Q&A | WITH SHARON LEWIN, DIRECTOR OF THE DOHERTY INSTITUTE

The Doherty Institute opened in 2014 and it's a joint venture of the University of Melbourne and The Royal Melbourne Hospital.

The idea for the Institute started about 10 years earlier when it became clear that infectious diseases are a really important issue for Australia and for the world, they're not going away and that there was all this expertise in different parts of the University and the Hospital. For example, diagnostic labs, research labs and clinical services, and if we brought all of those pieces together we could build something really fantastic and that it would be really well placed to respond to any infectious disease outbreak. 

In many ways, the Doherty Institute was created for an event like COVID 19. It was actually a really good lesson in strategy. They had a strategy around setting up an Institute that brought expertise in infection and immunity together and named it after Peter Doherty who won the 1996 Nobel Prize in Physiology or Medicine with his Swiss colleague, Rolf Zinkernagel, for discovering how the immune system recognises virus-infected cells.  Then during the global financial crisis in 2009, Kevin Rudd was looking for shovel-ready projects, and this was a shovel-ready project, which already had a lot of thinking behind it and was of national significance. The Federal government provided $90 million towards building it, and then the state government $55 million and the rest came from the University of Melbourne. In total, the building cost around $210 million to build. Another interesting point to note is that it came out of a crisis being the consequence of the global financial crisis.

The physical building has been really important for the identity and the activities of the Institute.

Sharon and David, we can’t have visitors at the moment, but once we’re allowed to we will definitely have you in!

We have high security labs for dealing with organisms like COVID 19 and Ebola.  So that’s really how it began, the money came quite quickly in 2009 and then by 2014 it was built. I was recruited and started here in September 2014 and that's the story of how it all began.

We have done a bit of work on coronaviruses including Severe Acute Respiratory Syndrome (SARS), which caused an outbreak in 2003. We’ve also done a bit of work on Middle Eastern Respiratory Syndrome (MERS) which first appeared in 2012. We haven’t had a MERS diagnoses in Australia but we've got the capability to test for it.

SARS-COV-2 is the virus that causes COVID-19 and it is what we call a novel or new virus, meaning we haven’t seen it before. 

The group that actually isolated the virus and grew it in the lab, the first to do so outside of China at the end of January was VIDRL (Victorian Infectious Diseases Reference Laboratory) here at the Doherty Institute. They’re experts in virus isolation and developing new tests and have existing capability with other viruses such as MERS, SARS, flu, HIV – everything! The first external reports of this new virus came out on 6 January, and by 8 January the genetic code of the virus was released from China. By 9 January, VIDRL were already developing a test. They're constantly aware of any new viruses. When MERS started in Saudi Arabia in 2012, VIDRL was the first lab to develop a test for it here in Australia. So they had a level of preparedness, but of course this is a new virus so no one had worked on it before. 

You may have heard of the mathematical modellers, the people that are creating these curves that need to be flattened. All of that comes from the Doherty Institute. In particular, Jodie McVernon, she's an expert in flu modelling, but mainly for different strains of influenza. The minute COVID-19 came along she could apply all of those models to it. 

I’ve also been leading a national network on preparedness research called APPRISE (Australian Partnership for Preparedness Research on Infectious Diseases Emergencies). There's a range of things that you can do to be prepared, such as having the capacity for testing. Jodie’s been part of the modelling work and we also established what's called a ‘preapproved protocol’ to enrol patients in studies should something new happen.  All of this work allowed the Institute to respond very quickly.

There’s so much happening. Work usually follows the from funding we receive; we don't have an enormous discretionary budget that we can just say right, we're going to move all of our funding towards COVID-19, that’s not how we're set up. Most of our funding comes from existing grants.  Because we specialise in infection and immunity and having existing expertise there’s a lot happening, particularly in diagnostic testing. We also have projects on ways to test and do it faster and more accurately. In addition, there’s a lot of work on treatment, developing new drugs and also testing existing drugs in clinical trials. 

But we are not starting from scratch because people were doing this sort of work and developing drugs for influenza, HIV or Hepatitis C. We also have a lot of people who’ve been working on vaccines and immunology and now they are redirecting what they’re doing to COVID-19. Lockdown has meant closing down all other research areas. For example, I work mainly on HIV and all my HIV research has stopped because there are no clinical trials because no one is going to hospital unless it is urgent, and the University requires everyone to work from home, so the only work that is continuing is COVID-19 research. This has meant that people with regular work have stopped.  I’ve got a big clinical trial lab that supports 20 or so clinical trials, in HIV, they’re all now supporting COVID-19 clinical trials.  

Yes, there's lots of collaborations with different people. Probably the biggest collaborative effort is with the University of Queensland. You may have read that they've had a pretty advanced vaccine candidate they had existing funding for to develop a vaccine for MERS and they've shifted all of that to focus on COVID-19 and some of our staff were involved in that big grant. Our role is on testing whether the vaccine is inducing an immune response or not. There are a few groups who have developed tests that can let you work out what the immune responses are like. 

So your group is testing how their vaccine is going? 

Exactly. Yes, not my work specifically, but two of our staff are.

When you give a vaccine to a mouse and you want to know whether the vaccine can induce an immune response there is a way of testing for those antibodies and they have those tests. They've been testing the immunised mice.

Then we’re doing a lot of work with a group down in Geelong, the Australian Centre for Disease Preparedness (CSIRO) who run a high containment facility for animal infectious diseases – you would have read about them. We are developing new drugs with them.  

We're running a clinical trial across Victoria. The four main hospitals – The Royal Melbourne, Alfred, Monash and Austin – are a part of an observational study. Any frontline staff who get COVID-19 will have blood samples collected.  

We are also leading a national trial looking at new treatments. A lot of the work is collaborative.

We also have links internationally with China and the US and quite a lot of work happening internationally as well.

Well my role has changed dramatically because I've been the Director of the Institute for five years.

I had a very busy role with my HIV work and I haven’t been able to travel, so I have been here since February and normally I am travelling twice a month, so I have been here the whole time which is quite nice actually. Our work on COVID-19 has received huge interest from the media and philanthropists. That’s how my days are filled and have changed dramatically. I usually see patients once a week, but I’ve actually put that on hold.

Hugely influential, yes largely through Jodie and her team - she's been doing the modelling.

The government make decisions on advice of a national committee called AHPPC (The Australian Health Policy Protection Committee) and that committee meets every day and includes the chief medical officers from each state, the chief medical officer of the country, Brendan Murphy, and a few experts, just a handful of experts. Jodie has been on that committee from the beginning and she and her team have been developing these models, which is heavily influencing the government policies.

On a state level, several of our staff are on are on the state committees. Our staff have been doing most of the testing for Victoria so that's been really important and impactful on guidelines.

Yes, to be honest, the Australian government's pretty good with that.

A great example, HIV – the HIV response in Australia was heavily influenced by scientific expert opinion, and HIV is still around of course, but for years, up until last year, there’s been a ministerial advisory committee on blood borne viruses and sexually transmitted infections.  I chaired that committee for about eight years, so I think that traditionally in regards to the health of Australians and work that they do, they do listen to scientific advice.

Yes, unbelievably well. One of the best in the world. 

And it's done well because government are making policies based on the best advice – they're making policy that's not political. There is support from both sides of the government. Australian takes what's going on in China quite seriously. In early January when all of this was happening in China, most of my colleagues here at the Doherty Institute were all talking about this new virus and none of my colleagues in the US were talking about it until about early March.

We really thought this was so important with all the traffic to and from China, student tourism, and business. It was a very important issue for us here, whereas I don't think even in Europe, they didn’t take it that seriously and then I think the US and the UK were really slow on the testing.

That was probably their biggest problem.

Best advice is physical distancing.  So staying 1.5 metres away from other people, staying home if you’re sick, getting tested, wash your hands often and get a flu vaccine.

Your generosity will drive our research forward. All of our research is funded through grants, so when you have donations from philanthropic support it gives you more flexibility in your research to tackle new problems. What we spend the most money on depends a little bit on the amount, but it might go to a piece of equipment that people need, it might go to support a specific study. We have a whole kind of mix of studies that we would like to support.

Through our website – Doherty.edu.au. There's a ‘Support COVID-19 research’ button at the top of the site. We can’t thank Fella Hamilton and your customers enough for supporting us!