How a “Nerd Club on Twitter” Developed a Saliva-Based Test for COVID-19

Two Sullivan Foundation partner schools—the University of South Carolina (UofSC) and Clemson University—played key roles in the development of a new saliva-based test for COVID-19.

The new saliva-based COVID-19 surveillance test, introduced last week at UofSC, provides rapid results within 24 hours. It is a key tool in the university’s efforts to monitor and contain the spread of the virus within the campus community. The test—which is recommended specifically for asymptomatic cases and offered for free to UofSC students, faculty and staff—bypasses the discomfort of nasal swabbing and is much less expensive to process, allowing retesting multiple times throughout the semester.

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Development of the test might never have happened if not for the efforts of a spontaneously formed coalition of scientists in South Carolina and across the country who worked nearly nonstop and shared results and materials with one another in the weeks before and after the initial lockdown in March. Phil Buckhaults, an associate professor in UofSC’s College of Pharmacy, likened the collective effort to “a nerd club on Twitter.”

“Most of us weren’t even COVID researchers, but we were scientists whose labs were shut down, and we started keeping track of the COVID literature and discussing with each other what needed to be done,” said Buckhaults, a molecular biologist and cancer geneticist in the pharmacy college’s Department of Drug Discovery and Biomedical Sciences. Buckhaults developed high-throughput genomic techniques to more quickly characterize cancer genomes.

Buckhaults, Michael Wyatt, Carolyn Banister and Michael Shtutman in UofSC’s College of Pharmacy kept their labs running during the lockdown and soon joined forces with Helmut Albrecht, an infectious disease M.D. and clinical professor at the School of Medicine Columbia, to focus their efforts on developing novel testing capabilities. They also collaborated with two scientists at Sullivan Foundation partner school Clemson University, Mark Blenner and Delphine Dean.

Buckhaults pointed to other scientists across the country, including Feng Zhang at MIT and virologist Nathan Grubaugh at Yale, who adopted open-door approaches to sharing with researchers at other institutions.

“There was like three months of time where everybody stopped behaving like competitive academicians who were always trying to get to the punch line first, and everyone was very open-handed because there was this feeling that this might be the end of the world,” Buckhaults said.

One day, Buckhaults recalled, “Nathan blasted out on Twitter and said, ‘We all are going to need RNA standards to get this PCR test going. My post-docs just made a bunch. Anybody who wants [COVID] standard RNA, let me know.’ And I thought he was just talking to his virology buddies, you know, and I just kind of raised my hand and said, ‘Hey, can I have some, too?’ And he says, ‘Absolutely, give me your address and I’ll ship it to your house tomorrow morning.’ And it continued like that, where we were all sharing protocols and results, things that didn’t work and things that did work.”

In the early days of the pandemic, wide-scale testing was needed, but nasal swab tests proved uncomfortable, the results took days to come back (and often still do) and the necessary supplies and chemical reagents were in short supply because every testing site was competing for them.

“Twitter is a place where people just give their opinions all the time, and scientists were like, ‘Why the heck are we doing [the testing] this way? We do this all the time this other way.’ And I’m not even sure who suggested it first, but several of us started looking at saliva,” Buckhaults said.

Albrecht said that saliva testing made perfect sense from a biological point of view, but the sophisticated instruments used to analyze nasal swab samples don’t handle saliva samples well.

“And there are standard operating procedures for these swabs and PCR machines, but that doesn’t help anybody in developing countries where they don’t have the swabs,” Albrecht said. “So we tried Q-tips—everybody can get Q-tips—and they aren’t as good as swabs, but they work. And the scientists have solved some of these other challenges through technical expertise.”

“That’s how saliva testing and scaling saliva testing came about,” he added. “If there hadn’t been enthusiastic researchers who listened to people about what we really need, this wouldn’t have happened.”

This story has been edited from the original version appearing on the University of South Carolina website.

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