At least for Australia, our Institute is structured in a way that has proven to be uniquely ‘fit for purpose’ during the COVID-19 pandemic. On the one hand, we house the ‘immediate response’ teams of infectious disease physicians Victorian Infectious Disease Service (VIDS), and the sophisticated, laboratory-based diagnosticians of the Victorian Infectious Disease Reference Laboratory (VIDRL) and the Microbiological Diagnostic Unit (MDU). In the same building are the established academic researchers, emerging investigators and graduate and undergraduate students of two leading university departments – the Department of Microbiology and Immunology and the Department of Infectious Diseases. One result has been, particularly in the human immunology area, outstanding research publications that benefit from synergies between these different areas of expertise.
Though primarily tasked with diagnostic and investigative functions related to bacterial diseases, the MDU switched some of its capacity for rapid nucleic acid sequencing to define the genetic signatures of SARS-CoV-2 variants and apply the new field of public health genomics that enables the rapid identification and tracking of SARS-CoV-2 variants as they spread through the community. The leadership of VIDRL, the virus diagnostic service, changed when Mike Catton (a ‘founder’ of the Doherty Institute concept) stepped down to take on the task of being our institutional representative in the design and construction phases of the new building that will effectively double the size of the current Institute to form the Australian Institute of Infectious Disease (AIID). Mike was succeeded by Deborah Williamson, a clinical microbiologist with an outstanding track record in research using genomics to understand sexually transmitted and other infections. Deb is now embedding genomics across the many virology laboratories in VIDRL, while expanding efforts focused on evaluating new diagnostics, such as rapid diagnostic tests for community use.
The AIID is funded by the Victorian government and will see the Burnet Institute move from its current site at the Alfred Hospital to be housed alongside us in the new building. Though the Doherty Institute and the Burnet Institute share a number of research interests and will remain independent entities, the Burnet Institute brings unique skills in community-based social research as well as expertise in global health. They have a stellar track record as consultants to National Governments, particularly in countries of our region. Also housed in the new building will be a new Human Clinical Trials Unit that will specialise in infection challenge models. The AIID will be complete by 2027 and has the potential to substantially enhance infectious disease research and prevention across the nation.
Some of our basic researchers – particularly Tim Stinear who normally works on mycobacterial diseases like Bairnsdale/Buruli ulcer – and diagnosticians allocated part of their effort to new initiatives, like the ‘lab in a van’ and ‘lab in a container’ that have been deployed at regional sites of high COVID-19 incidence to provide rapid results that inform local public health responses. Once we have COVID-19 behind us, these mobile facilities have obvious potential for both screening programs and for containing future infectious disease outbreaks.
On the immunology side, Dale Godfrey – who normally works on non-conventional immune mechanisms – developed a novel SARS-CoV-2 vaccine, in partnership with a large team across the Institute. This spike protein receptor binding domain (RBD) vaccine is currently in a Phase 1 human trial locally, with that effort being led by Terry Nolan who has enormous experience in the highly specialised clinical trials area. The Doherty Institute continues to build for the future, in the laboratory science, preventive medicine and economic senses!
Perhaps the most publicised Institute input during COVID-19 has been the contribution of our modelling team – led by public health specialist Jodie McVernon – that was contracted by the Australian Government to help advise the ongoing pandemic response. Apart from that activity, our modellers have also been contracted by the Australian Department of Foreign Affairs (DFAT) and the World Health Organisation (WHO) to inform response in other countries, like Papua New Guinea and some Pacific Island States.
The COVID-19 containment/exclusion policy practised in 2020 throughout Australia, and at different levels by State Governments, progressively fell apart (at least for Victoria and NSW) after the highly infectious, and generally severe, Delta variant was first diagnosed in Sydney (June 2021). Aided by community fatigue, the Delta variant ‘blew through’ the established ‘containment’ defences. The vaccines made against the original Wuhan variant were still reasonably effective against Delta and it was very clear that those who had not been vaccinated were much more likely to be hospitalised and potentially suffer severe consequences.
The extent of vaccine coverage became progressively greater through 2021, with most people receiving the standard two doses and, from July, a third booster ‘shot’ being made available for everyone aged 18 or older. As the Delta outbreak waned, governments, with some pressure from Canberra and increasing public fatigue, began to open-up. By the time we had our first Omicron case in December, the situation was set for a great public health ‘experiment’ that would tell us how well a population that was heavily vaccinated against an increasingly distant SARS-CoV-2 variant would fare in an increasingly open society. But that’s a story for 2022 .