In the SARS-CoV-2 pandemic’s city of origin, a Duke-NUS scientist experiences first-hand an unprecedented level of medical security.
Something awful is coming, Professor Wang Linfa realised that cold mid-January night after he was dropped off at Wuhan’s Tianhe International Airport and
had checked in for his flight to Singapore.
Even before he reached passport control, he saw a long line of people building up at a fortified temperature monitoring station manned by airport medical and security staff kitted out in full personal protective equipment.
“Usually you’d just walk through,” says Wang, who leads a lab at Duke-NUS that investigates emerging infectious diseases and bat biology. “But this time, they controlled the flow of people so that only four in a group walked slowly
past the three cameras.”
“Most people had to do that twice,” adds Wang, who himself was asked to repeat the process. “That immediately gave you that fearful feeling that something serious is going on.”
It was, quite evidently, important to be sure. Wang had never, in all his 30-plus years as a researcher, experienced anything of this level, not even during the 2003 SARS outbreak, revising his initial perception of the likely scale of the outbreak: How do I protect myself? I’m not wearing a mask.
Once onboard the Singapore-bound plane, he cleaned his seat handrail with the little wet towel provided. Wuhan is five hours from Singapore, and Wang spent his flight time staying put and interacting as little as possible with the other passengers and
cabin crew. He gained a newfound appreciation for his business-class seat — there wasn’t anyone next to him, so he could reassure himself that he was at least within his own airflow space.
Less than a week later, on 23 January 2020, Wang would address his peers in the Duke-NUS boardroom. By then, the confirmed number of novel coronavirus infections would have risen to 581 cases, with all but 10 from China. But those ten would include
infections reported from as far afield as the United States and South Korea, hinting at the global spread to come. Even Singapore would be on the verge of reporting its first case.
Wang’s medical research expertise, as well as his inadvertently first-hand ethnographic experience, would become sought after by the School, the Ministries and international health bodies.
Honing expertise one virus at a time
Wang’s long career in research has taken him on several unexpected journeys — being in a city while it began spreading a global pandemic was but the latest. He is a biochemist by training, working in labs around the world from the University
of California, Davis, in the United States to Monash University in Victoria, Australia.
While at Monash, a job advertisement caught his eye. The Australian Animal Health Laboratory (now the Australian Centre for Disease Preparedness) under the state-run Commonwealth Scientific and Industrial Research Organisation (CSIRO) was calling
for a PhD scholar with a molecular biology background to study infectious diseases. Another Master's researcher, skilled in either biochemistry or protein chemistry, was required there, too. The listing gave him, and his wife, pause.
“It’s almost like insider trading. The advertisement was like it was written for the two of us,” Wang recalls saying to his wife. “And it was a permanent job.”
Wang’s career blossomed. He traced the origins of the Hendra virus in Australia. Helped curb a Nipah virus outbreak in Malaysia. And in 2005, reported that horseshoe bats are major reservoirs of SARS-like coronaviruses. He rose through the ranks
from research scientist to CSIRO Office of the Chief Executive Science Leader before joining Duke-NUS in 2012 as Director of and Professor with the Emerging Infectious Diseases Programme.
Here, he leads research teams examining how animals — particularly bats — transmit diseases
between each other and humans, studying why these otherwise innocuous flying mammals harbour a
kaleidoscope of viruses. He also teaches undergraduates, supervises PhD students and communicates
science to the public through media appearances.
WHEN WANG MOVED TO SINGAPORE, HE SET UP A BAT COLONY TO STUDY THESE FLYING MAMMALS THAT HARBOUR A KALEIDOSCOPE OF VIRUSES
Responding to a national call
With decades of experience and his first-hand knowledge of events at the epicentre of this new outbreak, the School and the research community turned to Wang.
The day before that initial meeting in the Duke-NUS Boardroom, Wang would respond to another call — a national call for experts.
The government was forming a national research working group that would inform policy decisions and guide the nation through the pandemic. At the first meeting of the research work group on 22 January 2020, Wang would be asked to spearhead
the virology research.
Recalling that meeting, Wang says, “Then I said, ‘Personally, I think serology’s important and I don’t mind leading that, too.’
“And people said, ‘Oh. That’s good. Yeah. Just add that in.’”
With these two duties settled, Wang would do what he had always done — make sense of the unexpected.
Racing to track the new virus and planning for the future
Serology is the study of blood and other bodily fluids. It lets researchers investigate problems with a patient’s immune system, determine if organs and fluid transplants are possible, and identify antibodies produced in response to
a foreign substance in the body.
In the context of SARS-CoV-2, patients produce these antibodies even after the virus has left their body. Just under half of the people carrying SARS-CoV-2 do not, and may never, show outward symptoms of illness. Here then, serological tests
would let experts like Wang understand just how many people were really infected, how fast the virus was spreading, how fatal it is, and the population segments especially resistant or susceptible to it.
Wang had, while still in Wuhan, alerted his team, including then research fellows Drs Chia Wan Ni and Tan Chee Wah, that they would be looking for neutralising antibodies produced by this novel virus. With the genome published seven days ago,
on 11 January, the reagents needed for such serological investigations were en route and the team was ready.
In the weeks after his return, Wang would direct Chia and Tan remotely — through emails, phone calls, and videoconferencing — until mid-February; he would be in voluntary home quarantine for three weeks from 23 January. Never mind
that the Government would only declare enhanced quarantine measures for travellers arriving from Wuhan and its province, Hubei, on 28 January; why risk public health needlessly?
There should also be, Wang thought with foresight, a serological kit that can rapidly detect a person’s SARS-CoV-2 virus infection, and to trace the virus’ path.
“In any major disease outbreak, you’ll have different phases. In the initial phases, molecular testing is important,” explains Wang. “But later, serology is much more powerful. Because the virus is gone, but we can
still trace [its spread].”
Such a kit, then, would be at least a national-level intervention against the virus’ progress. Meanwhile, though, even as Wang accepted the World Health Organisation’s invitation to sit on its COVID-19 International Health Regulations
Emergency Committee, he knew that a new phase of the outbreak was imminent.
“All this was happening before the Chinese New Year. So, every other day, there were a few hundred people directly travelling from Wuhan to Singapore,” Wang notes.
His tone is firm. It is that of a man who already knew that he and his colleagues would, in the months and years to come, face one of the toughest challenges of their careers.