and it's that almost everybody is still susceptible. But in the future, we'll need estimates of that level of immunity that we can only get from those antibody tests in order to make those assessments and make those decisions.

Thank you, David. Takashi, do you have anything to add to that? I mean, the last time we spoke, we talked about, you know, the fact that this virus at the beginning, we all thought it was hitting this older population, but that's not true, right? I mean, there's been a lot of people that have actually died from this virus that are not just in this older population. And maybe you can talk to us a bit about the strains and the tracking of COVID-19, Takashi.

Yes, I think, Nadia, you made a very good point, very important point. I mean, for viral side, certainly we are working on genomic analysis, as Anab mentioned, and In our laboratory, we are developing a mutation tracker system in which such huge data can be analyzed in a way that we can predict what kind of mutations coming in, how they are differentiated in a semi-real-time fashion. And KAUST has a huge advantage of conducting such big data analysis because we have a supercomputer, Shaheen, and the cluster machines. And also we have talented, you know, faculty members and research staff. So therefore, I think by conducting such a big data analysis of a huge viral genome data, we can have predictive way of identifying new primers for RNA testing and maybe vaccine design and this kind of things. But on the other hand, we don't know yet what the host side, what the human genetic background or environmental factors by which such infectious, you know, patterns or death rate and how those are related or different between generations, individuals. But those analysis can be done in a very similar way, however much, much larger scale. Like a viral genome is only, say, 40,000 nucleotides in in terms of genomic information, very short. Therefore, even 30 minutes, we can sequence it completely. But for human genome or some human data, it's enormous. Therefore, I think the first kind of studies that has been done, David, is very important. We can focus on which aspect we can analyze for human factors. In explaining the difference of generations or ages, if exists, or if it's not statistically, you know, insignificant, we have to focus on the other. So therefore, in addition to viral genome or virus side, also we have to work on human host side, but it would take more time. Therefore, at this moment very difficult moment, we are focusing on the viral side, but in the future we have to work on a human host side too.

Thanks, Takashi. And as discussed earlier, I mean, a lot of people could be carriers of this virus and they are asymptomatic. And I've heard that if you test the wastewater and you will get a bigger or a better idea of how this virus is in a population. Arnab, maybe you can touch on that for me.

Yes, indeed. This very recent study— that's a report actually came up in Nature just last week— that actually talks about that the virus seems to be pretty stable in Suez water, and they have found traces of viral RNA there, viruses. And also in this regard, actually, one of my colleagues, Peiying Hong, she and her colleagues in the WDRC, the Water Desalination Research Center in KAUST, are also looking at this aspect of whether the team could detect the virus in the wastewater systems in this country. So this is very important because of 2 reasons. One, it could be seen that, well, we cannot perhaps test a population, but if it turns out, for example, that the viruses can be detected in wastewater, and of course the wastewater could be collected from across the population, across the households, and if it turns out that there are viruses around, or virus material, you know, that are found, then it could potentially give an early warning system, if you like, a molecular— again, work like a molecular detective system where you can find the virus. It shouldn't be there, but it is there. That means some households, if not all of course, are maybe infected. So that would allow the authorities perhaps to kind of have appropriate measures in place to know that, well, the infection is around. And also related to that, I would like to touch upon another quite recent finding. For example, children seem to be relatively protected. Of course, everything is in relative sense because there have been also a case of some 13-year-old boy losing life to this disease in Belgium, I think a few weeks back. But the thing is, what I heard and seen in terms of scientific literature is that apparently children also carry the virus, so they are also transmitters. They may not be showing any symptoms. Again, come to the same point that David has been making, that, you know, this is so important to test the population or get them immune over time. So they apparently did a study where they found that children have been— no apparent symptoms, but in their stool, so basically in their poo, some virus are being shed. And of course, you can imagine if that is happening and that system is going through the sewage system in our cities, then we would be able to actually have a very sort of an efficient way of detecting such kind of potential transmission events happening. So I think this is another very important part of a bigger puzzle that we need to solve. And I'm very glad that some of our colleagues in KAUST also are looking at it.

Really interesting. Thank you, Arnab. David, you have something to add?

Yeah, exactly. I wanted to add something to what Arnab said on this issue that you brought up about how COVID-19 affects different age groups. And here I'm not talking about models or predictions of the future, but just about the numbers that we have that we've recorded. So just to give you an idea, my sister currently has flu symptoms. She doesn't live here at Caltech. She lives in the United States. And she's very worried that she has COVID-19.

Right.

But she's a healthy woman in her 30s. And for that profile, having COVID-19 is not more dangerous than having the ordinary flu. Okay, it's actually about the same level of risk. So for her, you know, specifically concerned, it doesn't make a big difference in that. Of course, it's important to test people because Everyone is susceptible to this new virus, whereas for the flu, a lot of the population is already immune. If you ask me, you know, would I rather that my children were exposed to the flu or to COVID-19, I would absolutely choose COVID-19 because the risk is much, much, much smaller. There's no comparison. Of course, it's very small for both, right? Not very many people die from the flu, but it's not, you know, it's not zero in either case. And I think it's good to understand these risks by comparing them to other risks that we face. Now, if you ask the same for my parents who are closer to 70, the risk is much higher, significantly higher from COVID-19 than from the ordinary flu. So there is a very different profile here in terms of age and also very different from what other flu viruses Thanks, David.

And we wish your sister well. And you've touched on a really good topic there. I mean, because, well, why are we all doing these interventions? Why are we all social distancing? And how then does COVID-19 differ from MERS or SARS that we've already seen? And, and Like, it just must be so infectious. Is this the reason that we have all these interventions in place?

Yeah, that's exactly right. As I mentioned earlier, it's more highly infectious. And especially, it's less obvious when someone is infected and contagious. That's why we can't just try to quarantine people who are obviously ill. but we've had to take these broad society-wide measures.

Thank you for clarifying that. So I don't know if anyone else has anything to add to that, Takashi or Arnab, with regards to just how infectious COVID-19 is and what we already knew before with MERS or SARS. Takashi?

Yes, just before finishing this Science Café, I really personally thank, like, KAUST community team and KAUST health team, and really appreciate, you know, we, we have to work at home. But we have only 7 patients, and most of them now cured, and no further infection is not taking place here. I think that this is really, you know, what we have to thank them. Also, because of that, we have time or efforts in which we can contribute to this country, to join the fight. So this is really marvelous. And that would like— that would like to say from myself. Thank you.

Thanks, Dakashi. And it's true, yeah, there's parts of the country now in Saudi Arabia that are under 24-hour lockdown. And for our listeners out there, the population of KAUST at the moment is 7,000 people. And because we have put those interventions in place, we have stopped the spread of COVID-19 within such a small population. So one— and this is the last question I'm going to ask— but One of the biggest questions that came in time after time before we did this was, how long are we here for? How long do we need to continue these interventions and social distancing? When can I get back into work instead of working remotely? I know probably you won't have a definitive date on that or an answer, but maybe you could speak to that, Arnab, if I could get you to But I'll make my best guess at it.

First and foremost, this is a virus the world has never seen before. It's transmitting like crazy, which also has not been— I mean, we have seen MERS, we have seen SARS, but this one has really taken over the whole world and making our life really, really tough in many ways. And so in terms of what When I think it's probably if all these measures are in place, and yet now there is of course a global sort of ramification of this. So if a country, for example, restricts all their movements and takes the right measure at the right time, but all the neighboring countries don't, it's not going to work because we are now living in a very interconnected world. So I could be speaking here now, and by 8 o'clock this evening, I might be in London. Just by catching a flight from Jeddah. So it's very, very important that we follow all the restrictive guidelines that all our respective governments are putting in place. And if all the world are following this, and also as responsible citizens, we need to kind of follow the guidelines that have been given to us. If that happens, I would suggest probably anywhere between 4 to 6 months, but depends on how the second or any other waves come and how well we treat it. But as Takashi mentioned, that we already know what is needed in order to fight those kind of waves. So hopefully we would reduce that duration. But it's really, I think, it is a question I really don't have an answer to. But all I really hope that it's not going to be long and things will be brought under control, whether by restriction of movements, therapeutic intervention or other, like vaccination, but vaccination, as we discussed, that probably not immediately on the horizon.

Thanks, Arnab. David, do you have anything to add to that with regards to your statistical modeling? When do we see an end in sight?

Yeah, so obviously this will depend on the decisions that we as a society society make in part. So we can just talk about different scenarios that depend on those decisions. So if we had done nothing, right, and just allowed the virus to spread freely, it would have taken about 3 to 4 months for this epidemic— I think everyone's seen these curves now, right, that are generated by these mathematical models that I'm talking about, right, where the number of infected goes up and then it reaches a peak and it comes down. Right. That peak occurs when you, when you hit that level of herd immunity that I talked about before, right? That for this virus is probably 60 to 80% of the population having caught it already, right? And in that case, most of the rest of the population would still catch the virus after that peak, right? But in about 3 to 4 months, we would have most of the world now immune, and this would behave more like other flu viruses. Right, where you just get smaller localized outbreaks. Now what we're doing is flattening the curve, right? So we've artificially reduced that reproduction number, right, to something much smaller than 3 or 4. I think in many countries, and in KAUST for instance, it's less than 1 now, right? Meaning if you introduced 1 infected person, they will infect on average less than 1 other person. So you won't have a new outbreak. outbreak. But that lasts only as long as we keep these interventions in place, right? And it's only as effective as those interventions. And we're— I think it looks like in all of the countries that are being hard hit, like those epidemics are going to come back down, this first wave, long before we reach the number of cases to have herd immunity, right? Which is good. That was the whole point of it. But it means that we can't go back then to life as normal, or we'll just have the same scenario that we have just tried to prevent. It also— but the other thing that happens is when you flatten that curve, you broaden it also, right? So that peak comes down, but it's shifted further into the future. So it's going to take— months, right, even for this first wave to come down. And so there's no easy solution. There are a lot of potential options, like having stronger restrictions for people who are at high risk and less restriction for people who are at much lower risk. This is a way to build up that immunity in a society in the absence of a vaccine for now, while still keeping as small as possible the number of severe cases and deaths. And I think that's one of the most promising strategies, given that we can't just keep everyone in their home for a year until we have a vaccine. That doesn't seem like a— Yeah.

Thanks, David, for shedding some light on that. Takashi, do you have any finishing comments to make?

Yeah, just brief comment. I think things would be very gradual, not on the particular day everything is solved. It's not possible. So gradually things will be improved improved. And second, there will be 2 epoch-making times. One, I think effective drug or new effective drug is found and started to be distributed. This is very important timing. Second, vaccine. I think effective vaccine will be available. Therefore, I think we have to be keen to those 2 timings. that would give us kind of bright light in the future. This is what I like to say.

Thanks, Takashi, and I think we'll leave it at that. And I just want to thank all 3 of you, and of course, for your tireless efforts out there working hard. And of course, this conversation, this discussion has just touched on what's happening at KAUST. I mean, there's a lot of people behind the scenes working very hard behind the scenes. And tomorrow, just a reminder, I am with another 3 other KAIST faculty for the Asper World Forum that's going live in Saudi Arabia at 7 PM. And we're going to discuss the world after the coronavirus, which will be an interesting one. And I just want to say again, a special thanks to you and all the researchers and healthcare workers around the globe. And to our listeners, thank you for listening. Stay safe and stay at home. Thank you very much.

Thank you.